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By Jill Ross, HealthAtoZ contributing writer
Many women may know that folic acid can prevent birth defects, yet a March of Dimes survey reports that few women seem to realize they should be taking folic acid even if they're not pregnant or even contemplating pregnancy.
While awareness of folic acid and its benefits have continued to increase since 1995, less than a third of American women of childbearing age who aren't pregnant take a daily multivitamin containing folic acid, according to the survey.
Women who are least likely to consume a vitamin containing folic acid daily are between the ages of 18 and 24. The survey, conducted by the Gallup Organization, was based on telephone interviews with a national sample of 2,000 women ages 18 to 45.
Doctors drop the ball
The survey also found that more than half of women who do not take folic acid daily said they would be very likely to do so if their physician or other health care provider recommended it.
"Women look to their doctors for advice on how to do everything possible to have a healthy baby," says Jennifer L. Howse, M.D., president of the March of Dimes. "And it takes very little time for a doctor to say, 'You need to take a multivitamin containing folic acid every day before you get pregnant.'"
Folic acid plays an essential role in preventing possible serious birth defects of the brain and spine. Each year, an estimated 2,500 babies are born with these abnormalities called neural tube defects (NTD), and many additional affected pregnancies result in miscarriage or stillbirth. The most common NTD is spina bifida, a leading cause of childhood paralysis. Another NTD is anencephaly, a fatal condition in which a baby is born with a severely underdeveloped brain and skull.
The reason for taking folic acid as a matter of course is that if you should become pregnant - planned or unplanned - your baby's brain and spine will have started to form by the time you discover you're pregnant.
"It's true that most people aren't thinking about folic acid until they have to (when they become pregnant)," says Janis Biermann, director of the March of Dimes National Folic Acid Campaign. "Part of the message here is, take folic acid every day. You have to establish a behavior."
Biermann also points out that nearly half of all pregnancies in the United States are unplanned. So if you take folic acid and you get pregnant, you're already covered.
Folic acid recommendations
To help prevent NTDs, all women in their reproductive years should take a multivitamin containing 400 micrograms of the B vitamin folic acid every day. In addition, they should eat a healthy diet that is rich in folate, which is another form of folic acid that occurs naturally in foods such as orange and other citrus juices, broccoli and beans. Women who have already had a pregnancy affected by a NTD and are planning to become pregnant should talk to their doctor about how much folic acid they should take.
Recent studies have also shown that many people beside women of childbearing age may benefit from folic acid. Investigations are ongoing to find out if it may reduce the risk of cancer.
The best way to get the required 400 micrograms of folic acid daily is to take a multivitamin. The body more easily absorbs multivitamins, breakfast cereals and grain products fortified with folic acid than the natural form of the vitamin.
Waking up to folic acid
But can you get enough folic acid through your breakfast cereal? The answer is "yes," although there is a caveat. Some cereals are sprayed with folic acid, as opposed to having it mixed in. Then it would dissolve, and you would have to make sure you drink all the milk that's in the bowl to get the full benefit.
Also, not all cereals are 100 percent fortified with folic acid, so you have to make sure you read the label carefully, Biermann advises. She says up to 28 cereals, including Total®, Product 19®, and Smart Start®, are fortified with the full daily recommended amount of folic acid.
"It's a lot easier to take a multivitamin," Biermann adds. "That way you know you're getting your 400 micrograms of folic acid."
You should also know that some common prescription drugs could interfere with your body's ability to use folic acid. Oral contraceptives, the antibiotic tetracycline and some drugs used to treat urinary tract infections, heartburn, reflux and high blood pressure can all interfere with folic acid. If you are on certain medications, you may need higher doses of folate.
This article was reviewed and updated June 2007.
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