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Investigations over the past twenty to thirty years have demonstrated that folic acid, a B vitamin, is critical for the normal development of a human fetus. The primary benefit of adequate intake of folic acid is a reduction of a category of birth defects known as neural tube defects. These defects represent a failure of normal closure of the spinal canal (spina bifida) or failure of the top portion of the skull and brain to develop (anencephaly). Folic acid is essential for rapid cell division essential to make tissues and organs in the fetus. More research is needed to understand specifically how folic acid works.
If a woman has delivered a child with a neural tube defect, the risk this will happen in a subsequent pregnancy is about 3%. In this circumstance, a prescription for folic acid will be given to the mother. She will be instructed to take of folic acid daily from 1 to 2 months prior to any subsequent attempt to conceive another child and through the months of the pregnancy.
A major public health effort is underway to educate the population about the benefits of adequate consumption of folic acid. The U.S. Public Health Service has recommended that all women of reproductive age consume 0.4 milligrams of folic acid daily. To help insure that more women are adequately supplemented, the Food and Drug Administration has fortified grain products with increased folic acid. A healthy diet which emphasizes fresh fruits, green leafy vegetables (e.g.,spinach, broccoli, asparagus), orange juice, enriched whole grain foods and fortified cereals will allow some women to achieve the recommended daily intake of folic acid.
Many women, however, will remain undersupplemented. While fortification offers some protection, this strategy is not optimal unless used in combination with a vitamin supplement. The current recommendation therefore, is to consume a healthy diet rich in folic acid, but to also take a multivitamin daily which contains 0.4 milligrams of folic acid. If every female of childbearing age in the United States followed this recommendation, it is estimated that the incidence of neural tube defects would be decreased by at least 50%.
Other health benefits may also be associated with the daily consumption of adequate folic acid. Abnormalities in the development of the heart, limbs, urinary tract, lips and palate may be decreased. However, more studies need to be done to know definitively whether folic acid will decrease these defects, as has been the case for neural tube defects.
There are also studies which show that some of the more serious health problems which affect adults, such as heart attacks and strokes, may occur less frequently in individuals who consume the recommended daily dose, 0.4 milligrams of folic acid. More research is needed to clarify the effects of folic acid in the prevention of these types of diseases, but the message is clear regarding the potential benefits related to consuming folic acid starting in the teen years and continuing throughout life.
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