Folate, which is one of the B vitamins, is essential for the formation of red and white blood cells in bone marrow. Medical research has shown that folate has a protective effect against conditions such as spina bifida which causes severe disability in babies. It is estimated that taking folic acid (a synthetic version of folate) when trying to conceive a baby and in the early stages of pregnancy could prevent 1,000 cases of spina bifida a year, many of which result in termination of pregnancy. So it is important for every woman who might be thinking of having a baby to make sure she is getting enough folic acid in her diet.
The Department of Health recommends that:
- women planning to conceive should take 400 micrograms of folic acid daily as a medicinal food supplement from when they begin trying to become pregnant until the twelfth week of pregnancy.
- women who think they might be pregnant but have not been taking extra folic acid should start doing so immediately and continue until the twelfth week of pregnancy.
- women who have had a previous child with spina bifida should take daily folic acid supplements of 5 milligrams (5000 micrograms) until the twelfth week of pregnancy. Women taking this much folic acid should only do so under a doctor’s supervision.
There are three possible ways of getting extra folate in the diet:
- more folate-rich foods such as green vegetables
- foods fortified with folic acid such as some breakfast cereals
- take folic acid as a medicinal supplement
The best way to make sure you get enough folic acid is to take a supplement or eat foods such as soft grain breads and breakfast cereals which have been fortified with folic acid. You can use a combination of all three sources of folic acid. However, recent research shows that the body cannot absorb as much folic acid from folate-rich foods, such as green vegetables, as it does from supplements or fortified foods such as some types of breakfast cereals and bread. Therefore if you are planning to have a baby, a healthy diet with plenty of green vegetables will not be enough to give you all the folate you need.
Bread is a source of folate. Other sources include leafy green vegetables, dried beans, legumes, oranges and orange juice.
- Four medium slices (140g) of malted grain (also sold as Granary®) bread provides 123 mcg of folate, 4 slices of wholemeal bread delivers 56 mcg and 4 slices of white bread 35mcg
The Government is currently reviewing the possibility of fortifying white flour in the UK with folic acid, to decrease the incidence of neural tube defects during pregnancy. Such a move could also be of benefit for heart health, as poor folate status is associated with high homocysteine levels, which are an emerging risk factor for cardiovascular disease. However there are some concerns that there could also be adverse effects and worries about reduced freedom of choice. Nevertheless, the government’s Scientific Advisory Committee on Nutrition has recommended statutory fortification, as has the board of the Food Standards Agency. These recommendations are being considered by Chief Medical Officers, but no decision is expected before the second part of 2013 at the earliest: