By John Messmer
Penn State Family & Community Medicine
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine
Folic acid is an essential nutrient that keeps nerves working properly and is important in blood production and protein and DNA synthesis. It also has been found to be extremely important for developing babies. During development, the brain and spinal cord grow from embryonic tissue called the "neural tube." This literally is a tubular structure that is open at both ends but normally closes well before birth. The signs of its prior existence can be seen in the "soft spot" or anterior fontanelle on a newborn baby's head and sometimes by a dimple at the base of the spine.
Spina bifida is one type of birth defect called a "neural tube defect." About 3,000 children are expected to be born with a neural tube defect this year. Spina bifida results when the opening at the base of the spine does not close properly. It can allow the spinal cord to protrude from the back. Children with spina bifida can have paralyzed legs and bowel and bladder problems, in addition to the risk of infection of the spinal cord if it is exposed.
Research has shown that extra folic acid in the diet of women who might conceive can cut the risk of neural tube defects. The first three weeks of pregnancy are critical for proper spinal cord development -- a time before most women even know they are pregnant. The good news is this birth defect is down about one-third. In the last few years, physicians and other health-care providers have spread the message that extra folic acid is important before pregnancy for any woman who could become pregnant whether or not she is planning a pregnancy. If all women consumed enough folic acid, about 70 percent of neural tube defects could be prevented.
Folic acid is a B vitamin and is present in most multivitamin supplements but a very good source is enriched grain products, such as bread and cereals. Other foods that can supply folic acid are legumes, nuts, seeds, eggs, fruit, and vegetables -- particularly asparagus and leafy vegetables. Liver is an excellent source. About two ounces of chicken livers provide an entire day's requirement of folic acid. Unfortunately, liver is very high in fat and cholesterol. Including fortified cereal, some bread, green leafy vegetables, some nuts, legumes and fruit daily is not only good nutrition, it should provide a full day's supply of folic acid.
All women of childbearing years, even if not planning on a pregnancy, should consume at least 400 micrograms of folic acid, more if possible, through diet and/or vitamin supplements. Hispanic women are being targeted for this in particular since Hispanics have as much as twice the risk of having a baby with a neural tube defect.
During this folic acid awareness week, consider a dietary re-evaluation, particularly if you are a woman in childbearing years. For more information, go to http://www.folicacidinfo.org/ online.