Taking folic acid both before and during the early stages of pregnancy is vital to help prevent neural tube defects such as spina bifida and, with 50pc of pregnancies unplanned, every woman of childbearing age who is sexually active should be taking folic regardless. Grainne Rothery reports
THE trend in recent years by the food industry to voluntarily add folic acid to a range of food products, including bread, breakfast cereals, dairy spreads, fruit juices, milk, yogurts and soups, means that a healthy balanced diet will provide the general Irish population with all their folic acid needs.
However, women who have a chance of becoming pregnant are strongly recommended to take a daily supplement of the vitamin.
Folic acid is a water-soluble B vitamin that provides a range of health benefits to the general population. It is important for brain and nervous system function and a deficiency is associated with an increased risk of heart disease, some cancers and depression.
It’s probably best known, however, for its role in helping to prevent neural tube defects ( NTDs), a group of birth defects, including spina bifida, that occur when the brain, spinal cord, or the covering of these organs have not developed properly.
According to the Implementation Group on Folic Acid Food Fortification, a committee made up of experts from a range of Irish health and food authorities, folic acid reduces the risk of NTDs by up to 70pc if it’s taken as a supplement ( at a level of 400 micrograms daily) before, and up to 12 weeks after, conception. Women who discover they are pregnant are also strongly advised to start taking folic acid supplements straight away and to continue taking them until the 12th week of their pregnancy.
“ There’s really strong evidence that having sufficient folic acid in your blood can prevent most of what’s classified as neural tube defects – not all, but the majority,” explains Dr Marian Faughnan, chief specialist in nutrition at Safefood. “ Folic acid is required in the very early days of pregnancy to ensure the proper closure of the neural tube. That’s why it is really important in terms of development of babies.
“ You need 400 micrograms per day during that period. The key time to take it is before pregnancy, so you build up the folic acid levels in your blood to the required level, and then for at least three months into your pregnancy.”
It’s very difficult to get the 400 micrograms of folic acid required daily for pregnancy purely from diet, she adds. “ You’d really have to focus on taking folic acid from folate-rich foods and it is very, very challenging and you might affect the balance of your diet and the other nutrients. The folic acid that’s in food, which is called folate, is actually not as easily absorbed in the body as what you take in a supplement.”
In general, women of child-bearing age who are sexually active are advised to take folic acid supplements as part of their daily routine, regardless of whether they’re planning a pregnancy. “ The important thing to remember is that 50pc of pregnancies are unplanned,” explains Dr Faughnan. “ If we just say to women who are planning a pregnancy to take folic acid, we’re missing 50pc of the pregnancies.
“ With the HSE we’ve been looking at communicating that and the big challenge is to engage those who aren’t planning a pregnancy. It’s a very important message because we have so many children born every year with conditions like spina bifida, the majority of which we know could be prevented by sufficient folic acid.”
It’s also worth noting that Ireland has traditionally had a high incidence of spina bifida, compared with many other countries, although the rate has fallen in recent years. “ One of the reasons that we as a population are at risk is that we have a genetic profile that doesn’t absorb folic acid from food as well as other genetic profiles,” says Dr Faughnan. “And we have a higher percentage of that genetic profile in Ireland than other populations in the world.”