Thinking about a baby? Consider folic acid
Tantri Yuliandini, The Jakarta Post, Jakarta
Women planning to have a baby should begin thinking about adding folate folic acid, a water-soluble B vitamin, to their daily diet, an obstetrician and gynecologist from the University of Indonesia, Noroyono Wibowo, said.
"Women of reproductive age need 0.4 milligrams of synthetic folic acid daily in addition to their normal dietary intake," he said during the recent launch of New Zealand Milk's Anmum hi- folate powdered milk, adding that this should be doubled to 0.8 milligrams a day during pregnancy.
The reason for this is that a deficiency of folate and folic acid may result in anemia in a pregnant woman, and increase the risk of a newborn suffering from neural tube birth defects (NTD), or malformations of the spine (spina bifida), skull and brain (anencephaly).
"It may also cause non-NTD birth defects such as heart defects, cleft lip and palate, limb defects, as well as urinary tract defects," Noroyono explained.
The tricky part is that NTDs can occur in an embryo before a woman realizes she is pregnant, which is why it is important for women of childbearing age to include folate in their diets, he said.
Although folate can be found naturally in foods -- such as in liver, dark-green leafy vegetables, broccoli and asparagus, citrus fruits and juices, whole-grain products, wheat germ and dried beans and peas -- it is easily destroyed by cooking, particularly microwave cooking and cooking at high temperatures with large amounts of water.
Therefore, many people need a synthetic form of the vitamin, called folic acid, found in supplements and enriched foods, to meet their needs, Noroyono said.
Synthetic folic acids added to enriched foods and dietary supplements have simpler chemical structure than the natural form of folate, and is absorbed more easily by the body. However, after digestion and absorption, the two forms are identical and function in exactly the same manner.
Folate comes from the Latin word folium meaning "leaf", and was discovered in the 1930s by researcher Lucy Wills as a key nutrient needed to prevent anemia of pregnancy.
Folate's potential to reduce the risk of NTDs in newborns was so important that the United State's Food and Drug Administration (FDA) published regulations in 1996 requiring the addition of folic acid to enriched breads, cereals, flours, corn meal, pastas, rice, and other grain products. Indonesia adopted this policy toward its wheat flour products in 2001.
The National Institutes of Health (NIH) recommends a folate intake of 0.4 milligrams a day for men and women above 19 years of age, 0.6 milligrams a day for pregnant women and 0.5 milligrams a day for lactating women.
Some situations that increase the need for folate include pregnancy and lactation, alcohol abuse, malabsorption, kidney dialysis, liver disease and certain forms of anemia.
Certain medications can also interfere with folate utilization, including anticonvulsant medications, metformin, sulfasalazine, triamterene and methotrexate.
Signs of folic acid deficiency are often subtle, involving diarrhea, loss of appetite, weight toss, weakness, sore tongue, headaches, heart palpitations, irritability and behavioral disorders, NIH said on its website www.cc.nih.gov
However, it is important to keep folic acid intake below one milligram per day, or else it could interfere with the diagnosis of a vitamin B12 deficiency.