Something Different: Take your Folate

This is totally different than the things I normally blog, but I think it is really important so I'm going to take up a little front page space for it. A recent study, reviewed here at Nature, shows that women are getting much less folate than previously consumed. What is folate? More after the break.

Folic acid and folate (the anion form) are forms of a water-soluble B vitamin. These occur naturally in food and can also be taken as supplements. Folate gets its name from the Latin word folium ("leaf").

Why is it important?

During the late 1990s, rates of such defects in the United States fell to roughly 3,000 per year, a 25% drop compared with levels in the previous decade. This improvement is thought to have been a product of the government's decision to promote folate; by 1998 they had made it compulsory for 'enriched' foods to contain folate, as well as a suite of other vitamins.

So, what is going on now?

The decline may be due to increased consumption of wholegrain breads and cereals, which are not fortified with folate, says Joseph Mulinare of the National Center on Birth Defects and Developmental Disabilities in Atlanta, Georgia, who led the survey.
But ironically, the fashion for non-processed wholegrain foods means that folate consumption has now begun to fall. On average, women now consume only around 150 micrograms per day — less than half the recommended amount, Mulinare says.

What does a lack of folate put you at risk for?

The US Public Health Service recommends that women consume 400 micrograms of folic acid per day to help prevent developmental problems called neural tube defects, which occur early in pregnancy and give rise to crippling conditions such as spina bifida and anencephaly.

Folks, we are talking about a 25% decrease nationwide in the number of cases of neural tube closure defects. That is huge. It's like what would happen to lung cancer if NO ONE SMOKED. All you have to do is get some folate. So, if you are eating organic, low-glycemic index, whole grain foods - you are probably not getting folate.

The answer?

He suggests that all women of childbearing age take supplements of the related compound folic acid, even when not pregnant.

Get on it.


I haven't read your post

...but it looks like a bug.....ewww...

Now I'll be a grownup and go read.

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

If only everything were so easy.

I do wonder what the rate of lung cancer would be if there was no smoking?

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.


80% of lung cancers occur in smokers, if I remember my oncology correctly. The remaining 20% occur in former miners, people exposed to asbestos and other known carcinogens that aren't cigarettes, and secondhand smokers, though some are purely idiopathic. So with asbestos almost entirely phased out, and the secondhand smoke gone, we'd just have the miners and silicates and idiopathic. At a guess, maybe 10% of the current rate.

And folic acid isn't just good for women. I remember seeing studies showing that it's good for the heart, along with other B vitamins. Everyone should take a B-complex supplement every day.

You are right, it has other roles...

but there is almost no other single thing that has an impact on developmental disease as folic acid.

That is why it is dumped into everything from cereal to bread to all multivitamins.

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

Pre-natal vitamins

Don't they have folic acid? I remember that discussion with my doctor and never missed a day of vitamins.

Some day, I hope they come up with a pre-natal supplement that will prevent 13-yr-olds from giving their mother "that look". :)

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

yes, all women of reproductive age...

should be taking prenatal vitamins for just that reason. By the time a person realizes they are pregnant, it can be too late. That is why getting folate every day is so important, and that is why many Ob-gyns suggest a "pre-natal" type vitamin for all women of reproductive age.

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

One thing that annoys me

is that all women of reproductive age should be considered "pre-pregnant." (That's what the CDC release said!) I'm not "pre-pregnant." I'm nulliparous and staying that way, thanks. Assuming that all women want kids is just wrong.

HOWEVER (and a big one), some percentage >50 of pregnancies are unplanned. So for the vast majority of women of childbearing age, it's not a bad idea to take at least a standard multi every day -- but everyone, regardless of age or reproductive potential, should take a multivitamin/mineral supplement.

What I would like to see is an approach targeting the fact that the majority of pregnancies aren't planned - contraceptive education and making them more widely available, as well as getting more nutritious foods into the poorest neighborhoods. But in the meantime, until this happens, using a patch like vitamins will prevent birth defects, which is a good thing.

kids vs. sex

I think the point is that all women may not WANT kids, but there are few HUMANS that do not want sex. Since no birth control is 100%, and since sex leads to babies, and lack of folate leads to birth defects - it is probably wise for all women to take folate.

Also, as you mentioned, folate isn't a one-trick pony. If this were something that ONLY played a role in embryonic development, then there might be more of a debate.

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

Vitamins good.

No disagreement there. Birth control not 100%, also true, but some come pretty close (IUDs, for example, are 99.8% effective per year.) Not using it because you don't have access, however, is 0%. And in Durham, there are a lot of folks without access -- to BC or vitamins or enriched cereals & breads.

So as a short-term solution, taking vitamins is great. Even as a long-term solution, since in general vitamins are good for you. But a really long-term solution would be to change the way we eat and the way society views sex and sexuality (which, at the moment, is very unhealthy) and to reduce poverty. Which isn't quite related to the topic of your post, but I'm still an idealist.

good diet is a good point.

Thank God, my son had food allergies. Because of it we eat fresh fruit and vegetables at every single meal. We cook almost all our own food, using only things like Olive Oil and fruit for sweetening, no refined sugars.

You, meaning everyone, has no idea what they are eating until they are forced to learn what the hidden ingredients mean.

Now. That doesn't mean I don't go "off the diet" sometimes, my wife and I ate at Monterey's this weekend and the Tacos Pepe were delicious and probably not at all healthy.

Still and all, a good diet would make up for not taking the folate supplements, but hardly anyone has that diet - hence, the 25% decrease in neural tube defects when we started adding it to cereals.

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

Food is one of my Issues.

I'm reading Michael Pollan's book The Omnivore's Dilemma right now, and when I get through it, I'm going to blog it. Commodity corn is in every damn thing, and it all comes down to fossil fuels.

Mmm, Monterey. Good, cheap Mexican. I'm still sad Charlie's closed. But still, there's nothing wrong with eating out sometimes -- where we have problems is with eating out all the time, because restaurant portions are getting huger and huger.

I'm not allergic to any foods

but refined sugars make my arthritis worse. My doctor has said there is no proven medical link, but I hear this from a lot of folks with RA.

It isn't just in restaurants that portion size is a problem. I've been paying attention to it at home. My husband doesn't have a weight problem, but I do. My entire family does going back many generations. We all start out skinny, but don't end up that way and many of us get plenty of exercise. While I prepare most of our meals from scratch and we are big on fresh fruits and vegetables, I worry that my daughters (who currently do not have weight issues of any variety) will take a clue from portion sizes they see while out. Fortunately, we talk about it because they are old enough to help prepare and serve meals. Maybe they'll be more informed and will make better choices and be healthier even though we share genes.

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

Tricks for keeping portions small at home

Dieticians and diabetes educators call it "portion creep," and it's been going on for decades.

Use smaller plates. The American dinner plate has gone from 9-10 inches across to 11-12 in the last 20 years. I know mine are huge, like 13". We eat dinner from the salad plate.

When serving food, fill half your plate with non-starchy veggies, 1/4 with starch/grains (a roll, potatoes, etc), and the remaining 1/4 with your protein. Assuming you have multi-dish meals; we often have casserole-type things.

Use your hand to gauge portions. A serving of meat is 3 oz, which is approximately the size and thickness of your palm or a deck of cards. A piece of fruit should fit comfortably in your hand, not like the monster apples in the store. A serving of starch (rice, bread, potatoes) is the size of your fist.

Then there's the strategy to eat veggies first (salad, etc) then the rest of your meal. Or if you go back for more, get more veggies instead of more bread or meat.

I used to do diabetes education in my last job. I had a lot of suggestions for ways to work in healthier choices and control how much you eat, and they were very dependent on the patient.

Excellent, excellent

Some I had heard, but most had not. I do eat from the salad plate, but the rest of the family does not. We don't have bread with dinner or as a matter of habit, but we all LOVE bread. Everyone but dad eats veggies first, but it wasn't by design. It will be from now on. We are veggie and fruit lovers, so I think if we can control portions over time, my girls will not face the problems I have and I will rid myself of a few problems. (.....and maybe some pounds. I don't do diets, though.)

Thank you for the tips. They will be put to good use.

Robin Hayes lied. Nobody died, but thousands of folks lost their jobs.

Vote Democratic! The ass you save may be your own.

SD, I didn't know you had RA

So does my beautiful daughter and so did my dad. Are you on any medication?


Omnivore's Dilemna - Fantastic

Great book, even went back and read sections again. His layout of monoculture and energy dependencies was well done, and explanatory in ways I had not noticed -- despite a lot of reading in these areas. Like the Irish, we could wind up SOL should corn become blighted, particularly since there are no backups which could be sent into battle. And, his explanations of the energy used in agriculture are well done - most people dont realize just how much our crops depend on constant infusions of artificially produced fertilizers from fossil fuels. Great book, let me know if you want to discuss it.



Robert - thanks for the information.

It would be wonderful if we could all get the vitamins we need from the food that we eat, unfortunately, that doesn't seem possible. I didn't realize that all women of childbearing age should be taking pre-natal vitamins, though. I was concerned that would be "too much" of a good thing.

However, I will say in favor of good nutrition - my husband has lost 85 pounds since April 2006 by eating properly. No refined sugars, controlled carbs, whole grains, etc. Yes, you read that right - 85 pounds. I've lost about 45. We were both pre-diabetic, and decided we were too young to be old and sick. So there you have it - eat right, in controlled portions, no refined sugars, and even couch potato geeks can lose a significant amount of weight. We've both got another 30 or so to lose. The holidays set us back a little bit, but by the next Edwards rally, expect to see less of us. :-D

"Be the change you wish to see in the world." - Gandhi

That's great!

I once lost 55 pounds in a year through diet and exercise and I felt like a whole new person. I hope by the next rally to have dropped the "baby weight" : )

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

Vitamins: too much of a good thing?

There are few vitamins you can overdose on (well, unless you take a whole bunch of pills at a time.) The fat-soluble vitamins (ADEK) can be over-done, as can minerals (iron, selenium, etc). But the water-soluble vitamins (pretty much the remainder), any excess comes out in urine.

iron with children

is one of the only concerns i know about

Jesus Swept ticked me off. Too short. I loved the characters and then POOF it was over.

Yeah, it's amazing how much better we both feel

Health problems that plagued us both have become much less of an issue, even though they're still hanging around. Energy to actually do things - it's wonderful. But the best thing for me is that now I crave apples instead of potato chips. You have no idea how great that makes me feel.

"Be the change you wish to see in the world." - Gandhi