Neural tube defects, or NTDs, are abnormalities that occur in the brain or spinal cord of a developing fetus. Such defects include absence of parts of the brain, protrusion of nervous tissue through openings in the skull or spine and failure of the spine to close normally over the spinal cord. According to an April 2011 review in the German journal "Deutsches Arzteblatt International," 20 to 60 percent of all NTDs result from inadequate folic acid in the mother's diet.
Defects Occur Early
The development of your infant's neural tube occurs quite early in your pregnancy. In fact, some of the initial cellular changes that become the embryo's neural tube occur prior to its implantation in your uterus. Normally, the fetal neural tube has closed by the 28th day after conception, often before you even realize you are pregnant. Thus, any factors that can be modified to prevent NTDs are ideally addressed prior to pregnancy.
Folic Acid
Folic acid, or folate, is a water-soluble vitamin belonging to the B-complex family. In your body, folic acid functions as a cofactor for enzymes that aid in the production of red blood cells, the metabolism of amino acids and proteins and the synthesis of DNA and RNA. Folic acid is also instrumental in the manufacture of neurotransmitters in your central nervous system. Its roles in supporting rapid cellular division and neurotransmitter production help to explain folic acid's importance in the development of your fetus' nervous system.
Recommendation
The Institute of Medicine recommends that all women who are capable of becoming pregnant consume 400 mcg of folic acid every day, either through diet or supplements. Once pregnancy is detected, increase your intake to at least 600 mcg daily. Food sources of folate include dark leafy greens, such as spinach, chard and kale, liver, kidney and brewer's yeast. Bean sprouts are also high in folate, as are wheat germ and soy flour. Many foods are now fortified with folic acid in the United States.
Considerations
A May 2000 review in "The American Journal of Clinical Nutrition" reported that food-based folate is less absorbable and less stable than the folic acid found in fortified foods and in supplements. Although supplements offer a means of increasing your blood folate levels, in some studies fewer than half of pregnant women correctly followed recommendations for folic acid supplementation. In 1998, the U.S. Food and Drug Administration enacted legislation requiring folic acid fortification of all enriched grain products. However, this measure is estimated to furnish only an additional 100 mcg of folate daily. Ask your physician about the best dose of folic acid for you.
References
- "Deutsches Arzteblatt International"; The Mandatory Fortification of Staple Foods with Folic Acid: A Current Controversy in Germany; W. Herrmann, R. Obeid; April 2011
- Linus Pauling Institute at Oregon State University: Folic Acid
- "The American Journal of Clinical Nutrition"; Response of Red Blood Cell Folate to Intervention: Implications for Folate Recommendations for the Prevention of Neural Tube Defects; H. McNulty, et al.; May 2000
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