Folic Acid, Spina Bifida, Pregnancy and You

The incidence of babies being born with spina bifida is on the increase – in Scotland it has just been announced that this year has seen the numbers double and it is thought that this will be the same for the whole of the UK, where incidents of spina bifida are, already, the highest in the world!

The average worldwide incidence of spina bifida is 1 case per 1000 births. In parts of the British Isles, however (mainly Ireland and Wales), 3-4 cases of myelomeningocele per 1000 population have been reported, along with more than 6 cases of anencephaly (both live births and stillbirths) per 1000 population. The reported overall incidence of myelomeningocele in the British Isles is 2-3.5 cases per 1000 births. This is anywhere between 5 and 30 times higher than in countries such as France, Norway, Hungary, Czechoslovakia, Yugoslavia, and Japan.
 
Experts are calling for wider use of folic acid supplements to help prevent this condition and even recommend that it should be added to bread and flour to ensure we all have sufficient in our diets. In the USA, folic acid has been added to enriched grains and flour since 1998, resulting in an estimated 70% reduction in the cases of spina bifida.

However, in the UK we seem to believe that education is the answer. Unfortunately, what I find when talking to customers in the shop is that they:

a)   Don’t know much about folic acid & it's importance and assume they get sufficient from their diet, anyway.

b)   Find out about folic acid and start to take it once they know they are pregnant (when it’s too late).

c)   Know about folic acid and take it, but don't know what dosage they should be taking, or what the upper safe limits are.

Hopefully, this article will help to address these problems and clarify the situation for everyone.

What Is Folic Acid?

Folic acid is a naturally occurring, water-soluble, B vitamin (sometimes referred to as vitamin B9). Because it is water-soluble, the body doesn’t store it for long, so it has to be replenished regularly.

Folic acid is used in every process that requires cell division in the body and is critical to DNA and RNA formation and ensures that cells replicate normally. Folic acid works along with vitamin B12 and vitamin C to help the body digest and utilize proteins and to synthesize new proteins when they are needed.

Folic acid is often referred to as “folacin” or “folate”. Folacin is a synthetic product used in supplements and to fortify foods, whereas folate is the naturally occurring form that is found in foods. Unfortunately, folate is easily destroyed in cooking and even storage, so it is generally accepted that folacin is the best type of folic acid to supplement your diet with.

Foods rich in folate are:

Folic acid deficiency may cause a number of disorders. Some of these are:

• Anaemia – usually associated with the advanced stages of folic acid deficiency
• Severe diarrhoea
• Sore, red tongue
• Greying hair
• General weakness

But the most important disorder is "neural tube defect" (NTD) that is the cause of spina bifida and anencephaly in babies – the neural tube is what will become the spinal cord and central nervous system of a baby.

Spina bifida is a birth defect of the central nervous system in which the bones of the spine do not completely form, resulting in an incomplete spinal canal.

Myelomeningocele is one of the most common NTD birth defects (roughly 75% of all cases), in which the bones of the spine do not completely form, resulting in an incomplete spinal canal. This causes the spinal cord and its protective membrane to stick out of the child's back. Most children survive birth with this condition, but have to contend with lower body paralasis and loss of bowel and bladder control for the restt of their lives.

Anencephaly is an NTD that occurs when the head end of the neural tube fails to close – usually during the 4^th week of pregnancy. This leads to brain tissue being exposed through a defect in the scalp and skull and can lead to no forebrain being formed. Most babies with this disorder are either stillborn or die shortly afterwards.

The Role of Folic Acid

Because of its critical role in DNA and RNA formation, folic acid plays a major role in the development of your baby’s neural tube.

However, as the neural tube is formed during the first 4 weeks of pregnancy – and bearing in mind that most women don’t even know they’re pregnant until after this – taking a folic acid supplement after you have confirmed pregnancy, is probably too late!

Additionally, studies have shown that women who take 400micrograms of folic acid for at least a year before conception have a considerably lower chance of having a premature baby.

It is therefore essential that you take a folic acid supplement if you are trying to conceive and, in fact, it is probably best to do so if you are of child bearing age – in case of accidental conception.

Taking the Correct Dose of Folic Acid

Up to 50% of all pregnancies are unplanned, so it is advisable for women of child bearing age to take 400micrograms of folic acid per day.

Once pregnancy is confirmed, the suggested dose is between 400 and 600micrgrams per day for at least the first 12 weeks of pregnancy and, if breastfeeding, 500micrograms per day. The advised upper safe limit is 1,000micrograms per day.

Alcoholics, people on medication for cancer or epilepsy and those with Crohn’s disease or are coeliacs are likely to be severely deficient in folic acid and should consult their doctor regarding dosage.

Some medications may interact with folic acid including those for epilepsy, controlling blood sugar, treating cancer and diuretics. If you are taking any of these medicines, you should contact your doctor.

Very large dosages (5,000 – 10,000microgarms) offer no extra benefit and may be dangerous for anyone with breast cancer and may cause seizures in people with epilepsy.

Large dosages of folic acid are also thought to be linked to incidents of colorectal cancer (cancerous growths of the colon, rectum and appendix) and there is a growing belief that they may also be contributing factors in the increase of autism in children. More research is required to confirm this, though.

Folic acid supplements may mask a type of anaemia caused by a vitamin B12 deficiency that can lead to nerve damage and dementia. It is advisable, therefore, to take a B12 supplement as well.

On the plus side, folic acid ensures healthy skin, hair and nails, reduces heart disease and risk of strokes, can alleviate depression and may have a role to play in preventing Alzheimer’s disease.

As always, all information in this article is provided for educational purposes only. Consult your own physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition!

Steve Stapleton

http://www.wincantonwholefoods.com/newsletter.html

The shop is open:

Monday – Thursday 8.30am to 1.00pm

Fridays – 9am to 5pm

Saturdays – 9am to 2pm

Wincanton Wholefoods. 43, High Street, Wincanton. BA9 9JU   Tel: 01963-31005

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