On Nutrition by Ed Blonz

Folate Crucial During Early Pregnancy

DEAR DR. BLONZ: We are feeling lots of joy from our daughter’s recent marriage, and we just learned that they have plans to start a family. We set a good example of healthy eating and an active lifestyle, but have been thinking about encouraging her to begin taking a supplement to provide more B vitamins, especially folate. Before doing so, I wanted a reasonable argument to support my case. I am hoping that you might be able to help. -- G.P., Scottsdale, Arizona

DEAR G.P.: Congratulations and best wishes to your daughter and her new partner. The diet and lifestyle example you have set will prove to be persuasive, but you ask about folate, so let’s look at what gives this nutrient its status with child development.

Our bodies are constantly being broken down and remade; whatever can be reused, is. If we could check the passport of an essential amino acid, for example, we would probably find notations that it had been part of hormones, enzymes and disease-fighting antigens, as well as various organs and tissues.

Folate, also called folic acid, is integral to the body’s construction mechanism, moving around single carbon “bricks” as needed. Folate is also essential for the synthesis of DNA and RNA, the genetic material involved in cell division and reproduction. That’s quite a dance card.

One of the first places to reflect a folate deficiency is the blood, as our doughnut-shaped red blood cells have a relatively short lifespan. If there’s insufficient folate, red blood cells get improperly constructed, resulting in a type of anemia. Resupplying the needed folate will bring about a dramatic recovery in those suffering from folate-deficiency anemia.

But a folate deficiency isn’t as easily solved during pregnancy. Following conception, various bodily systems begin to develop, and this involves a massive expansion of “construction projects.” One of the first systems to develop is the fetal nervous system, including the spinal cord and the bony column that protects it. Adequate folate must be present during the first few weeks after conception for this process -- but during this time, a woman might not yet be aware that she is pregnant. If the body is folate-deficient during this period, it can lead to mistakes in the formation of the nervous system, and unfortunately, no amount of folate can correct such problems after the fact.

Spina bifida is a congenital disability in which one or more of the vertebra of the spinal column fails to develop properly. It affects approximately 1 out of every 1,000 babies born, and as much as 75% of all cases of spina bifida are attributable to a folate deficiency during those first few weeks of pregnancy. This makes it especially important for women to have adequate folic acid before pregnancy even begins.

The problem is that less than half of all pregnancies in the United States are planned. The U.S. Public Health Service recommends that all women of childbearing age who are capable of becoming pregnant should consume at least 400 micrograms of folic acid per day. The requirement rises to 600 micrograms during pregnancy, and drops to 500 micrograms during breastfeeding. Good sources of folate include legumes, vegetables (especially leafy greens and asparagus), citrus fruits, eggs and various fortified foods.

Best to you and your potentially expanding family.

Send questions to: “On Nutrition,” Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to questions@blonz.com. Due to the volume of mail, personal replies cannot be provided.