About folic acid
- What you need to know about folic acid
- What women know about folic acid
- What women do regarding folic acid
What you need to know about folic acid
Folic acid (pteroylglutamic acid) is a B vitamin that acts as a coenzyme in single-carbon transfers. It is involved in many reactions, especially those in cell division, including:
- DNA synthesis as part of a coenzyme for pyrimidine nucleotide
synthesis and purine synthesis - Amino acid conversions, most notably the conversion of
homocysteine to methionine
Folate is the natural form of folic acid found in food. Food folates are pteroylpolyglutamates, which contain one to six additional glutamates compared to folic acid. These polyglutamate derivatives must be hydrolyzed to monoglutamate forms prior to absorption in the proximal small intestine. In addition, dietary folates are heat-liable, thus easily destroyed by storage and cooking. It is estimated that the bioavailability of dietary folate is approximately 50 percent. Thus, it is almost impossible to obtain the recommended 400 mcg of folic acid from food sources alone.
Only folic acid supplementation, along with a healthy diet, has been proven to reduce NTD risk. This is true even when women are counseled about increasing dietary folates. Liver, most dried beans and peas, some green vegetables and oranges are good sources of folate. Yet, one would need to eat four cups of black beans or 16 oranges to obtain the equivalent of 400 mcg of folic acid.
Folic acid’s role in the prevention of birth defects is well documented and supported by scientific evidence. This includes observational and randomized control trials.
Recent research suggests that folic acid supplementation may play a role in reducing the risk of other congenital conditions such as orofacial clefts, cogenital heart defects and defects of the urinary tract. For adults, it may play a role in reducing the risks for heart disease, stroke, vascular diseases, poor cognitive function in the elderly and colorectal cancer. Due to its ubiquitous role in coenzymes and DNA synthesis, folic acid will continue to be a topic of research.
What women know about folic acid
Many women state they know about folic acid and its role in preventing birth defects. According to data obtained through the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS)** survey and the Behavioral Risk Factor Surveillance System (BRFSS)++ survey, the majority of women know the following information.
Recent data show that in North Carolina:
- About 82 percent know that folic acid can help prevent some birth defects. Women under the age of 20 are least likely to know that folic acid can prevent some birth defects. (PRAMS, 2005)
- About 60 percent of women of childbearing age (18-44) correctly identified birth defect prevention as the reason why health experts recommend 400 mcg of folic acid. (BRFSS, 2006)
- Eighty-two percent of women get information about folic acid from a doctor, nurse or other health care provider. (PRAMS, 2005)
What women DO regarding folic acid
There is a disconnect between what women know about folic acid and how they behave. Recent data show that only 38 percent of women ages 18-44 in North Carolina take a multivitamin or vitamin pills/supplements containing folic acid daily (BRFSS)++, 2006). Nationally, women’s folic acid-taking behavior is not much different. A national survey conducted by the Gallup Organization for the March of Dimes shows that only 40 percent of women take folic acid daily (2007).
In addition, the 2007 March of Dimes Gallup survey reported that 88 percent of women who do not currently take any multivitamin supplements on a daily basis report they would be likely to take a daily multivitamin if advised to do so by their physician or other health care provider.
** PRAMS is an ongoing, population-based, randomized survey of North Carolina resident women who have recently given birth. Information is collected on pregnancy risk factors, access to health care services and other issues related to improving the health of both the mother and the baby. It is conducted by the NC Center for Health Statistics.
++ BRFSS is an ongoing, population-based, randomized survey of state residents aged 18 and older in households with telephones. Information is collected on a variety of health behaviors and preventive health practices related to the leading causes of death and disability such as cardiovascular disease, cancer, diabetes and injuries. It is conducted by the NC Center for Health Statistics.
This web site is designed for informational use only; it is not designed to give advice or cure or treat any medical condition you may have. If you have any questions about your health, please contact your health care provider. If you need immediate medical attention, please call 911.
