Although we here at ACSH have often been skeptical about the utility of various dietary supplements including many vitamins and minerals there is one that we think is vitally important. That supplement is vitamin B9, aka folic acid. And recent data from the CDC definitely support its use by women in their childbearing years.
The reason that folic acid is so important for moms-to-be is that it is essential for the formation of new cells which is obviously what happens as a new baby is formed. Lack of folic acid during very early pregnancy can result in malformations of the central nervous system such as spina bifida and anencephaly (neural tube defects or NTDs), which can result in paralysis among the surviving neonates, or fetal or neonatal death.
As a result of research demonstrating the clear link between lack of folic acid and such birth defects, in 1998 the US mandated that all enriched cereal grain products also be fortified with folic acid in the amount of 140 micrograms per 100 grams of the product. Thus, a woman who eats about 285 grams (about 10 ounces) of an enriched grain product would consume just about the 400 micrograms that is currently recommended during pregnancy, even if she did not eat any of the dark green leafy vegetable or the fruits (such as oranges) that are high in this vitamin.
The recent report from the CDC relied on data from 19 surveillance programs in 11 states to estimate the prevalence of such birth defects both before and after the mandate of folic acid fortification (1995-2011). Results of the study are summarized in the graph below:
Clearly, the prevalence of NTDs diminished substantially after folic acid fortification began. The CDC s report estimated that folic acid fortification prevented the occurrence of approximately 1300 cases of NTDs. The authors of the report commented Mandatory folic acid fortification remains an effective public health intervention.
ACSH s Dr. Ruth Kava added Obviously folic acid supplementation has been a great public health success. For women who tend to not eat the fortified products on a regular basis, it is imperative that they be educated about the importance of this vitamin in protecting the health of their future babies. It is also crucial that even women who may become pregnant be advised to consume at least the recommended 400 micrograms of folic acid whether from fortified products or from supplements because the brain and spinal cord are developing very early in pregnancy often even before a woman knows she is pregnant.