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By Stephanie Brown, About.com Guide to Toddlers since 2003

Survey Says: Many Women Still Not Taking Supplements with Folic Acid

Thursday September 29, 2005
A March of Dimes survey that was published in today's issue of the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report reveals that only a third of women are taking vitamin supplements that contain folic acid. Even though there has been much press about how folic acid can prevent neural tube defects like spina bifida, there has not been an increase in women taking folic acid in the last ten years.

So what is the solution to this problem? Jennifer L. Howse, president of the March of Dimes, says, "We need to increase the amount of folic acid in the grain supply and add it to corn flour. That way, women will get most of the folic acid they need through a healthy diet -- without having to think about it -- and their babies will be safer."

Poll: Women, do you take a supplement containing folic acid each day?
March of Dimes
The scoop on prenatal vitamins

Only one-third of childbearing age women are taking a multivitamin containing the B vitamin folic acid daily to prevent serious birth defects of the brain and spine in their future babies, according to a decade of March of Dimes surveys.

The survey results, published in the September 30 issue of the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report (MMWR), highlight the need to increase folic acid fortification of the grain supply, the March of Dimes says.

Daily use of folic acid has not shown a substantial increase between 1995 and 2005 despite nationwide educational efforts by the March of Dimes and other agencies.

The results of the survey, conducted for the March of Dimes by The Gallup Organization with funding from the U.S. Centers for Disease Control and Prevention, highlight the need to increase folic acid fortification of the grain supply, the March of Dimes says.

"Folic acid must be part of women's daily diet. That's the best way we know to spare thousands of babies the risk of death or disability caused by neural tube defects," said Dr. Jennifer L. Howse, president of the March of Dimes. "The survey results show that despite our efforts and those of other organizations, two-thirds of women ages 18-45 are not taking all the necessary steps to help reduce the risk of neural tube defects. We need to increase the amount of folic acid in the grain supply and add it to corn flour. That way, women will get most of the folic acid they need through a healthy diet -- without having to think about it -- and their babies will be safer."

Currently, enriched grain foods in the United States must contain 140 micrograms of folic acid per 100 grams of grain.

Neural tube defects (NTDs), such as spina bifida and anencephaly, are among the most serious types of birth defects. Each year, NTDs affect about 3,000 pregnancies. To help prevent NTDs, the March of Dimes says, all women capable of becoming pregnant should take a multivitamin containing at least 400 micrograms of folic acid every day beginning before pregnancy, as part of a healthy diet containing foods fortified with folic acid and foods that naturally contain folic acid, such as leafy green vegetables, and beans.

Studies show that, if all women consumed the recommended amount of folic acid before and during early pregnancy, up to 70 percent of all NTDs could be prevented.

Daily consumption of folic acid beginning before pregnancy is crucial because NTDs occur in the early weeks after conception, often before a woman knows she is pregnant.

The number of women who said they had heard of folic acid reached an all- time high in the 2005 survey at 84 percent, up from 52 percent in 1995. The most common reason women gave for not taking the supplement daily is that they forgot.

The March of Dimes survey on folic acid has been conducted nine times since 1995. In 2005, 2,647 women between the ages of 18 and 45 were asked about their awareness and knowledge of the benefits of folic acid and their use of vitamins. For results based on samples of this size, one can say with 95 percent confidence that the error attributable to sampling and other random effects could be plus or minus two percentage points.

The survey also found:

  • Nearly 90 percent of women surveyed believe there are things they can do to prevent births defects. These women cited avoiding alcohol and drugs and not smoking as the top two things that could be done to prevent birth defects, followed by proper diet and vitamins. Only 9 percent of the women mentioned folic acid.
  • Folic acid use declined to 33 percent in 2005, down from 40 percent in 2004. However the 2005 rate is consistent with years prior to 2004.
  • Only 24 percent of younger women (age 18-24) take a vitamin containing folic acid daily compared to 36 percent of older women (age 25 to 45).
  • Only 7 percent of women surveyed knew folic acid should be taken before pregnancy.
  • Of women who didn't take a multivitamin daily, 28 percent said it was because they forget, 16 percent said they don't need them, and 9 percent said they get the nutrients and vitamins they need from food.

    Source: March of Dimes

  • Comments

    April 5, 2006 at 2:16 pm
    (1) ktm says:

    Just because women are not taking folic acid in the form of suplements does not necessarily mean that they are not getting enough folic acid. Sure, for people who have bad diets, supplements of any sort will likely be an improvement, especially when a baby depends upon it, but a family friend who is getting her Ph.D in clinical psychology recently mentioned that one of the most interesting studies going on right now is that folic acid supplements may be related to increased incidence of autism. You can google it to read more of this debate One site is: http://asmonline.org/dec04news/autismneurology.htm

    Though I don’t know the details of the specific study she mentioned, the main point is to look at the foods you are eating. So many foods in the US are processed and add vitamins and minerals already.

    The logic and benefits of taking folic acid may be sound, but it still has yet to been seen whether excessive folic acid is good for babies. Studies are now coming out that excessive intake of certain vitamins can be bad, and folic acid may not be immune from this conclusion either — we will have to wait and see. The above URL states the following about the folic acid-autism link: “This particular hypothesis has not yet been published, but if proven correct, could result in changes in government-mandated vitamin supplementation. I would hope that we could find an optimal level of folic acid intake, a “bottom of the U shaped curve”, which would protect babies against spina bifida, but not raise the risk of autism.”

    Regardless, taking suplements is not the issue. Healthy women who have a good diet and eat products that are already fortified with folic acid may not need it. Go to your pantry and look at your own cereal products. One cup of an off-brand cherrios on my shelf provides 50% of the daily recommended intake of folic acid.

    The key is having a good diet and being aware of what you eat, especially if you are eating processed or fortified foods. The other problem is getting people with bad diets to do what is right during that crucial period in a childs life. I know this is a tricky message. “Take your folic acid supplements” was much easier, but I bet many mothers would like to be aware of folic acid issues a bit more.

    September 8, 2006 at 12:30 am
    (2) Kari says:

    I believe I concieved on 8/29. I began taking folic acid on 9/6. Am I too late to provide those nutrients in time to avoid spinal deformaties? My diet does not provide other great sources of folic acid. I know this seems early to think that I am pregnant… but you will have to trust me on this one. Thanks for any advice.

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