Folate Can Help Prevent Birth Defects : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 2)

Folate Sources

Folate occurs naturally in a variety of foods, including liver; dark-green leafy vegetables such as collards, turnip greens, and Romaine lettuce; broccoli and asparagus; citrus fruits and juices; whole-grain products; wheat germ; and dried beans and peas, such as pinto, navy and lima beans, and chickpeas and black-eyed peas.

Under FDA's folic acid fortification program, which became effective January 1998, the agency requires manufacturers to add from 0.43 mg to 1.4 mg of folic acid per pound of product to enriched flour, bread, rolls and buns, farina, corn grits, cornmeal, rice, and noodle products. A serving of each product will provide about 10 percent of the Daily Value for folic acid. Whole-grain products do not have to be enriched because they contain natural folate. Some of the natural folate in non-whole-grain products is lost in the process of refining whole grains.

Folate also can be obtained from dietary supplements, such as folic acid tablets and multivitamins with folic acid, and from fortified breakfast cereals.

A report recently released by the Institute of Medicine indicates that the evidence suggests that folic acid, the synthetic form of folate, may be better absorbed than folate found naturally in foods. The report also points out that, if taken in adequate amounts, food folate may eventually be demonstrated to be as effective as folic acid.

Finding Foods with Folate

Certain information on food and dietary supplement labels can help women spot foods containing substantial amounts of folate. Some labels may claim that the product is "high in folate or folic acid," which means a serving of the food provides 20 percent or more of the Daily Value for folic acid. Or the label may say the food is a "good source" of folate, which means a serving of the food provides 10 to 19 percent of the Daily Value for folic acid. The exact amount will be given in the label's Nutrition Facts panel.

Some food and dietary supplement labels may carry a longer claim that says adequate folate intake may reduce the risk of neural tube birth defects. Products carrying this claim must:

• provide 10 percent or more of the Daily Value for folic acid per serving
• not contain more than 100 percent of the Daily Value for vitamins A and D per serving because high intakes of these vitamins are associated with other birth defects
• carry a caution on the label about excess folic acid intake, if a serving of food provides more than 100 percent of the Daily Value for folic acid. FDA has set 1 mg (or 1,000 micrograms) of folate daily as the maximum safe level. There are limited data on the safety of consuming more than 1 mg daily, and there may be a risk for people with low amounts of vitamin B12 in their bodies — for example, older people with malabsorption problems, and people on certain anticancer drugs or drugs for epilepsy whose effectiveness can diminish when taken with high intakes of folate.
• list on the label's Nutrition or Supplement Facts panel the amount by weight in micrograms and the %Daily Value of folate per serving of the product. This information, which appears toward the bottom of the panel, along with the listing of other vitamins and minerals, can be used to compare folate levels in various foods and supplements.

Optional information may appear with the health claim to let consumers know about other risks associated with neural tube birth defects, when to consult a doctor, other foods that are good sources of folate, and other important messages about neural tube defects.

Other Considerations

The claim about folate cannot imply that adequate folate intake alone will ensure a healthy baby, since so many factors can affect a pregnancy.

Women should bear this in mind when contemplating pregnancy, advises Jeanne Latham, a registered dietitian and consumer safety officer in FDA's Office of Special Nutritionals. "Folate can make a significant contribution," she said, "many factors, including an overall good diet, are involved in having a healthy baby."

Genetics plays a role, as do other healthful prenatal practices, such as eating an all-around good diet. But unlike genetics, diet is a risk factor women can modify to their — and their baby's — advantage, said Jeanne Rader, Ph.D., director of the division of science and applied technology in FDA's Office of Food Labeling.

"Folic acid is one of many nutrients needed in a healthy diet for women of childbearing age," she said. "A well-balanced diet with a variety of foods can provide all those nutrients, including adequate amounts of folate."

Women have options for reaching the folate intake goal: They can get the necessary nutrients and calories both before and during pregnancy by eating a well-balanced diet, keeping in mind folate-rich foods, nutrition experts say. Folic acid-fortified grain products, including breakfast cereals, will help, too. Dietary supplements are another source of folate. Any one or a combination of these options for ensuring adequate folate can help assure women of childbearing age that, if they become pregnant, their babies will be off to a healthy start.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.