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A Cup of Health with CDC
January 19, 2007
Folate Status in Women of Childbearing Age by Race/Ethnicity
--- United States, 1999--2000, 2001--2002, and 2003-- 2004

[Announcer] This podcast is presented by the Centers for Disease Control and
Prevention. CDC – safer, healthier people.

[Matthew Reynolds] Welcome to A Cup of Health with CDC, a weekly broadcast of
MMWR, the Morbidity and Mortality Weekly Report. I’m your host, Matthew Reynolds.
Here to discuss the importance of folic acid in preventing certain types of birth defects is
Dr. Sheree Boulet. It’s great to have you here, Dr. Boulet.

[Dr. Boulet] Thank you, Matthew. Yes, you’re right. Babies may be born with neural tube
defects that affect their brain or spinal cord if their mothers don’t get enough folic acid
during their pregnancy. In 1992, the Public Health Service recommended that all women
from the ages of 15 to 44 who could become pregnant take 400 micrograms of folic acid
every day. And by 1998, the Food and Drug Administration required that all enriched flour
and flour products be fortified with folic acid. Still, only about 1 out of every 3 women
actually get enough folic acid each day. Even for women who are not planning to get
pregnant, it’s important that they get enough folic acid. Many pregnancies aren’t planned
and a woman may not know for a month or two that she’s pregnant. By then it will be too
late to start taking folic acid since the brain and spinal cord – or the neural tube – are
among the earliest structures to develop in the first weeks of pregnancy. The best way to
insure that you’re getting enough folic acid is to take 400 micrograms as a supplement
each day.

[Matthew Reynolds] Dr. Boulet, can you explain what a neural tube defect is?

[Dr. Boulet] Sure. During the first four weeks of pregnancy, the baby’s brain and spine
may fail to close properly. If that happens, the baby will have what we call a neural tube
defect. This is a serious birth defect of the brain or spine that results in conditions called
spina bifida or anencephaly. Since this can happen so early in pregnancy, most women
may not even know they’re pregnant. Every year, there are about 3,000 babies born with
neural tube defects. Even so, that’s much lower than in the past, because we’ve learned
that folic acid can often prevent most neural tube defects. Scientific studies found that folic
acid can prevent more than half of neural tube defects that might otherwise occur.

[Matthew Reynolds] What kind of food does a woman need to eat in order to get enough
folic acid?

[Dr. Boulet] Well, some people think if they have a healthy diet they will get all the folic
acid they need, but it’s actually not that easy to get enough folic acid from food. For
example, a woman would have to eat 10 bunches of broccoli or drink 17 glasses of orange
juice every day to get enough folic acid to prevent neural tube defects. For most people,
eating that much food would be difficult. Besides, buying such large amounts of the foods
that are high in folate would also be expensive.

[Matthew Reynolds] I like broccoli, but I can’t say that eating that much of it would be
attractive to me either. Is there an easier way to get enough folic acid then?

[Dr. Boulet] Sure, one way is to eat foods that have been enriched with folic acid, like
some breads or cereals. That doesn’t usually include whole grains, though, which may not
be enriched with folic acid. And as you know, whole grains are very popular now. Another
reason why people may not be getting enough folic acid from enriched flour products could
be the popularity of low carbohydrate diets. But the best way to get enough folic acid is to
take a vitamin that contains 400 micrograms of folic acid. It’s really easy to take a multivitamin
every day, and it’s less expensive than buying all those fruits and vegetables. That
way, a woman knows she’s getting enough folic acid because it’s right there on the bottle.
This is especially important because there has to be enough folic acid in a woman’s body
before she becomes pregnant.

[Matthew Reynolds] What about women who don’t plan on getting pregnant?

[Dr. Boulet] I’m glad you asked because that’s an important question. One reason we
want all women of childbearing age to get enough folic acid every day is because we know
that about half of all pregnancies in the United States are unplanned. In the first few
weeks, a woman might not even know she’s pregnant and, by that time, starting to take
folic acid wouldn’t help protect the developing baby. The neural tube develops into the
baby’s brain and spinal cord and that part of the baby develops in the first few weeks of
pregnancy. And it’s during that time that it’s especially important for a woman to get
enough folic acid to protect her unborn baby.

[Matthew Reynolds] What’s the most important message that you want people to get
today?

[Dr. Boulet] Well, we need to get the word out that the best way to get enough folic acid is
by taking a supplement containing 400 micrograms of folic acid each and every day. Your
mother used to say, “Eat your vegetables!” Well, we agree, but we also want to add “And
take your folic acid.” A healthy diet that includes fruits and vegetables and enriched breads
and cereals is very important, but taking a supplement containing folic acid every day
should become as automatic as brushing your teeth or combing your hair. That way, we
can ensure that more babies are born healthy and don’t have neural tube defects.

[Matthew Reynolds] Well, thank you Dr. Boulet, for taking the time to talk with us about
this important topic.

[Dr. Boulet] It was my pleasure.

[Matthew Reynolds] Well, that’s it for this week’s show. Don’t forget to join us next week.
Until then, be well. This is Matthew Reynolds for A Cup of Health with CDC.

[Announcer] To access the most accurate and relevant health information that affects
you, your family, and your community, please visit www.cdc.gov.