Women Are Missing the Folic Acid Message

Too few consume the B vitamin, which helps prevent birth defects

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By Kathleen Doheny
HealthDay Reporter

SUNDAY, Dec. 4, 2005 (HealthDay News) -- Too many women of child-bearing age just don't get it -- folic acid, that is.

Despite years of public health campaigns telling women who are capable of getting pregnant to take in enough folic acid every day to prevent birth defects, the message isn't getting through.

Fewer women are getting enough of the B vitamin, according to a recent report from the March of Dimes. The number of women in the United States taking folic acid supplements to prevent birth defects dropped from 40 percent in 2004 to 33 percent this year, the report stated.

Other than repeating the message about the importance of folic acid, most public health officials can't decide what else might persuade women to follow the advice. But at least one expert says that, perhaps, the focus should shift to just a simple message to take your vitamins daily, since most supplements contain adequate folate.

"I think it's basic education," said Dr. Tsunenobu Tamura, a professor of nutrition science at the University of Alabama at Birmingham, who has focused on folic acid in his research. "If we are aware that it is important then we tend to take it. It's awareness."

Taking 400 micrograms of folic acid, a vitamin crucial for proper cell growth, every day can dramatically reduce birth defects such as spina bifida and other problems of the brain and spine. About 3,000 pregnancies a year are afflicted with these problems, called neural tube defects, according to the U.S. Centers for Disease Control and Prevention.

To get that much folic acid isn't difficult -- you can take a single vitamin pill or you can get it from folate-rich foods, such as leafy green vegetables and citrus fruits, or from folate-fortified foods like enriched breads and cereals. Fortification of foods such as breads with folic acid has been mandated since 1998 in the United States, in an effort to boost folate intake.

Perhaps the message should emphasize how important it is to take a daily multivitamin, said another expert, Kathleen Yadrick, a professor of nutrition and food systems at the University of Southern Mississippi in Hattiesburg. She and her colleagues studied 100 black, female college students to determine what would convince them to take vitamins daily, since most vitamins contain the recommended amount of folate.

"The essence of this research is that women are more likely to pay attention to things that encourage them to take supplements in general rather than just folic acid," Yadrick said. She concluded that future campaigns should stress taking vitamins, instead of focusing solely on folate.

And how to remember to take that vitamin pill?

"First educate yourself about why you need to take it," suggested Dr. Siobhan Dolan, associate medical director of the March of Dimes. "And then you might make it a higher priority."

Dolan said women need to find a way to make taking a multivitamin a daily habit, "such as take it at the same time every day." Leaving the bottle of vitamins near something associated with a morning ritual, such as a coffee cup or a box of cereal, might help boost compliance, she said.

It's most important that all women of child-bearing age follow the advice about multivitamins and folic acid because many pregnancies are unplanned, Dolan said. "Do it not just when you are thinking about getting pregnant, but when you are of reproductive age," she said.

More information

To learn more about folic acid and preventing birth defects, visit the March of Dimes.

SOURCES: Siobhan Dolan, M.D., associate medical director, March of Dimes, White Plains, N.Y.; Kathleen Yadrick, Ph.D., professor of nutrition and food systems, University of Southern Mississippi, Hattiesburg; Tsunenobu Tamura, M.D., professor of nutrition science, University of Alabama at Birmingham

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