CDC Urges Women
To Take Folic Acid

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

February 27, 1998

NEW YORK (Reuters) - Less than one third of American women of reproductive age are taking the recommended amount of folic acid in the form of a daily supplement, according to a report issued Thursday by the US Centers for Disease Control and Prevention (CDC) in Atlanta.

In 1992, the US Public Health Service recommended that all women of childbearing age who could potentially become pregnant should take 400 micrograms of folic acid daily, either through diet or by means of a supplement. Adequate amounts of folic acid reduce the occurrence of birth defects such as spina bifida, which affects the spine and spinal cord, and anencephaly, a lethal disorder affecting the brain and skull.

"The reason that all women between 15 and 45 years of age should consume enough folic acid is because half of all US pregnancies are unplanned, and birth defects of the spine and brain occur early in pregnancy before most women realize they're pregnant," according to a CDC statement.

In 1997, the March of Dimes commissioned the Gallup Organization to conduct a survey of American women, inquiring about their knowledge of the benefits of folic acid intake and their use of vitamins. About 50% of 2001 women between the ages of 18 and 45 contacted by telephone agreed to participate in the survey.

The survey found that 64% of the women took some type of vitamin regularly, but only 44% took one that included folic acid. Of those that took a supplement containing folic acid, only 32% took it daily.

Of women who had heard recommendations regarding daily folic acid intake, 45% took a supplement containing the nutrient daily, compared with 29% of women who had not heard the recommendation.

The survey also found that vitamin use was lowest among women in minority groups and those with low incomes. The majority of women (60%) who did not take a supplement daily said cost was the reason, and 58% of them said they needed more information on vitamin and mineral supplements.

From the study findings, CDC officials conclude that there is a need for more health education about the importance of folic acid and multivitamins in preventing birth defects. "In addition... providing multivitamins at reduced or no cost may enhance the consumption of multivitamins (among women of child-bearing age)," according to the CDC.

The CDC report notes that all enriched cereal grains are now required to be fortified with folic acid. To ensure getting the recommended amount of folic acid, "women will need to either take a folic acid supplement daily, eat a fortified breakfast cereal containing 100% of the daily value of folic acid, or increase their consumption of foods fortified with folic acid (e.g. cereal, bread, rice, and pasta) and food naturally rich in folates (e.g. orange juice and green vegetables."

But even with eating folate-rich foods, "...many women will not consume enough folic acid to prevent... birth defects. Taking a folic-acid containing supplement is the most effective way of ensuring a woman has an adequate intake of folic acid," advises the CDC.

About 4,000 US pregnancies are affected by birth defects of the spine and brain each year. The CDC estimates that 3,000 of these defects could have been prevented with adequate folic acid intake.

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SOURCE: Morbidity and Mortality Weekly Report (1998; 47: 131-133)

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