Folate deficiency primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Maintaining adequate folate level in the body, is the most effective approach to prevent folate deficiency in states of increased demand such as pregnancy.The source of folic acid to the body is diet. Consuming folic acid rich food will prevent folate deficiency.

Primary Prevention

Maintaining adequate folate level in the body, is the most effective approach to prevent folate deficiency in states of:

  • increased demand such as pregnancy and lactation
  • Malabsorption such as celiac disease
  • Chronic loss due to hemolytic disorder
  • Preconception folic acid supplementation in women can also prevent fetal neural tube defects.Therefore, preconception folic acid supplementation is recommended at a dose of 400-800 micrograms/day for women who are planning to or are capable of becoming pregnant, with higher doses (up to 4 mg/day) recommended for certain risk groups.[1][2]
  • Folic acid supplementation during pregnancy reduces megaloblastic anemia in mothers, but there is no conclusive evidence to suggest any beneficial effect on pregnancy outcomes e.g. preventing premature birth, stillbirth, neonatal mortality, or miscarriage.[3]
  • The best way to replenish the folate level in the body in by consuming folic acid rich diet.
  • Folate occurs naturally in the following foods:
    • Beans and legumes
    • Citrus fruits and juices
    • Wheat bran and other whole grains
    • Dark green leafy vegetables
    • Poultry, pork, and shellfish
    • Liver
  • The Institute of Medicine's Food and Nutrition Board recommends that adults should have 400 micrograms of folate daily.
  • Specific recommendations depend on a person's age, gender, and other factors (such as pregnancy).

References

  1. Centers for Disease Control and Prevention (CDC) (2010). "CDC Grand Rounds: additional opportunities to prevent neural tube defects with folic acid fortification". MMWR Morb Mortal Wkly Rep. 59 (31): 980–4. PMID 20703205.
  2. US Preventive Services Task Force. Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW; et al. (2017). "Folic Acid Supplementation for the Prevention of Neural Tube Defects: US Preventive Services Task Force Recommendation Statement". JAMA. 317 (2): 183–189. doi:10.1001/jama.2016.19438. PMID 28097362.
  3. Lassi ZS, Salam RA, Haider BA, Bhutta ZA (2013). "Folic acid supplementation during pregnancy for maternal health and pregnancy outcomes". Cochrane Database Syst Rev (3): CD006896. doi:10.1002/14651858.CD006896.pub2. PMID 23543547.

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