Folate deficiency primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Primary Prevention
- Folic acid supplementation can prevent folate deficiency in states of increased demand (e.g., pregnancy and lactation) and in conditions with folate malabsorption (e.g., celiac disease) or loss (e.g., chronic hemolytic disorder). Preconception folic acid supplementation in women can also prevent fetal neural tube defects.
- 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.
- There is conclusive evidence that use of folic acid supplementation preconceptually and during pregnancy can prevent fetal NTDs. 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.
- The best way to get the daily requirement of all essential vitamins is to eat a balanced diet that contains a variety of foods from the food guide plate. Most people in the United States eat enough folic acid because it is plentiful in the food supply.
- 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.
- Women capable of becoming pregnant should receive this amount with folic acid supplements, not just fortified foods, to ensure the proper daily intake.
- Specific recommendations depend on a person's age, gender, and other factors (such as pregnancy). Many foods now have extra folic acid added to help prevent birth defects.