Hi , login or create a new account below

What is Folate / Folic Acid?

Folate is a B vitamin and is found naturally in leafy vegetables, citrus fruits, whole wheat bread, yeast, liver and legumes.

Folic acid refers to pteroylmonoglutamic acid and is the synthetic version of folate. Folic acid is used in dietary supplements and fortified foods.


Why do we need folate?

Folate is important in cell growth and reproduction. Folate deficiency can result in a type of anaemia called ‘megaloblastic anaemia’.

Studies have also found that if women planning their pregnancy take a folic acid supplement of 0.4mg daily for one month before conceiving and for 12 weeks after conceiving, they can reduce the risk of having a baby with a neural tube defect (NTD) by up to 50 percent.


What are recommended intakes of folate?

The recommended dietary intake of folate for adults is 0.2 mg a day. However, to prevent neural tube defects, women have to consume more than this (0.4 mg) – the easiest way to do this is through a folic acid supplement or to consume food that has been fortified with folic acid.


What is New Zealand's current policy on folic acid for reducing neural tube defects?

New Zealand's policy is to recommend that women planning a pregnancy should take 0.8 mg of folic acid daily for four weeks prior to conception and for 12 weeks after conceiving to reduce the risk of NTDs. Women who have had a child with a neural tube defect are recommended to take a higher dose of folic acid (5 mg) with subsequent pregnancies.

Since 1996 voluntary fortification of certain food products with folic acid has been permitted but apart from breakfast cereal manufacturers there has not been any significant uptake by the food industry.


Can we increase folate intake naturally?

Folate is found naturally in green leafy vegetables (such as spinach and broccoli), citrus fruits and juices, whole wheat bread and legumes. Animal liver is also a rich source of folate. However, it is difficult to get enough folate from natural sources to reduce the risk of neural tube defects in pregnancy as natural folate is not so easily absorbed as a folic acid supplement.

For example, if women relied on green leafy vegetables and fruit to increase their folate intake, they would have to eat the equivalent of 500g of raw spinach or 900g of boiled spinach or raw broccoli to get the amount needed to reduce the risk of having a baby with a neural tube defect.

Further information on eating well for pregnancy can be found the article entitled: Eating for Healthy Pregnant Women.


What are the current levels of folate in the New Zealand diet?

Approximately half of New Zealanders meet the recommended dietary intake of folate for adults. Women aged 25-44 years have an average intake of 0.213 mg, and this is not enough to reduce the risk of neural tube defects.


Why is mandatory fortification an option?

Although fortification is allowed, it is only voluntary and there has been poor implementation by the food industry. Only about 27 percent of women eat breakfast cereals which are the most common foods fortified. If fortification was mandatory it would mean that bread or flour which are consumed by approximately 90 percent of women would be fortified. Mandatory fortification also means that regulation is easier.

The key issue surrounding mandatory fortification is balancing the needs of the target group (women planning pregnancy) against ensuring excessive amounts are not consumed by the general population.

However, modelling done by the University of Otago suggests that even mandatory fortification is unlikely to result in more than 20 percent of women of childbearing age consuming over 0.4 mg of folic acid daily. Therefore in either a voluntary or mandatory fortification environment, the recommendation that women should consume a folate-rich diet and folic acid supplements should continue.


Are there any adverse effects to taking folic acid?

High doses of folic acid are not known to have any adverse effects on healthy individuals. There is however concern that high levels of folic acid may result in the masking of vitamin B12 deficiency in certain groups such as the elderly, thus delaying diagnosis. Masking of vitamin B12 deficiency is unlikely to occur if intakes of folic acid are less than 1 mg a day.


What do other countries do?

The US and Canada are among the few countries that have implemented mandatory fortification of flour products while Australia and the UK have a similar policy to New Zealand which permits voluntary fortification.


What is a neural tube defect (NTD)?

Neural tube defects are a major group of birth defects and mean that the brain, spinal cord, or the covering of these organs has not developed properly. Spina bifida and anencephaly are the most common types of neural tube defects.

Babies born with anencephaly have underdeveloped brains and incomplete skulls. Most infants born with anencephaly do not survive more than a few hours after birth.

Spina bifida, is the most common NTD. It results from the failure of the spine to close properly during the first month of pregnancy. Children with spina bifida can have varying degrees of paralysis of their lower limbs – some children can be confined to a wheelchair whereas others have almost no symptoms at all. The condition can also cause bowel and bladder problems.


How common are neural tube defects in New Zealand?

In 1999 NTDs were found in five per 10,000 total births (live births and stillbirths). Approximately 20 to 30 children with spina bifida are born each year.