So, you’re ready to conceive a baby? Congratulations! Seems it’s time to start preparing your body for the 40 weeks following conception and give your little one the best possible start in life. You might be wondering when you should start supplementing folic acid into your care regime, how long to take it, in what amount, and why this is so important. Below you’ll find my all-inclusive guide to prenatal folic acid.
First, What’s the Difference Between Folate and Folic Acid?
Before you start down this journey of prenatal care, it’s important to understand the difference between folate and folic acid, which are commonly believed to be the same compound. But they’re not! In actuality, folate is an organic group of water-soluble b-vitamins (various tetrahydrofolate derivatives) known as B9. Folate can be found, naturally occurring, in green leafy vegetables and other whole foods. Folic acid, on the other hand, is the common term used to describe the synthetic compound (pteroylmonoglutamic acid) used in dietary supplements and in food fortification. A simple way to look at it is that folate occurs naturally while folic acid does not.
Why is This Nutrient Particularly Important for Women Trying to Conceive?
If you don’t have enough folate while trying to conceive and during early pregnancy, the outcome can be very detrimental to your babies health. B9 deficiency is linked to anaemia, certain cancers, cardiovascular disease, and Neural Tube Defects (NTDs) in early embryo development. The most common NTD (with an overwhelming amount of research linking this condition to a lack of dietary folate during pregnancy) is spina bifida. To ensure that your unborn child has everything it needs to thrive, getting twice the normal intake of B9 is crucial immediately before pregnancy.
How the Body Processes Folate vs Folic Acid
Folate is metabolized to THF in the lining of the small intestine, after which it can be utilised by the body. Folic acid is different. It must be processed in the liver where an enzyme called ‘dihydrofolate reductase’ converts it to THF. Unfortunately, this enzyme isn’t very efficient. This combined with the unnaturally high intake of folic acid (due to fortification and supplements) means that some folic acid doesn’t get converted to THF and enters our blood stream as unmetabolised folic acid. This is where the problem lies.
Advantages and Disadvantages of Folic Acid Supplements and Fortification
Australia, along with other countries around the world, has mandated folic acid food fortification in all flours and breads (other than that labelled “organic” or those not containing wheat flour). Many breakfast cereal manufacturers opted-in, voluntarily, to enrich their products with folic acid and use this as a selling point. This happened because NTDs can occur during the early stages of pregnancy, before a woman even knows that she has conceived. Since the introduction of fortification, the amount of NTDs has decreased. This is great news but unfortunately the risks associated with overconsumption of the synthetic version of B9 compounds, are very rarely discussed and often overshadowed by clever marketing.
The potential side effects of folic acid include abdominal cramps, diarrhea, rash, sleep disorders, irritability, confusion, nausea, stomach upset, behavioural changes, skin reactions, seizures, gas, excitability, and an increased risk of heart attack and cancer. Getting too high a dose can pose serious health threats. For this reason I recommend eating real foods as your first option, because you avoid the risks and reap the benefits of cofactors not included in supplements. Remember that Mother Nature is smarter than us!
What Are Some Whole Food Sources & How Much Do You Need?
Below are 7 excellent real food sources of folate. Increase your intake of these foods to ensure you’re getting adequate amounts. A healthy adult requires 400 mcg, and a pregnant woman should aim for 800-1200 mcg daily.
Lentils: 1 cup = 358.38 mcg, 45% DV
Asparagus: 1 cup = 268.20 mcg, 33.5% DV
Spinach: 1 cup = 262.80 mcg, 33.3% DV
Turnip Greens: 1 cup = 169.92 mcg, 21% DV
Broccoli: 1 cup = 168.48 mcg, 21% DV
Beets: 1 cup = 136 mcg, 17% DV
Romaine Lettuce: 2 cups = 127.84 mcg, 16% DV
The daily value (DV) percentages above are based on an 800 mcg dietary intake – the amount needed during pregnancy.
What About Folate Supplements?
Ladies, I know how you work; you want to know about supplements (i.e. the easy route) right? First, a disclaimer: if you do choose to take prenatal supplements, check the label to ensure that you’re supplementing with real folate, NOT folic acid. By doing this, you will avoid the potential risks discussed above. Here are some good options.
Frequently Asked Questions About Folate by Mothers-to-Be
Anyone who has decided to conceive is excited, and should be able to rest easy knowing that they are doing everything they can to ensure a healthy pregnancy and a happy baby. Here’s what mothers are asking. I’ve taken the guesswork out of it for you.
So, when should you start increasing your intake of folate and/or supplementing?
A: It’s ideal to start several months prior, aiming to consume 800-1200mcg daily. If you are already trying and/or are pregnant, I would suggest supplementing with 600-800mcg per day.
And, how long should you continue with the increased amount?
A: Throughout pregnancy, for 6-12 weeks after delivery, and for as long as you are breastfeeding.
But, how much folate is too much when you are pregnant?
A: The body does not store whole food derived folate, so it is perfectly safe — too much folic acid can be harmful, though.
Remember that even during the earliest stages of pregnancy, rapid cell duplication is taking place, and your baby needs proper nutrition now more than ever. Consult with your midwife, naturopath, or health care practitioner (as soon as you make this exciting decision) to discuss any health concerns you may have.