Many young women may have been advised by their gynaecologist to take folic acid supplements if considering having a baby in the near future. Let’s take a look at the reasons why there is all the hype around this supplement.
Folate is one of the B vitamins, namely Vitamin B9. It is a naturally occurring B vitamin found in a variety of foods, which the body is unable to produce itself, making it an essential vitamin. Its function is to assist the body in making DNA, RNA, for cell division and in metabolising amino acids. Folic acid is a synthetic form of folate which can be incorporated into the diet via supplementation.
The recommended daily allowance (RDA) of this vitamin increases by 50% in pregnant women. It is suggested that supplementation of 400–800ug takes place 2 months prior to conception and continues right through pregnancy (Danielewicz et al. 2017). Most pregnancy vitamins contain 500ug of folic acid.
Why then, is this vitamin so essential to young women of a fertile age?
The most important reason is to prevent neural tube defects (NTD) in the growing foetus (Lassi et al. 2013). The most common NTD is spina bifida, which is an abnormality resulting due to failure of the neural tube (which forms part of the spinal cord) to close properly. This may result in paralysis and sensory loss of the lower limbs resulting in the child requiring assistive devices to help with mobilisation. It was discovered that women with a red blood cell folate concentration of below 1000 nmol/L were most at risk for having an infant with this congenital abnormality.
A large study done in China (1993–1995) showed a dramatic decrease in NTD with folic acid supplementation (Crider et al.2014). This lead to food fortification of breads, grains and cereals with folic acid in countries such as Chile, USA and South Africa which decreased the incidences of NTD by at least 50% (AAP).
A Cochrane review discovered that folic acid supplementation increased a women’s pre-delivery serum folate levels and allowed for much fewer incidences of megaloblastic anaemia during pregnancy. Megaloblastic anaemia is when abnormal red blood cells are produced due to insufficient folate available to the body to assist in making DNA for the cells. Symptoms may include fatigue, shortness of breath, increased heart rate, nausea and muscle weakness. Pregnant women are at risk of folate deficiency and megaloblastic anaemia due to large amounts of folate being used by the body to accommodate the rapidly dividing cells. Hence another reason why supplementation is so important.
According to Patrick Holford in his book The Optimum Nutrition Bible, signs that you may be deficient in folate are anaemia, eczema, cracked lips, anxiety or depression, poor memory, lack of energy and poor appetite.
Unfortunately today it is very difficult to meet the requirements of 500ug in our food substances which is why it is suggested that all women that are pregnant or planning to conceive begin taking this vitamin. Embryologically, the neural tube is formed as early as 4–6weeks gestation which is why it is so important that the mother has the correct levels even before fertilization has taken place.
Of course, we can also do our part in eating foods rich in folate to give us the extra boost we need for optimal levels of this wonder vitamin. Foods rich in folate are wheat germ, leafy greens such as spinach and kale, avocados, broccoli, cauliflower, asparagus, sesame seeds, peanuts and sprouts to name a few.
Four easy tips for increasing your body’s folate supply:
1- A quick & easy On-The-Go smoothie: Add plain yoghurt, one banana, frozen baby spinach leaves, a tablespoon of wheat germ (sold at any health food shop), a teaspoon of sesame seeds & a handful of macadamia nuts. Blend together in a nutribullet/smoothie- maker with your choice of milk (cows milk, almond milk or soya milk).
2- Take a lunch break from work and assemble a quick broccoli salad with peanut dressing. Chop up two small broccoli heads and two small seedless cucumbers. Add olive oil & top with cranberries and chopped coriander. For the dressing mix together 1/4cup sugar-free peanut butter, a tablespoon of soya sauce, two tablespoons of rice wine vinegar, a teaspoon of honey and a teaspoon of sesame oil. Add some finely grated ginger, mix into the salad and enjoy a simple tasty lunch rich in folate.
3- Grab yourself a multivitamin and check to see that it includes at least 500ug of folic acid per tablet per day.
4- Excessive consumption of alcohol can cause folate deficiency so it is also a good idea to only have those much needed glasses of wine (if you are not yet pregnant) in moderation.
In conclusion, through extensive research and development into modern medicine, a simple, cheap and effective solution has been discovered and is available for a healthier pregnancy for mother and baby. All pregnant ladies and those considering starting a family, use this simple piece of advice, provided to us after years of hard work, and take the initiative to optimise your health.
“Our children are the rock on which our future will be built, our greatest asset as a nation” (Nelson Mandela, 1995). This famous quote says it all regarding the investment we make into childhood health and development. We need to provide our children with a solid foundation to ensure that they are able to live successful, healthy and productive lives, which will ultimately help to populate a better South Africa.
We are targeting malnourished children to ensure optimal health with numerous programmes across the country, but on the opposing side we are also faced with the growing trend of childhood obesity.
What are the implications of this and how can we take the time to make a difference?
Obesity is associated with a rise in non communicable diseases such as insulin resistance, diabetes, heart disease and strokes to name a few. (The Hybrid Diet by Patrick Holford & Jerome Burne). These diseases place an additional demand on our exhausted health care services, overcrowding our hospitals and increasing health care costs. This is why it is so important to implement correct nutrition and promote regular physical activity from a young age. We need to start how we would like to finish.
According to the South African National Health and Nutrition Examination Survey (NHANES-1) conducted in 2012, the prevalence of obesity and excessive weight gain in children is increasing, making it a cause of concern for public health.
The reasons for weight gain in children are multi-factorial as they can range from genetic, social, environmental and psychological causes (Mchiza et al. 2013). The key is to address these early on so that this doesn’t result in further complications into adulthood.
Physical activity implemented from a young age can decrease the risk of childhood obesity. The increase in the use of screen time is preventing children from being appropriately active. A statitsitc from the HAKSA Report 2018 in SA states that on average children spend more than 3 hours per day looking at screens, excluding during school time and more television time is related to weight gain. This is not only due to a more sedentary lifestyle but also due to the increased advertising on unhealthy foods, encouraging children to partake in this type of snacking.
A study conducted in Stellenbosch showed that children whose mothers’ had long working hours were at increased risk of being overweight or obese (Kirsten et al. 2013). This may be due to the fact that working mothers don’t have time to prepare home-cooked meals with more wholefoods than refined substances. Today, even in South Africa, we have quick and easy access to meals via takeaways and fast foods, uber eats or even supermarket pre-made meals. Unfortunately most of these are very high in salt, sugar and preservatives and can contribute to high cholesterol, raised insulin levels and ultimately excessive weight gain. Unlike in the past, most parents need to work full time to provide for their families so we need to find a solution to incorporate healthy eating even in a busy lifestyle.
What small alterations can parents make to keep their children at a healthy weight and provide them with a beneficial start to grow on into adulthood?
Let’s take a look at a few tips: