Thursday, August 7, 2008

Studies Say Most Women Still Unaware of Importance of Folate Supplementation

Just the other day I saw something I had never seen before – a public service announcement on the side of a bus encouraging women to supplement their diets with folic acid. I was glad to see that the importance of supplementing with this vital nutrient is going mainstream.
Even so, studies show that the majority of U.S. women of childbearing age do not comply with government requirements to take a daily supplement of folic acid.

Folic acid and folate are two forms of vitamin B-9, and sufficient levels are required for the proper development of the fetal nervous system. Low maternal levels of folate can cause neural tube defects, including brain and spine abnormalities that can lead to disability or death.Because the neural tube develops within the first weeks of pregnancy - before women typically realize that they are pregnant - it is important that women of childbearing age maintain sufficient levels of folate at all times.Two studies published in the Journal Morbidity and Mortality Weekly Report highlight folic acid intake as a continuing maternal health issue.

In the first, researchers from the Centers for Disease Control and Prevention (CDC) analyzed the results of Gallup surveys conducted between 2003 and 2007 to determine women's awareness, knowledge and use of folic acid supplements. All women surveyed were between 18 and 45 years of age. Excluding those with confirmed pregnancy, no more than 48 percent of women in any one age group took a folic acid supplement daily. Rate of supplementation was lowest among women between 18 and 24, ranging between 25 and 31 percent. Women between 18 and 24 also had the lowest awareness and knowledge about the importance of folic acid for healthy pregnancy.

In the second study, researchers from the CDC and the Puerto Rico Department of Health compared folic acid knowledge and consumption with the occurrence of neural tube defects among Puerto Rican women between 18 and 44 years of age between 1996 and 2006. In 1997, only 22.4 percent of women surveyed were aware of the importance of folic acid, and only 20.4 percent used supplements. These numbers rose to 70.2 and 30.9 percent respectively by 2003, but had fallen to 56.5 and 24.8 percent by 2006. The occurrence of neural tube defects among Puerto Rican children fell between 1997 and 2003, and has remained steady since then.

Folic acid is important not only for prevention of neural tube defects, but also for prevention of various cancers. It is a major player in the prevention of heart disease, and deficiencies have been shown to be involved in depression and other neurological conditions. In light of the vital role that folate plays in our health, and in consideration of how many women (and men) still don’t understand its importance – at least not enough to actually begin taking it, it seems imperative that practitioners begin promoting its use among their patients.

The Right Form
Folate in the form of folic acid is effective in many people, but research has shown that there is a significant portion of the population that cannot metabolize folic acid in that form. Folic acid must be metabolized through five biochemical processes from an enzyme called, L-5-methylenetetrahydrofolate reductase (I must really be a nerd because I didn’t even have to look that up to spell it!) into the end metabolite called, 5-methyltetrahydrofolate (5-MTHF). Because of specific genetic mutations referred to as single-nucleotide polymorphisms, as much as 40% of the adult female population is missing the L-5-methylenetetrahydrofolate reductase enzyme, and therefore cannot metabolize folic acid. However, the enzymatic processes leading to conversion of folic acid can be bypassed entirely by supplementing with the end metabolite – 5-MTHF – instead of using folic acid.
NOTE: Refer to the ingredient index in the back of your product catalog to find 5-MTHF-rich products.