1. Chapter 2

2. An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri

3. Also consider…. Taking a Multi-Vitamin containing Folic Acid

4. An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri

5. HOW MUCH FOLIC ACID SHOULD I TAKE? The recommended amount of folic acid is 0.4 milligrams (or 400 micrograms). This amount is present in most multivitamins. These amounts can be purchased without a prescription and do not cause medical harm in young, healthy individuals. An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri

6. Good Sources of Folic Acid

7. U.S. DIETARY SOURCES OF FOLATE Highest Contributors orange juice white bread dried beans eggs liver super-fortified cereals Richest Sources liver super-fortified cereals cold cereals asparagus spinach instant breakfast bran/granola cereals broccoli avocados Adapted from Am J Clin Nutr, 1989, Subar et al. An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri

8. WHEN SHOULD A WOMAN TAKE FOLIC ACID? All women of child-bearing capability should take folic acid. In order for folic acid to have a protective effect on the developing fetus, it must be in the woman’s system at the time of conception and during the first trimester. Since most pregnancies are unplanned and since many women do not know they are pregnant for 4-6 weeks, the window of opportunity to affect neural tube closure is missed if a woman begins taking folic acid when she learns she is pregnant. NEURAL TUBE DEFECTS: Caused by a chromosome abnormality, a genetic syndrome, or more commonly a combination of genetic and environmental factors. Neural tube closure takes place by day 28 of pregnancy. An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri

9. IMPORTANT! There is a 50-90% reduction in neural tube defects in mothers who get enough folic acid the first 28 days of pregnancy!

10. An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri

11. Reprinted by permission from The New England Journal of Medicine, 341[1999]:1509-1519. Features of Neural-Tube Development and Neural-Tube Defects An Ounce of Prevention  2000, 2005 The Curators of the University of Missouri