Folic acid is a B-list celebrity in waiting
Unless you've been pregnant, you probably haven't heard of it. Yet research shows that folate, or folic acid (the synthetic form of folate found in fortified foods and supplements), is as important to general health as its more celebrated cousins, vitamin C, calcium, iron, and protein. Part of the B-vitamin family, today it's a routine part of prenatal care because of its role in the prevention of birth defects such as spina bifida.
Lifestyles, however, don't appear to be keeping up with the research. The risk of folate deficiency is on the rise, nutritionists say, a result of its near anonymity within the general population and the continued popularity of low-carbohydrate diets, which tend to prohibit foods rich in folates.
Thirteen percent of the population is on some type of low-carb regime such as the Atkins or South Beach diets, according to an August 2005 survey by U.S. polling company Opinion Dynamics Corporation. Other estimates put the statistic closer to one out of every nine or 10 adults in North America. A September 2004 Centers for Disease Control and Prevention report estimates that 48 percent of dieting women are on a low-carb diet.
Patricia Chuey is a registered dietitian, sports nutritionist, and founder of Eating for Energy, a Vancouver nutrition consulting company. In a phone interview, she told the Georgia Straight that although the popularity of low-carb diets, which became the "it" diets about four years ago, has waned somewhat, they are still a significant weight-loss choice among dieters looking for quick results. Unfortunately, these dieters might lose more than a few pounds in the process, because bread, pasta, and breakfast cereals, which are fortified with folic acid, are largely shunned by such diets. "If you're on a strict low-carb diet," Chuey said, "you're probably also avoiding legumes: the lentils, chickpeas, and kidney beans that are the best source of folates.
"Some purists might even be avoiding vegetables altogether," she added, "which means cutting out the green leafy veggies high in folates: romaine lettuce, spinach, asparagus, and Brussels sprouts." Fortunately, Chuey pointed out, most of today's low-carbers are on a less extreme version of the diet.
Folates aren't the only sacrifice, Chuey likes to remind people. "We need about 50 vitamins and minerals every day-many of them found in vegetables and fruit-for optimum health."
Folates, it appears, are particularly susceptible to being overlooked, though, despite being a key factor in the production of normal red blood cells-and, therefore, the prevention of anemia and poor growth in kids.
Research on folates is fairly recent, according to Chuey. It peaked in about 1997, when studies establishing a firm relationship between birth defects and folate deficiency led to the routine provision of folic-acid supplements to women actively planning to have babies. Further research, she said, started to establish links between the micronutrient and prevention of cardiovascular disease and certain kinds of cancer, including cervical and colon cancers, and, possibly, breast cancer. An article in the February 1998 issue of the Journal of the American Medical Association showed that folate and vitamin B6 protected women from developing coronary heart disease, reducing the risk by as much as 45 percent. A study in the June 2002 issue confirms the link between folates and the prevention of heart disease and certain cancers, and another in the January 2005 issue shows that women who consume more folates have a significantly reduced risk of developing high blood pressure, or hypertension.
Chuey thinks folates might be underappreciated because, unless they are pregnant and focused on the development of their fetus, people generally have a difficult time relating to something that operates at the cellular level, where folates do all their best work. "It's much easier to relate to calcium," she said, "which affects our bones, visible to the naked eye." Or to vitamin C, which benefits our bones and skin.
So how to make sure folates get the attention they deserve on our grocery lists? Chuey advocates variety when it comes to diet. "Don't limit yourself to six or so standard veggies; go beyond the carrots, cucumber, and celery to include the dark-green leafies," she suggested. And stock up on lentils, chick peas, and all kinds of beans. She also recommends taking a multivitamin containing 400 micrograms of folic acid, especially for people who are hit-and-miss with the high-folate foods. Women who are planning to get pregnant and people with heart problems should talk to their doctor about taking a folic-acid supplement. (Folic acid is most beneficial to the neurological development of a fetus 18 to 26 days after conception, when many women are unaware they are pregnant.) The generally recommended amount for healthy fetal development is 400 to 800 micrograms daily.
In the end, getting enough of all of the daily nutrients, including folate, may mean more than the right grocery list. Chuey believes it requires a change in attitude. "People need to focus more on what they should eat instead of what they shouldn't. You can easily avoid the bad stuff and still not be getting enough of the good stuff."
So shift gears. Next time you're at the grocery store, buy all the foods you should have first. Then head for the ice-cream freezer.