Once a woman finds out she's pregnant, the questions begin."What should I eat?" "What should I remove from my diet?"—the list of answers can be long. So how do you cut through the noise to decide what's best for your baby and for you?
All of the science and research points to following a healthy balanced diet that provides an abundance of vitamins and minerals from whole and minimally processed sources to best support the baby's growth and development. Increasingly, there's more of focus on what you "can't have" as a pregnant woman. But as a registered dietitian, I tell my clients that what is consumed is as important as what is not consumed.
Often our diets don't meet our bodies’ nutritional needs—pregnant women need more of certain vitamins and minerals to help support the growing baby. Prenatal vitamins and supplements enriched with vitamin D, calcium, DHA, and other pregnancy-specific nutrients can be immensely helpful in prepping the body to be ready to conceive and supporting it throughout the pregnancy. Finding a prenatal with sufficient folic acid or to supplement with folic acid separately before getting pregnant is particularly important.
What is folic acid (and folate)?
Folic acid is the synthetic form of the B vitamin folate, and folate naturally occurs in food. Folic acid can be found in fortified foods and supplements. For women older than 19, the recommended dietary allowance for folate is 400 mcg daily. During pregnancy, the recommendation increases to 600 mcg daily and during lactation decreases slightly to 500 mcg.
Folic acid and birth defect prevention.
In the first weeks of pregnancy, embryonic development is fast and furious. Nerves are configured, organs begin to grow, and the neural tube forms, laying the pathway for later development of the brain and spinal cord.
If the mother is unaware of her pregnancy, she may also not know about her own nutritional deficiencies. At this developmental stage, a folate deficiency could result in a defect in the neural tube, a structure that becomes the baby’s spine. Neural tube defects (NTDs) are birth defects that negatively affect the spinal cord, spine, and brain. When the neural tube isn’t properly formed, it can result in spina bifida or anencephaly, two of the more commonly known NTDs.
When to take folic acid supplements.
In an effort to mitigate the adverse effects of having insufficient amounts of folic acid, the U.S. government began to require the supplementation of folic acid in grain-based foods in 1998. This was a public health measure to increase the population-wide consumption of folic acid as a widespread tool for decreasing the risk of NTDs. When someone consumes folate in food, the body uses energy for absorption in the gut, and it passively diffuses across the cell membrane. So when it comes to women who are of childbearing age, recommendations focus on supplementation along with dietary intake.
So women of childbearing age are recommended to supplement with 400 mcg of folic acid at least one month before conception and during the first four weeks of pregnancy, which can prevent up to 70 percent of NTDs. The risk for NTDs is highest during the first few weeks of the pregnancy. Once the neural tube is closed, the protective effects of folic acid supplementation wear off. Because the neural tubes close so early in pregnancy there are worldwide public health recommendations that strongly encourage all women in their childbearing years to supplement with 400 mcg folic acid daily to reduce the risk of NTDs. When it comes to folic acid, timing of supplementation is key to reaping its protective effects.
Some research suggests that vitamin C may boost folate absorption as a result of the protective antioxidant properties of vitamin C, so try taking it with your vitamin C or vitamin-C-rich foods.
Whole food sources of folate.
Any woman who is thinking about getting pregnant should know the CDC's recommendations and begin taking a prenatal vitamin with 400 mcg of folic acid at least three months before trying to get pregnant. This preconception time is a wonderful moment to re-examine and to take a good look at what is being consumed on a regular basis while continuing to incorporate well-balanced whole and minimally processed foods that provide an array of vitamins and minerals. It's a great way of showing your body and growing baby some love.
When thinking about obtaining folate from food sources, fresh is best. Because folate is a water-soluble vitamin, it can be subject to easy degradation. This means that supplemental folate may be easily broken down and/or become unstable as a result of extended storage and being exposed to heat such as in cooking, so keep that in mind when preparing your folate-rich foods. For the veggies, I would recommend shorter cooking times and methods that do not leach nutrients from the food. The most bioavailable plant-based food sources of folate are spinach, black-eyed peas, and fortified breakfast cereals. Liver provides more than 50 percent of your daily value for folate in one serving.
According to the USDA, here are some high-folate, whole food sources:
- 3 ounces of beef liver 215 mcg/serving
- ½ cup boiled spinach 131 mcg/serving
- ½ cup black-eyed peas 105 mcg/serving
- 1 serving fortified breakfast cereal 100 mcg/serving
- 4 spears of boiled asparagus 89 mcg/serving
- 1 cup romaine lettuce 64 mcg/serving
- ½ cup avocado 59 mcg/serving
Want to know more about prenatal supplementation? Check out our guide to prenatal vitamins and supplements.
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