Folic Acid : Every Woman, Every Day.


This post is based on a session I attended at the Iowa Governor’s Conference on Public Health in April 2013 by the Siouxland District Health Department. For More posts from the Governor’s Conference, click here.   For presentation slides, click here.

Folic Acid can help prevent strokes, heart disease, colon cancer, cervical cancer, and even possibly autism. Benefits also include increasing academic performance, decrease of Alzheimers, and increase in sperm count and quality. Also- Folic acid improves the health of your hair and nails!

Folate vs Folic Acid

  • Folate – natually in foods, leafy green veggies, orange juice, nuts, seeds, beans
    needs to be processed by body
  • Folic Acid – synthetic, fortified grains, vitamin supplements, better absorbed
  • about 50% of folate is absorbed
  • about 85% of folic acid is absorbed

Folic Acids – Basics

  • B Vitamin
  • Involved in DNA synthesis/mitosis
  • Especially vital in first 4 weeks of pregnancy
  • 2/3 of women dont get enough folic acid. Most people get some in their diet, not all fortified cereals have 100%


Birth defects related to lack of folic acid:
Neural Tube defects (NTDs)
Neural Tube forms spine/brain/skull in first 4 weeks of a pregnancy. NTDs are result of when nerual tube/fold doesn’t close correctly
Adequate folic acid can prevent 50-70% of NTDs if levels are adequate in first month of pregnancy.

  • Spina Bifida – may cause paralylsis / bowel or bladder control – most survive into adulthood
    Average lifetime cost for amilies is over $600,000. Caregiver costs alone are over $164,000 until age 25
  • Acencephaly – neural tube doesnt close correctly and parts of brain are missing. Most children are stilborn or die shortly after birth. 25% live up to 10 days.

Cleft Lip and Palettes
18-50% reduction of these if folic acid intake is adequate

Women’s knowledge of folic acid is very low.

  • 80% have heard of it.
  • 21% know it can prevent birth defects and only
  • 11% know it should be taken before pregnancy

Folic Acid and Public Health

  • -1930s we found out it can prevent anemia
  • 1998 -US begins to fortify foods – this increased folic acid by 190 mcg /day which decreased NTDS by 25-30% The economic estimate is $312-425 MILLION in savings each year.
  • From 2004 – 2007, more countries are fortifying grains with folic acid. It has increased from 33 to 52 countries. When Chile implemented this, their NTDs decreased by 50%.

To increase understanding and supplementation of Folic acid

  • Siouxland WIC reviewed OTC supplements, did an outreach to area healthcare offices, and had billboards made.
  • They had a OTC vitamin comparison on fortification of folic acid.Supplements are not always equal! They are minimally regulated by the FDA.
  • Education was provided to all health professionals and presented to 16 clinics, residents, and their own staff. Included information on where to obtain posters and handouts (CDC), the folic acid recommendation, and suggest to designate a folic acid ‘champion’ in each office.
  • Promoted to Health Occupation Students of America.(HOSA) Their local group is going to their own students and presenting folic acid information
  • They have seen an increase, especially in post-partum daily supplement use (44% to 55%)

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