Folic acid is form of Vitamin B. It is also called as folate, the name being derived from the Latin word folia which means leaf. It is required in small amounts daily for all humans. It plays an important role in the manufacture of DNA within cells and helps in cell growth and development. However it assumes special importance in pregnancy. Studies have shown that those women, who consumed 400 micrograms or 0.4 milligrams of folic acid daily prior to conception and during the early months of pregnancy during the peak growth and development of the fetus, show a reduced risk of serious neural tube defects in the fetus, the risk being reduced by around 70 %. Neural tube defects develop in the first 28 days of pregnancy, as the growth of the neural tube, spinal cord, and brain occur during this period of conception. The most common neural tube defects that are seen are spina bifida which refers to incomplete fusion of the spinal cord, anencephaly refers to non development or poor development of the brain, and encephalocele which is a condition where there is incomplete closure of the skull and a part of the brain protrudes out to the skin through this abnormal opening of the skull. Thus any woman who is planning pregnancy must be given oral supplementation of folic acid and be continued through the initial months of pregnancy. As most cases of pregnancy are unplanned, it is wise that all women of childbearing age should get enough folic acid through diet or with the help of oral supplements.
Folic acid occurs in food in two forms as free folates and bound folates. The total folates are representing both the groups together. In man free folates are rapidly absorbed from the proximal part of the small intestine. The availability of the bound folates by the body is uncertain.
Sources of folic acid: It is found abundantly in green leafy vegetables such as spinach, asparagus. Egg yolks, milk, liver and liver products and kidney are rich sources of folates. Legumes such as beans, peas and lentils are also good sources. Moderate amounts are found in fruits like oranges, pineapples, melons, bananas, grapefruits and strawberries. It is also contained in vegetables like beets, corn, broccoli, lettuce and tomatoes. Overcooking destroys much of folic acid and thus contributes to folate deficiency in man. Several food items like breads, pastas, rice and breakfast cereals are fortified with 100% of the recommended daily folic acid allowance.
Diagnosis of deficiency can be done by measurement of serum and red cell folate concentration.
Deficiency: Deficiency may be common as a result of poor dietary intake. Overcooking of food also is another common cause of deficiency of folic acid. In pregnancy and lactation the requirements of all nutrients as well as that of folic acid is increased and hence deficiency is caused. Deficiency leads to megaloblastic anaemia, glossitis, cheilosis, gastrointestinal disorders like diarrhea, distension of the abdomen and flatulence. Severe forms of deficiency may cause infertility or even sterility.
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