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Sun, May 19, 2019

Birth Defects
The Health Benefits of Fruits and Vegetables



Neural tube birth defects occur when the neural tube – which eventually becomes the spinal tube – fails to close about three to four weeks after an egg is fertilized by sperm (112). When the neural tube fails to close toward the bottom, the child is born with spina bifida. If the problem occurs towards the top of the neural tube, the child is born without a brain (anencephaly), and usually dies soon after birth.


It is now proven that folic acid, a water-soluble B vitamin, can prevent neural tube defects such as spina bifida. The most substantial evidence comes from a randomized double-blind prevention trial in which folic acid showed a 72% protective effect in 1,817 women at high risk of having a pregnancy with a neural tube defect (113). Supporting evidence from a number of epidemiological studies is also available (114, 115), including one case-control study that found low dietary folate intake to be a risk factor for neural tube defects (116).


Scientific experts now estimate that half of all neural tube defects could be prevented if women were to consume the recommended intake of folic acid shortly before they conceive. Recommended intakes are 0.4 mg or 400 micrograms of folic acid a day for all women of childbearing age who are capable of becoming pregnant.


“… Scientific experts now estimate that half of all neural tube defects could be prevented if women were to consume the recommended intake of folic acid shortly before they conceive… Folic acid containing fruits and vegetables, along with fortified grain products, can play a vital role in meeting folic acid recommendations to prevent neural tube defects.”


In the United States alone, about 2,500 infants are born each year with spina bifida and anencephaly, and about 1,500 fetuses affected with these birth defects are aborted each year (117). The medical and emotional costs of having and raising a child with these disorders are enormous.


Although we now know that adequate folic acid intakes can prevent neural tube defects, the mechanisms responsible are not yet fully understood. Sources of folic acid from fruits and vegetables in our diet include green leafy vegetables, oranges, and orange juice, and dried beans such as pinto and navy. Beginning in 1998, U.S. grain products are being fortified with 430 to 1,400 micrograms of folic acid per pound of food item, providing us with an additional source of dietary folic acid.


Estimated daily intakes of folic acid, before fortification, fall short of dietary recommendations for women of childbearing age. However, recent work by Firth and colleagues suggest that women of childbearing age can achieve daily intakes of 400 micrograms, without supplementation, now that fortification is in place (118). This suggests that folic acid containing fruits and vegetables, along with fortified grain products, can play a vital role in meeting folic acid recommendations to prevent neural tube defects. Although the folic acid naturally occurring in fruits and vegetables is not as readily available as that in fortified foods or supplements, an important opportunity exists to more widely promote this health benefit of fruits and vegetables as one way to better insure adequate folic acid intakes.

 

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