Despite years of public health campaigns
telling women who are capable of getting pregnant to take
in enough folic acid every day to prevent birth defects,
the message isn't getting through.
Fewer women are getting enough of the B vitamin, according
to a recent report from the March of Dimes. The number
of women in the United States taking folic acid supplements
to prevent birth defects dropped from 40 percent in 2004
to 33 percent this year, the report stated.
Other than repeating the message about the importance
of folic acid, most public health officials can't decide
what else might persuade women to follow the advice. But
at least one expert says that, perhaps, the focus should
shift to just a simple message to take your vitamins daily,
since most supplements contain adequate folate.
"I think it's basic education," said Dr. Tsunenobu Tamura,
a professor of nutrition science at the University of
Alabama at Birmingham, who has focused on folic acid in
his research. "If we are aware that it is important then
we tend to take it. It's awareness."
Taking 400 micrograms of folic acid, a vitamin crucial
for proper cell growth, every day can dramatically reduce
birth defects such as spina bifida and other problems
of the brain and spine. About 3,000 pregnancies a year
are afflicted with these problems, called neural tube
defects, according to the U.S. Centers for Disease Control
and Prevention.
To get that much folic acid isn't difficult -- you can
take a single vitamin pill or you can get it from folate-rich
foods, such as leafy green vegetables and citrus fruits,
or from folate-fortified foods like enriched breads and
cereals. Fortification of foods such as breads with folic
acid has been mandated since 1998 in the United States,
in an effort to boost folate intake.
Perhaps the message should emphasize how important it
is to take a daily multivitamin, said another expert,
Kathleen Yadrick, a professor of nutrition and food systems
at the University of Southern Mississippi in Hattiesburg.
She and her colleagues studied 100 black, female college
students to determine what would convince them to take
vitamins daily, since most vitamins contain the recommended
amount of folate.
"The essence of this research is that women are more
likely to pay attention to things that encourage them
to take supplements in general rather than just folic
acid," Yadrick said. She concluded that future campaigns
should stress taking vitamins, instead of focusing solely
on folate.
And how to remember to take that vitamin pill?
"First educate yourself about why you need to take it,"
suggested Dr. Siobhan Dolan, associate medical director
of the March of Dimes. "And then you might make it a higher
priority."
Dolan said women need to find a way to make taking a
multivitamin a daily habit, "such as take it at the same
time every day." Leaving the bottle of vitamins near something
associated with a morning ritual, such as a coffee cup
or a box of cereal, might help boost compliance, she said.
It's most important that all women of child-bearing age
follow the advice about multivitamins and folic acid because
many pregnancies are unplanned, Dolan said. "Do it not
just when you are thinking about getting pregnant, but
when you are of reproductive age," she said.
