A Recipe for Prenatal Nutrition: Folic Acid

Bettye Baxter, RNBettye Baxter, Research Nursing Supervisor at the Arkansas Center For Birth Defects Research and Prevention, discusses the importance of folic acid as a preventive measure against neural tube defects in newborns, and the best ways to cook foods to preserve their folic acid content.

Could you please tell us about yourself and your responsibilities/research at the Arkansas Center For Birth Defects Research and Prevention? 

Bettye Baxter RN, I am the Research Nursing Supervisor.  I oversee the various projects here at the AR center.  I manage, along with the other Project Coordinators, the Recruitment of subjects and collection of biological samples for the research studies.  I also oversee the standard operations of the various projects.   I am the representative for AR Center on the Arkansas Chapter of the March of Dimes Programs & Services Committee, and National Birth Defects Prevention Network (NBDPN), Neural Tube Defect & Folic Acid Education Committee.

Has medical research proven that Folic Acid is effective in preventing Neural Tube Defects?

Yes, clinical trial studies in the early 1990s have shown that women taking vitamins containing at least 400 mcg of folic acid before pregnancy reduced their risk of having a child with a birth defect, specifically neural tube defects. Since the U.S. has fortified grain and cereal products with folic acid in the late 1990s, we have observed a decrease in the overall occurrence of these birth defects in the birth population.

What foods are rich in Folic Acid? 

Green leafy vegetables and other vegetables like brussel sprouts, asparagus, & broccoli, beans, peas and lentils, oranges, strawberries, cantaloupe, and nuts contain natural folate. In the U.S., processed grains and some breakfast cereals contain fortified folic acid, which is thought to be the most advantageous for birth defect prevention.

Is Folic Acid destroyed during the cooking process?

Yes, it could be.  Most vegetables and fruit nutrients are concentrated just below the skin, so peeling before boiling increases the loss of nutrients.  A suggestion would be to consume fruits and vegetables in their raw form.  Thin peeling or scraping will preserve nutrients.
Root vegetables should be boiled with the skin on and then peeled afterwards to preserve nutrients.

In addition, about 40% of water soluble vitamin and mineral loss can occur when vegetables are soaked in water.  If soaking is necessary, use the water to prepare soups or gravies.

Believe it or not, microwave and pressure cooking are usually best at preserving nutrients in vegetables, because food cooks faster and requires no added water.  There is little nutritional loss when reheating leftovers or cooking frozen foods in the microwave.

Why should all women of childbearing age take the supplement? 

The preventive effects of folic acid work during the first few weeks of pregnancy, even before a woman can read a positive pregnancy test. We know from surveys of women who have delivered a baby that about half of all pregnancies are unintended. Thus, many women are becoming pregnant without planning to do so. By the time a woman has a confirmed pregnancy, these birth defects could have already occurred to the fetus. We would like to see all women who are capable of becoming pregnant taking folic acid to ensure that enough folic acid is reaching their baby during these early weeks of pregnancy.

Should a supplement be taken if one’s diet includes Folic Acid-rich foods?

Yes. We don’t know what the optimum dose of folic acid should be for women. In fact, some research is showing that there are varying levels for different groups of women. We would rather women have too much folic acid than too little until we know exactly how much is needed by each woman.


If you had to pick the most important feature of a recipe, what would it be?