Key Findings: Are Women Getting Enough Folic Acid?

Folic acid is a B vitamin that the human body uses to make new cells. Folic acid is also very important because it can help prevent some neural tube defects (serious birth defects of a baby’s brain or spine). The Centers for Disease Control and Prevention (CDC) urges women ages 15 to 45 years to get 400 micrograms (mcg) of folic acid every day, starting at least one month before getting pregnant, to help prevent neural tube defects. Women can get folic acid through three main sources:

Fortified enriched cereal grain products, like flour, bread, and pasta if they are labeled as enriched,

Fortified ready-to-eat cereals, like breakfast cereals and

Dietary supplements, like multivitamins.

Adding folic acid to foods in the United States has helped prevent about 1,300 neural tube defects each year, but about 3,000 neural tube defects still occur every year. Some neural tube defects are caused by reasons other than folic acid intake. However, not getting enough folic acid is one reason why some neural tube defects still occur.

Research shows that some women are still not getting enough folic acid in their diets to lower the risk of a neural tube defect. A study from the CDC found that consuming folic acid from a combination of sources

1. Helps women to get the recommended amount of folic acid in their diet and
2. Can prevent more neural tube defects each year.

The results from this study show that getting 400 mcg of folic acid every day can lower the risk of having a pregnancy affected by a neural tube defect.

Read the full scientific article.

Main Findings

• For most women, taking 400 mcg of folic acid every day helps to lower the risk of having a pregnancy affected by a neural tube defect.
• When taking supplements, a higher dose than 400 mcg of folic acid daily is not necessarily better to prevent neural tube defects, unless a doctor recommends taking more due to other health conditions.
• About half of the women in this study reported eating enriched cereal grain products as their only source of folic acid, and they had lower daily folic acid intake, lower levels of folate in their blood and a higher predicted risk for a neural tube defect than women who consumed folic acid from a combination of sources.
• For these women, adding other sources of folic acid, like ready-to-eat cereals and supplements, to their diet might prevent up to 700 more birth defects in the United States each year.

About This Study

• CDC researchers used data for non-pregnant women 12 to 49 years of age from 2007 to 2012 National Health and Nutrition Examination Surveys (NHANES).
• NHANES assesses the health and nutritional status of adults and children in the U.S.
• In this study, researchers used NHANES data and known relationships between neural tube defects risks and blood folate to predict the number of neural tube defects that could be prevented each year.

About CDC’s Folic Acid Recommendations

CDC recommends that women 15 to 45 years of age get 400 mcg of folic acid every day to prevent some serious neural tube defects. Learn more about CDC’s folic acid recommendations.

Our Work

CDC’s National Center on Birth Defects and Developmental Disabilities is working to understand folic acid and its relationship to birth defects by:

1. Tracks Birth Defects

CDC works with state birth defects programs to track the number of babies born with spina bifida and other birth defects in the U.S. CDC reports these numbers every year.

2. Conducts Research

CDC conducts research on birth defects through the National Birth Defects Prevention Study, National Health and Nutrition Examination Survey, Behavioral Risk Factor Surveillance System, and Pregnancy Risk Assessment Monitoring System.

3. Develops Programs

Birth Defects COUNT is CDC’s global initiative to reduce death and lifelong disability resulting from birth defects of the brain or spine.

Learn more about what CDC is doing.

More Information

• For more information about folic acid: https://www.cdc.gov/ncbddd/folicacid/index.html
• For more information about birth defects: https://www.cdc.gov/ncbddd/birthdefects/index.html
• For more information about Birth Defects COUNT: https://www.cdc.gov/ncbddd/birthdefectscount/index.html
• For answers to frequently asked questions about folic acid: https://www.cdc.gov/ncbddd/folicacid/faqs/index.html

Key Findings Reference

Crider, K. S., Qi, Y. P., Devine, O., Tinker, S. C., & Berry, R. J. (2018). Modeling the impact of folic acid fortification and supplementation on red blood cell folate concentrations and predicted neural tube defect risk in the United States: have we reached optimal prevention? The American Journal of Clinical Nutrition. doi:10.1093/ajcn/nqy065