Q: Since getting married, I have been on birth control and have followed a low-carbohydrate diet. My husband and I are now ready to start a family and my physician encouraged me to increase folate in my diet and as a supplement before coming off birth control to prevent birth defects.

I know that folate is found in fruits and vegetables, so why would following a low-carb diet increase my risk for birth defects?

A: Folate deficiency has a strong link to birth defects, namely Spina Bifida. Because this birth defect often develops within the first weeks of pregnancy, before one knows she is pregnant, increasing folate before getting pregnant is highly recommended.

While you are correct that folate is commonly found in fruits and dark-green leafy vegetables (as well as whole grains, dried peas and beans) the women of child bearing age frequently do not eat adequate amounts of these to get the needed amount of folic acid.

As a way to reduce birth defects, folate has been added to many grain products such as enriched pasta, rice, waffles and cereal bars but with the increase of low-carb dieters, there is a concern that these women may have increased risk of birth defects.

So, if planning to get pregnant or not, it is recommended that all women of child-bearing age, 15 to 45, increase folate in dietary sources. They also should speak to their physician about a multivitamin/mineral supplement that contains folic acid.

Things to remember:

· The FDA’s Daily Value for folic acid is 400 micrograms for non-pregnant women, as well as children four years of age and older as well as for adult men. For pregnant women, the Daily Value jumps to 800 micrograms. The FDA has set 1 mg (or 1,000 micrograms) of folate daily as the maximum safe level.

· Certain forms of epilepsy whose effectiveness can diminish when taken with high intakes of folate.

List on the label’s Nutrition or Supplement Facts panel the amount by weight in micrograms and the percentage daily value of folate per serving of the product. This information, which appears toward the bottom of the panel, along with the listing of other vitamins and minerals, can be used to compare folate levels in various foods and supplements.

· Folate occurs naturally in a variety of foods including liver, dark-green leafy vegetables, broccoli and asparagus, citrus fruits and juices, whole-grain products, wheat germ and dried beans and peas, such as pinto, navy beans, lima beans, chickpeas and black-eyed peas.

Under the FDA's folic acid fortification program, manufacturers must add 0.43 mg to 1.4 mg of folic acid per pound of product to enriched flour, bread, rolls and buns, farina, corn grits, cornmeal, rice and noodle products.

A serving of each product will provide about 10 percent of the daily value for folic acid. Whole-grain products do not have to be enriched because they contain natural folate. Some of the natural folate in non-whole-grain products is lost in the process of refining whole grains.

For more information about having a healthy baby, contact: March of Dimes Birth Defects Foundation, 1275 Mamaroneck Ave., White Plains, NY 10605, (914) 428-7100. Voice mail only at (914) 997-4750 or visit www.modimes.org.

For nutritional counseling, Norman Regional Health System offers the guidance of registered dietitians. Those interested can schedule an appointment for an assessment with a referral from their family physician.

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