25 March 2009

Pills for Pregnancy
Dietitians support supplementary measures to tell mums-to-be about folic acid pills

Dietitians are warning that women in the UK continue to risk Neural Tube Defect (NTD) affected pregnancies because they are not aware of official Department of Health advice given 16 years ago, which recommends women intending to become pregnant should take folic acid supplements from preconception.
 
A major study just published in the Journal of Human Nutrition and Dietetics has reported on the folic acid awareness and practices of over 400 newly pregnant women in East London, and found only one-in-eight (12%) women took folic acid pills preconception. The study was lead by Dr Louise Brough, researcher, at the Homerton Hospital in East London.

Dr Gail Rees, dietitian researcher with the East London project, said: “Folic acid is really important very early on in foetal development, especially as the neural tube closes within a month of conception, and having a good level of folate (folic acid) in the blood of the mother has been shown to prevent foetal defects such as spina bifida.”

The researchers were alarmed that so few of the women in the East London study benefited from the well documented protective effects of folic acid supplementation.

The study found that while three quarters of the pregnant women reported using folic acid supplements, in most cases this was after the period of neural tube closure of the foetus, and that only 12% of the mothers would have had the protective benefits of the supplementation. Blood tests confirmed the lowest levels of red cell folate in women who did not take supplements, higher levels in women who started after pregnancy confirmation, and the highest levels in women who started, as advised, preconception.

There were distinct social and ethnic differences in optimal supplementation practices. Caucasian women were twice as likely to take folic acid preconception (19%) compared to West Indian (8%) or African (5%) women. Women over the age of 30 years, and women with higher incomes or who had attained a higher level of education, were also more likely to have acted on the Department of Health advice to take supplements.

The study calls for clarification and a renewed focus of the health message. Dr Rees added: “There has to be a clear message about the importance of taking folic acid preconception. All women in a position to become pregnant should take folic acid supplements. While increasing intakes of foods rich in folate such as green vegetables, beans or oranges and increasing intakes of foods fortified with folic acid - some breakfast cereals, yeast extract - is helpful, it is not as effective in raising blood folate levels as taking supplements”.

The recommended dose of extra folic acid is 400 micrograms per day.

The BDA is about to launch a new fact sheet on diet and pregnancy as part of the Food Facts series of information on topical diet and health issues.

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Media enquiries to the British Dietetic Association should be directed to our media hotline on 0870 850 2517 or pr@bda.uk.com.

Notes to Editors

  1. L Brough, GA Rees, MA Crawford, EK Dorman (2009) Social and ethnic differences in folic acid use preconception and during early pregnancy in the UK: effect of maternal folate status. Journal of Human Nutrition and Dietetics 22:2; 100-107.
  2. Dr Louise Brough is currently a Lecturer in Human Nutrition based at Massey University, New Zealand.
  3. Dr Gail Rees is a registered dietitian, currently based at the School of Biological Sciences at the University of Plymouth.
  4. The Journal of Human Nutrition and Dietetics is the official journal of the British Dietetic Association: www3.interscience.wiley.com/journal/117979034/home.

The British Dietetic Association founded in 1936 is the professional association for registered dietitians in Great Britain and Northern Ireland. It is the nation’s largest organisation of food and nutrition professionals with nearly 6000 members. About two-thirds of members are employed in the National Health Service. The remaining members work in education, industry, research, sport settings or freelance.

Registered dietitians hold the only legally-recognisable graduate qualification in nutrition and dietetics. They are experts in interpreting and translating the science of nutrition into practical ways of promoting nutritional well-being, disease treatment and the risk reduction of nutrition-related problems. Their advice is sound and based on current scientific evidence. Registration, awarded by the Health Professions Council, is an indication that a dietitian is fit to practice, and is working within an agreed statement of conduct. For further details about the British Dietetic Association, please visit our website: www.bda.uk.com.

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