You Need More B Vitamins ~ [Issue 1099-3]
Oct 19, 1999 08:15 PDT
YOU NEED MORE B VITAMINS
Any woman who might become pregnant should either eat specially
fortified foods or take a vitamin supplement of folic acid (vitamin
B9) every day to protect against birth defects, according to a recent
report by the Institute of Medicine. The report went on to recommend
that all persons over age 50 should eat a bowl of fortified cereal
every day or take a supplement of Vitamin B12, a nutrient important
for making blood cells but one that declines with age.
The Institute of Medicine, a private organization which advises the
United States Federal Government, is reviewing the nation's
Recommended Daily Allowances, or RDAs, for nutrients.
Folate is found in such foods as spinach, beans and orange juice, but
the typical diet did not give some women enough to protect against
certain brain and spinal birth defects that afflict about 2,500
babies a year. So doctors have recommended that all women of
childbearing age consume 400 micrograms (mcg) of folic acid - the
pill form - per day. Folic acid provides about twice as much of the
nutrient as folate does.
The institute report concludes women can get enough protection if
they eat these fortified foods in combination with a diet rich in
folate foods, but they must choose either the new foods, a folic acid
supplement or both, to be safe. Try one-half cup of spinach, with 130
mcg; one-half cup of boiled navy beans, 125 mcg; one medium orange,
45 mcg; or one ounce of dried peanuts, 30 mcg. For extra folic acid,
some cereal brands provide 400 mcg in a single bowl.
Up to 30% of people over age 50 have lost the ability to absorb
adequate vitamin B12 from meat or dairy products, the report found.
People need only 2.4 mcg a day - the amount in a mere three ounces of
beef - but the institute recommended that older individuals eat
fortified cereal or grains or take a daily vitamin supplement to
People are flocking to folic acid and vitamin B6 supplements because
of reports that they might protect against heart disease or cancer.
That research "is promising," the experts said, but not conclusive -
so they did not recommend large increases.
FORTIFIED GRAINS STILL LOW IN FOLIC ACID
A new government requirement for adding folic acid to food is set too
low to reduce the risk of heart disease, researchers report.
The U.S. Food and Drug Administration (FDA) this year began requiring
fortification of enriched flour and pasta to boost each person's
intake by about 100 mcg a day. The FDA hopes to prevent the birth
defect known as spina bifida. Folic acid is needed in the first weeks
of pregnancy for spinal development.
Because folic acid also lowers plasma levels of homocysteine - a
byproduct of food metabolism that injures blood vessels - doctors
hoped the policy also would lower the risk of heart disease. The new
study suggests that it won't.
Manuel Malinow of the Oregon Health Sciences University, Portland,
and his colleagues studied folic acid and homocysteine levels for 15
weeks in 75 men and women with heart disease.
People who ate cereal with 127 mcg daily - an amount that
approximates the level achieved by the FDA's new policy - raised
their folic acid level by 31% but lowered their homocysteine levels
only 3.7%, which is not enough to prevent vessel damage.
Cereals with 499 mcg and 665 mcg reduced homocysteine by 11% and 14%,
the researchers report in the New England Journal of Medicine.
In an accompanying editorial, Godfrey Oakley of the Centers for
Disease Control and Prevention says the government's minimum standard
may also be too low to prevent birth defects. "This new data should
provide a rationale for increasing the levels of fortification," he writes.
WOMEN SHOULD TAKE FOLIC ACID, BUT DO NOT
Despite a Public Health Service (PHS) recommendation that all women
of child-bearing potential take 400 mcg of folic acid (vitamin B9)
daily, less than one-third do so, according to a recent report from
Centers for Disease Control.
PHS made this recommendation in 1992, because folic acid can reduce
the incidence of spina bifida and anencephaly in infants by at least
50% when taken daily by women before conception and during pregnancy.
But to what extent are women following this advice?
The CDC report, published in the February 27 edition of Morbidity and
Mortality Weekly Report, summarizes findings of a survey conducted in
Commissioned by the March of Dimes and conducted by the Gallup
Organization, the survey assessed respondents' familiarity with folic
acid and determined the prevalence of vitamin supplement use by 2,001
American women aged 18 to 45. The random-digit telephone survey
yielded a response rate of 50%.
Some 32.2% of women of childbearing age in the response group
consumed a supplement containing folic acid on a daily basis. Among
those younger than 25, daily use was 22.8%. Daily use was 19.6% among
women with less than a high school education, 26.1% among unmarried
women, and 28.8% among those who had not heard of the PHS
recommendation, compared with 45.2% among women who were familiar with it.
For women who occasionally (less than daily) took folic acid
supplements, forgetting to take the vitamin was the most frequent
reason cited for less than daily use (49%).
Those who did not use vitamin supplements cited the feeling that they
did not need them, insufficient information and cost as key reasons
for not taking the supplements. Some 55.8% felt that they did not
need the supplements or had no particular reason for taking them.
Some women (14.4%) said that they did not take the supplements
because they believed that their diets were sufficient.
Women may also obtain the recommended amount of folic acid by eating
a fortified breakfast cereal containing 100% of the daily value of
folic acid. (As of January 1, the FDA requires that all enriched
cereal grains be fortified with folic acid.) Alternatively, women can
increase their consumption of other foods fortified with folic acid,
including bread, rice, and pasta, or foods naturally rich in folates,
such as orange juice and green vegetables.
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