FOLIC ACID: For The Future
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Transcript of FOLIC ACID: For The Future
This presentation was developed by the Missouri Department of Health and SeniorServices through a grant from the Centers For Disease Control and Prevention
FOLIC ACID:FOLIC ACID:For The FutureFor The FutureFOLIC ACID:FOLIC ACID:For The FutureFor The Future
Missouri Department of Health and Missouri Department of Health and Senior ServicesSenior Services
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Course OutlineCourse OutlineCourse OutlineCourse Outline
What is folic acid?How do you get folic acid?Who needs folic acid?How do neural tube defects occur?What is a neural tube defect?What are the recommended levels of folic
acid?What can you do?
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What Is Folic Acid?What Is Folic Acid?What Is Folic Acid?What Is Folic Acid?
Folic acid is the synthetic form of a water soluble B vitamin that is needed to:
Make new cells/cell divisionMake normal-shaped red blood cellsHelp prevent anemiaHelp prevent birth defectsHelp prevent heart disease, stroke and certain
cancers.
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How Do You Get Folic Acid?How Do You Get Folic Acid?How Do You Get Folic Acid?How Do You Get Folic Acid?
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Foods Naturally High in Folic Acid Foods Naturally High in Folic Acid Foods Naturally High in Folic Acid Foods Naturally High in Folic Acid
Liver Nuts and peanut butter Dried peas or beans Juices: orange,
pineapple, tomato Fruits: orange,
avocado, cantaloupe Leafy green
vegetables
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Fortified Grain ProductsFortified Grain ProductsFortified Grain ProductsFortified Grain Products
Just right with crunchy nuggets
Multi-grain cheerios plus Product 19 Special K Whole grain total Total corn flakes Total raisin bran
SOME of the cereals with 100% of the recommended daily value of folic acid per serving:
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Easiest Way!Easiest Way!Easiest Way!Easiest Way!
Take a multi-vitamin with 400 mcg. of synthetic folic acid every day
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Who Needs Folic Acid?Who Needs Folic Acid?Who Needs Folic Acid?Who Needs Folic Acid?
All women aged 14-50 who COULD become pregnant
Pregnant womenEveryone,
including men
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How Do NTDs Occur?How Do NTDs Occur?How Do NTDs Occur?How Do NTDs Occur?
Baby’s brain and spine fail to close completely
Neural tube closing properly to form spinal column and brain.
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What Is a Neural Tube Defect?What Is a Neural Tube Defect?What Is a Neural Tube Defect?What Is a Neural Tube Defect?
Spina Bifida – 60%Anencephaly – 30%Encephalocele – 10%
Neural tube defects (NTDs) are the second most common cause of infant mortality.
NTDs occur in 1 out of every 2,000 babies.
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AnencephalyAnencephalyAnencephalyAnencephaly
Upper end of the neural tube fails to close
Brain either never develops or is totally absent
50% stillbirth rate Usually fatal, 5%
survive one week
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EncephaloceleEncephaloceleEncephaloceleEncephalocele
Defect of the skull – smaller defect than anencephaly
Protrusion of brain or skin-covered brainRarer than the other types of NTDsOverall mortality rate about 29%
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Spina BifidaSpina BifidaSpina BifidaSpina Bifida
Neural tube fails to close Neural tube fails to close properly:properly:• Occurs by 28 gestational
days Associated problems:Associated problems:
• Hydrocephalus• Clubfoot• Vertebral anomalies• Renal anomalies
Requires surgery 24-48 Requires surgery 24-48 hours after birthhours after birth
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Financial CostsFinancial Costs:: Average estimated lifetime cost of $532,000 for each infant born with spina bifida (CDC 1999) adds an estimated 19 million dollars every year to Missouri resident lifetime costs associated with spina bifida.
Physical CostsPhysical Costs:: Possible paralysis (the leading cause of childhood paralysis), bowel and bladder control problems, learning disabilities, hydrocephalus, surgical procedures, latex allergies, increased health problems with age
Emotional CostsEmotional Costs:: Miscarriage, stillbirth, infant mortality (death before 1st birthday), disability, feeling “different”
The High Cost of NTDsThe High Cost of NTDs
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Factors Associated With Factors Associated With Increased Risk of NTDs. . .Increased Risk of NTDs. . .Factors Associated With Factors Associated With
Increased Risk of NTDs. . .Increased Risk of NTDs. . .
Family history of NTD A previous pregnancy
affected with NTD Maternal insulin-
dependent diabetes Maternal obesity Anti-epileptic drugs
(Valporic Acid/Kepakene, Carbamazapine)
Lower socioeconomic/educational level
Race/ethnicity Geography Exposure to high
temperatures in pregnancy
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What Are the Recommended What Are the Recommended Levels of Folic Acid?Levels of Folic Acid?
What Are the Recommended What Are the Recommended Levels of Folic Acid?Levels of Folic Acid?
U.S. Public Health Service recommendation:
“All women of childbearing age capable of becoming pregnant should consume 400 micrograms (or 0.4 milligrams) of folic acid daily.”
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CDC RecommendationCDC RecommendationCDC RecommendationCDC Recommendation
“All women of childbearing age in the United States
who are capable of becoming pregnant
should consume 400 mcg. of folic acid per day
for the purpose of reducing their risk
of having a pregnancy affected
with a Neural Tube Defect.
Women who have had prior NTD-affected pregnancy
are at risk of having a subsequent affected pregnancy.”
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Folic Acid For WomenFolic Acid For WomenFolic Acid For WomenFolic Acid For Women
All women of childbearing age should receive 400 micrograms (0.4 mg) of folic acid daily.
Women who have had a previous child with NTD should receive 4000 micrograms (4 mg) of folic acid daily.
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Folic Acid Awareness:Folic Acid Awareness:Survey of Missouri Women Age 18-44Survey of Missouri Women Age 18-44
Folic Acid Awareness:Folic Acid Awareness:Survey of Missouri Women Age 18-44Survey of Missouri Women Age 18-44
47%
90%
0%
20%
40%
60%
80%
100%
Take Vitaminwith Folic Acid
Take daily
1999 Missouri BRFSS
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Folic Acid Awareness:Folic Acid Awareness:Survey of Missouri Women Age 18-44Survey of Missouri Women Age 18-44
The survey highlights the following characteristics of
women in the survey who were less likely to take a daily
folic acid supplement.
Women aged 18-24 (37.1%) Annual income less than $15,000 (27.1%) Less than a High School diploma (19.2%) High School diploma (39.1%)
1999 Missouri BRFSS
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Folic Acid Awareness:Folic Acid Awareness:Survey of Missouri Women Age 18-44Survey of Missouri Women Age 18-44
Folic Acid Awareness:Folic Acid Awareness:Survey of Missouri Women Age 18-44Survey of Missouri Women Age 18-44
1999 Missouri BRFSS
0.00%
5.00%
10.00%15.00%
20.00%
25.00%
30.00%35.00%
40.00%
Ages 18-24 Incomeless than$15,000
Less than H.S.
diploma
H.S.diploma
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Blood Pressure
Birth DefectsOther
Strong Bones
Unknown
Reasons for Taking Folic AcidReasons for Taking Folic AcidReasons for Taking Folic AcidReasons for Taking Folic Acid
1999 Missouri BRFSS
3.7
36.9
25.8
19.1
14.5
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What Can You Do?What Can You Do?What Can You Do?What Can You Do?
Take a multivitamin with 400 mcg. of folic acid every day for your health.
Help spread the message about the need for folic acid for health and to reduce birth defects.
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Resource ListResource ListResource ListResource List Missouri Department of Health and Senior
Services, Division of Nutritional Health and Services, 573-522-9144
http://www.health.mo.gov/living/wellness/nutrition/nutritionpregnancy/index.php
Centers for Disease Control and Prevention www.cdc.gov/ncbdd/folicacid/index.html
March of Dimes 1-888-MODIMES www.modimes.com