If you are significantly overweight, you will need a higher dose of folate as well. Research lead by Dr. Martha M. Werler, DSc, an epidemiologist at Boston University, suggests that typical prenatal vitamins don't contain enough folic acid to provide protection against neural tube defects in the babies of overweight women. Dr. Werler discovered that at least 400 mcg of folic acid a day (the government-recommended dose) reduced the risk of neural-tube defects by 40 percent for children of women weighing less than 154 pounds. However, this dose did not reduce the risk in heavier women. As a result, some physicians believe plus-size women should take additional folic acid supplements along with their prenatal vitamins to obtain full protection.
Ask your physician whether a higher dose of folic acid is right for you.
Where Do I Find Folates?
After the impact of folic acid on the reduction of neural tube defects was discovered, the US Food and Drug Administration authorized the fortification of many ready-to-eat foods (especially breads, pasta, and cereals). According to the CDC, this fortification led to a 25 percent decrease in neural tube defects. Today many women who eat healthy diets rich in folic acid (see below) ask why they need the supplement. The answer is that the synthetic form of folic acid is more effective for this type of protection, and pregnant women require more folic acid than non-pregnant women require.
Yet it's a good idea to strive to get folates from foods, even while taking a supplement. Why? Because it will lead you to a diet that is not only good for conception and pregnancy, but for your long-term health.
Folate is also contained in many foods, including leafy green vegetables like collard greens, kale, broccoli, cabbage, spinach, Brussels sprouts, and asparagus. Fruits such as oranges, grapefruits, papayas, and strawberries will offer a good dose of folate. Whole grain breads, lentils, corn, and chickpeas are also great choices, as are liver, peanut butter, dried beans, and peas. Many other foods, such as wheat and orange juice, have been enriched with folic acid. Check the package labels.
Despite its abundance in ordinary foods, only 30 percent of American women get the recommended daily allowance of folic acid through food, which is why doctors strongly recommend a daily supplement of folic acid for pregnant women.