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Folate and folic acid: A guide for nurses working in primary care

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Leafy green vegetables are a source of folate Leafy green vegetables are an excellent source of folate, but there are no long-term stores in the body

Since 1991, recommendations have existed for folic acid supplementation pre conception and during the first trimester of pregnancy for the prevention of neural tube defects. However, evidence demonstrates that this policy is not working. In June 2019, theGovernment started a 12-week consultation into the fortification of flour with folic acid to prevent neural tube defects in unborn babies, suggesting this could prevent up to 200 birth defects each year.1

Neural tube defects (NTDs) are defects of the brain, spinal cord and spine of a foetus where the spine, cord or surrounding vertebrae fail to develop properly. The two main forms of NTDs are anencephaly and spina bifida. It is estimated that 1000 NTD affected pregnancies are diagnosed in the UK each year, ending in termination, miscarriage, death soon after birth or long term disability.1

Folic acid is the man made form of folate. It is a water soluble vitamin, also known as vitamin B9. Folate helps the body form red blood cells, and reduces the risk of neural tube defects in unborn babies. A lack of folate could lead to folate deficiency anaemia.2

Folate is found in many foods such as liver, yeast extract, leafy green vegetables, broccoli, chickpeas and peas. Folic acid is used in supplements and fortified foods such as breakfast cereals. There are no long term stores of folate therefore foods containing it should be eaten frequently.2

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