The Importance of Folic Acid in Pregnancy - Includes Recipes-By Merrion Ultrasound
Packed with valuable information about folic acid, with a superb introduction from a top lecturer & nutritionist, plus recipes.
Packed with valuable information about folic acid, with a superb introduction from a top lecturer & nutritionist, plus recipes.
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A M E R R I O N U L T R A S O U N D M A G A Z I N E<br />
the importance <strong>of</strong> folic<br />
acid <strong>in</strong> pregnancy<br />
I S S U E 0 3 • M A Y 2 0 2 3
folic acid <strong>in</strong><br />
pregnancy<br />
A M E R R I O N<br />
U L T R A S O U N D<br />
M A G A Z I N E<br />
W E L C O M E<br />
Thank you for tak<strong>in</strong>g the time to read our magaz<strong>in</strong>e about<br />
<strong>Folic</strong> <strong>Acid</strong> <strong>in</strong> <strong>Pregnancy</strong>. We hope you will f<strong>in</strong>d it useful.<br />
D I S C L A I M E R<br />
This magaz<strong>in</strong>e is not <strong>in</strong>tended as medical advice.<br />
<br />
You should not consider the <strong>in</strong>formation <strong>in</strong>cluded to be<br />
medical advice. At all times, please seek direct medical<br />
<strong>in</strong>formation from your doctor.<br />
C R E A T E D B Y<br />
Creative Web Advertis<strong>in</strong>g
contents<br />
0 1 . WHAT IS FOLIC<br />
ACID?<br />
0 6 . THE IRISH CONTEXT<br />
0 3 . HOW MUCH FOLIC<br />
ACID?<br />
0 8 . HIGHER RISK<br />
GROUPS<br />
0 4 . THE BENEFITS OF<br />
FOLIC ACID<br />
1 0 . FOLATE RICH FOODS<br />
0 5 . WHAT HAPPENS IF<br />
THERE IS<br />
INSUFFICIENT FOLIC<br />
ACID?<br />
1 1 . FOLATE RECIPES
what is<br />
folic acid<br />
<strong>Folic</strong> acid, also known as folate, is a B<br />
vitam<strong>in</strong>. <strong>Folic</strong> acid is significant to the<br />
production <strong>of</strong> red blood cells and the<br />
development <strong>of</strong> a baby’s neural tube <strong>in</strong>to the<br />
sp<strong>in</strong>al cord and bra<strong>in</strong>. (1)<br />
<strong>Folic</strong> acid is necessary for produc<strong>in</strong>g and<br />
repair<strong>in</strong>g DNA. This is the body’s genetic<br />
map and the basic method <strong>of</strong> build<strong>in</strong>g cells.<br />
For that reason, folic acid is essential for the<br />
rapid cell growth <strong>of</strong> the placenta and the<br />
development <strong>of</strong> the baby. (7)<br />
<strong>The</strong> body requires folic acid to prevent a<br />
certa<strong>in</strong> k<strong>in</strong>d <strong>of</strong> anaemia and some research<br />
believes that tak<strong>in</strong>g folic acid daily may<br />
reduce the risk <strong>of</strong> develop<strong>in</strong>g preeclampsia.<br />
This is a multifaceted disorder<br />
that can affect the mother’s health as well as<br />
the baby’s health. (4)<br />
<strong>The</strong> CDC (Centres for Disease Control USA)<br />
suggests tak<strong>in</strong>g folic acid daily when<br />
pregnant and a month prior to becom<strong>in</strong>g<br />
pregnant.<strong>The</strong> CDC also recommends that any<br />
women <strong>of</strong> a childbear<strong>in</strong>g age beg<strong>in</strong> tak<strong>in</strong>g<br />
folic acid daily whether plann<strong>in</strong>g pregnancy<br />
or not. (10) This is due to the fact, that more<br />
than half <strong>of</strong> the pregnancies <strong>in</strong> the United<br />
States are unplanned. Tak<strong>in</strong>g this vitam<strong>in</strong> can<br />
help prevent birth defects that typically occur<br />
dur<strong>in</strong>g the first 3-4 weeks <strong>of</strong> pregnancy.<br />
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what is folic<br />
acid<br />
Hav<strong>in</strong>g folic acid <strong>in</strong> the system dur<strong>in</strong>g the<br />
early stages <strong>of</strong> development, when the baby’s<br />
bra<strong>in</strong> and sp<strong>in</strong>al cord are develop<strong>in</strong>g, is<br />
essential. One study proved that women who<br />
took folic acid for a year prior to gett<strong>in</strong>g<br />
pregnant decreased the chance <strong>of</strong> early<br />
delivery by 50% or more. (3)<br />
<strong>The</strong> neural tube beg<strong>in</strong>s form<strong>in</strong>g around three<br />
weeks after conception; this is why it is<br />
important to receive a daily dose <strong>of</strong> folic acid<br />
prior to conception and dur<strong>in</strong>g the first<br />
trimester. (4)<br />
<strong>The</strong> Food Safety Authority <strong>of</strong> Ireland has<br />
confirmed that synthetic folic acid has been<br />
proven to reduce the risk <strong>of</strong> neural tubal<br />
deformity.<br />
Revised HSE Guidel<strong>in</strong>es 2019<br />
In November 2019, the HSE guidel<strong>in</strong>es were<br />
revised. Pregnant woman are now be<strong>in</strong>g<br />
advised to take folic acid for their entire<br />
pregnancy and while breastfeed<strong>in</strong>g.<br />
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how much<br />
folic acid?<br />
<strong>The</strong> recommended dose for a woman plann<strong>in</strong>g<br />
a pregnancy is 400 mcg (micrograms) daily.<br />
Those who take multivitam<strong>in</strong>s daily should<br />
confirm that the recommended dosage <strong>of</strong><br />
folic acid is <strong>in</strong>cluded.<br />
For anyone that does not want to take<br />
multivitam<strong>in</strong>s, folic acid is also available as a<br />
supplement. However, the supplement and the<br />
multivitam<strong>in</strong>s should never be comb<strong>in</strong>ed. (3)<br />
<strong>The</strong> March <strong>of</strong> Dimes, <strong>The</strong> U.S. Public Health<br />
Service, and the American College <strong>of</strong><br />
Obstetricians and Gynaecologists (ACOG)<br />
strongly suggest that any woman <strong>of</strong><br />
childbear<strong>in</strong>g age, whether pregnant or not,<br />
take at least 400 mcg <strong>of</strong> folic acid daily. (4)<br />
When attempt<strong>in</strong>g to conceive: 400 mcg When<br />
Breastfeed<strong>in</strong>g: 500 mcg (12) Dur<strong>in</strong>g the first<br />
three months <strong>of</strong> pregnancy: 400 mcg Dur<strong>in</strong>g<br />
months four through n<strong>in</strong>e <strong>of</strong> pregnancy: 600<br />
mcg It is important to note that tak<strong>in</strong>g more<br />
than 1,000 mcg per day <strong>of</strong> folic acid can be<br />
dangerous, unless prescribed by a healthcare<br />
pr<strong>of</strong>essional. However, this ma<strong>in</strong>ly applies to<br />
vegans. Vegans are at a higher risk <strong>of</strong> be<strong>in</strong>g<br />
deficient <strong>in</strong> vitam<strong>in</strong> B12, as a result <strong>of</strong> the<br />
lack <strong>of</strong> meat and dairy <strong>in</strong> their diets. Tak<strong>in</strong>g<br />
an excess <strong>of</strong> folic acid can make a diagnosis<br />
<strong>of</strong> deficiency difficult for healthcare<br />
pr<strong>of</strong>essionals. (4)<br />
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the benefits <strong>of</strong><br />
folic acid<br />
It is suggested that folic acid can protect a<br />
baby from neural tube defects by at least<br />
50%. (1)(2) <strong>The</strong> Centres for Disease Control<br />
and Prevention (CDC) states that women who<br />
take the suggested dose <strong>of</strong> folic acid daily,<br />
beg<strong>in</strong>n<strong>in</strong>g one month prior to conception and<br />
dur<strong>in</strong>g the first trimester, help reduce the<br />
baby’s chance <strong>of</strong> neural tube defects by 50<br />
to 70 percent. (5)<br />
Mothers who have given birth to a baby with<br />
a neural tube defect can reduce the risk <strong>of</strong><br />
hav<strong>in</strong>g another child with a neural tube<br />
defect by as much as 70% by tak<strong>in</strong>g folic<br />
acid. (2) (8)<br />
When taken before and dur<strong>in</strong>g pregnancy,<br />
folic acid can protect a baby aga<strong>in</strong>st: (7)<br />
(10)<br />
Low birth weight<br />
Cleft lip and palate<br />
Premature birth<br />
<strong>Folic</strong> acid is also recommended to reduce<br />
the risk <strong>of</strong> other pregnancy complications<br />
that <strong>in</strong>clude:<br />
Several types <strong>of</strong> cancers<br />
Heart disease<br />
Alzheimer’s disease<br />
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what<br />
happens if<br />
there is<br />
<strong>in</strong>sufficient<br />
folic acid?<br />
An <strong>in</strong>sufficient amount <strong>of</strong> folic acid <strong>in</strong> the<br />
body may cause the baby’s neural tube to<br />
close <strong>in</strong>correctly and this could develop<br />
health issues known as neural tube defects or<br />
NTDs.<br />
<strong>The</strong>se defects <strong>in</strong>clude: (11)( 12)<br />
Sp<strong>in</strong>a bifida: occurs when the sp<strong>in</strong>al cord or<br />
the vertebrae do not develop correctly<br />
Anencephaly: occurs when major parts <strong>of</strong> the<br />
bra<strong>in</strong> do not develop correctly.Babies with<br />
anencephaly generally do not live long; while<br />
babies with sp<strong>in</strong>a bifida are permanently<br />
disabled.<br />
<strong>The</strong>se serious health issues may be<br />
preventable with the use <strong>of</strong> folic acid (12).<br />
Neural tube defects, or NTDs, can beg<strong>in</strong> at an<br />
early stage <strong>in</strong> development. In some cases,<br />
this is before the woman realises she may be<br />
pregnant. This affects more than 3,000<br />
pregnancies per year <strong>in</strong> the United States. (4)<br />
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the irish<br />
context<br />
<strong>The</strong> Report <strong>of</strong> the National Committee on<br />
<strong>Folic</strong> <strong>Acid</strong> Food Fortification which was<br />
published by the Food Safety Authority <strong>of</strong><br />
Ireland showed that: (13) Ireland has one <strong>of</strong><br />
the highest <strong>in</strong>cidences <strong>of</strong> NTD’s <strong>in</strong> Europe.<br />
Every year between 49 and 93 Irish babies<br />
are affected each year, most commonly with<br />
sp<strong>in</strong>a bifida. Between 70%* <strong>of</strong> NTDs can be<br />
prevented by tak<strong>in</strong>g the recommended<br />
amount <strong>of</strong> folic acid – we have known this<br />
s<strong>in</strong>ce 1991. *Other studies refer to 50% or<br />
between 50% and 70%<br />
Some <strong>of</strong> the more recent Irish studies show<br />
the follow<strong>in</strong>g (14): McGuire et al, 2010 85%<br />
took FA at some po<strong>in</strong>t dur<strong>in</strong>g the periconceptional<br />
period but only 28% took folic<br />
acid (FA) – antenatal and delivery records <strong>in</strong><br />
the Coombe Women and Infants University<br />
Hospital between 1 January 2000 and 31<br />
December 2007 Tarrant et al, 2011 88% <strong>of</strong><br />
women took FA dur<strong>in</strong>g pregnancy and 44% <strong>of</strong><br />
them took a supplement before<br />
conception/dur<strong>in</strong>g the 1st month <strong>of</strong><br />
pregnancy (n=450). McNulty et al, 2011 84%<br />
took FA dur<strong>in</strong>g pregnancy, but only 19%<br />
before pregnancy (n=296); ‘Red cell folate<br />
concentrations <strong>in</strong> women not comply<strong>in</strong>g with<br />
recommendations were suboptimal <strong>in</strong> relation<br />
to NTD risk’<br />
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the irish<br />
context<br />
Although the scientific evidence that folic<br />
acid can play a part <strong>in</strong> prevent<strong>in</strong>g NTDs came<br />
to light <strong>in</strong> the early 1990's, today there are<br />
still lots <strong>of</strong> Irish women <strong>of</strong> childbear<strong>in</strong>g age<br />
who don’t take folic acid as recommended.<br />
One big issue as po<strong>in</strong>ted out <strong>in</strong> the <strong>The</strong><br />
Report <strong>of</strong> the National Committee on <strong>Folic</strong><br />
<strong>Acid</strong> Food Fortification (13) is that 50% <strong>of</strong><br />
pregnancies are not planned – therefore<br />
unless women <strong>of</strong> childbear<strong>in</strong>g age appreciate<br />
that without tak<strong>in</strong>g supplements they are<br />
unlikely to consumed the recommended<br />
amount, this leaves a large group <strong>of</strong> women<br />
at risk, straight away.<br />
In fact this study also found that more than<br />
one third <strong>of</strong> Irish women <strong>of</strong> childbear<strong>in</strong>g<br />
age consumed no folic acid at all (35%).<br />
Although some foods <strong>in</strong> Ireland are fortified<br />
with folic acid, not everyone eats these<br />
foods. <strong>The</strong>re has been an ongo<strong>in</strong>g debate<br />
about fortify<strong>in</strong>g flour, and therefore bread,<br />
however at the time <strong>of</strong> writ<strong>in</strong>g this still hasn’t<br />
been implemented. Additionally it is not<br />
possible to add the full recommended amount<br />
to bread as this would result <strong>in</strong> excesses for<br />
other members <strong>of</strong> the population.<strong>The</strong> most<br />
important reasons why some Irish women<br />
don’t take folic acid are that 50% <strong>of</strong><br />
pregnancies are unplanned, f<strong>in</strong>ancial barriers<br />
and lack <strong>of</strong> knowledge concern<strong>in</strong>g folic acid.<br />
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higher risk<br />
groups<br />
Women with certa<strong>in</strong> genotypes that are<br />
associated with a higher risk <strong>of</strong> NTDs<br />
Women with prior pregnancies result<strong>in</strong>g <strong>in</strong><br />
NTDs or a family history <strong>of</strong> NTDs<br />
Women with certa<strong>in</strong> malabsorption<br />
disorders (such as <strong>in</strong>flammatory bowel<br />
disease)Women suffer<strong>in</strong>g from obesity with<br />
a Body Mass Index > 35 kg/m2<br />
Women diagnosed with diabetes<br />
Women diagnosed with liver disease<br />
Women diagnosed with sickle cell disease<br />
(12)<br />
Women deal<strong>in</strong>g with lifestyle and<br />
compliance issues – these women are also<br />
at an <strong>in</strong>creased risk <strong>of</strong> develop<strong>in</strong>g NTDs<br />
and may benefit from receiv<strong>in</strong>g higher<br />
dosages <strong>of</strong> folic acid: (2)<br />
Women who use anti epileptic drugs<br />
Women who take folate antagonists (such<br />
sulfonamides, asmethotrexate)<br />
Women who consume more than one<br />
alcoholic dr<strong>in</strong>k per day (12)<br />
Women who smoke regularly<br />
In most cases, women suffer<strong>in</strong>g from<br />
obesity are more likely to have a baby with<br />
a neural tube defect. Although the reason<br />
rema<strong>in</strong>s vague; some studies suggest that<br />
women with a higher Body Mass Index (BMI)<br />
usually have lower levels <strong>of</strong> folate <strong>in</strong> their<br />
blood.<br />
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higher risk<br />
groups<br />
If the mother has had a previous baby with a<br />
neural tube defect, it is important to alert the<br />
healthcare pr<strong>of</strong>essional before attempt<strong>in</strong>g<br />
conception.Without the assistance <strong>of</strong> a<br />
pr<strong>of</strong>essional, women <strong>in</strong> this particular<br />
situation are at a higher risk <strong>of</strong> experienc<strong>in</strong>g<br />
another pregnancy complicated by an NTD.<br />
However, the risk can be reduced significantly<br />
by tak<strong>in</strong>g a larger dose <strong>of</strong> folic acid. (1)<br />
Women that have been diagnosed with<br />
diabetes or women tak<strong>in</strong>g anti-seizure<br />
medications for epilepsy are at a higher risk<br />
<strong>of</strong> hav<strong>in</strong>g a baby with an NTD. Seek<strong>in</strong>g the<br />
help <strong>of</strong> a healthcare pr<strong>of</strong>essional at least a<br />
month prior to conception can help reduce<br />
the risk <strong>of</strong> hav<strong>in</strong>g a baby with NTD. A medical<br />
pr<strong>of</strong>essional can recommend the proper<br />
amount <strong>of</strong> folic acid and safely monitor the<br />
condition. (2)<br />
Research has shown that the body absorbs<br />
the synthetic form <strong>of</strong> folic acid easier than<br />
the form that is available naturally <strong>in</strong> foods.<br />
(12) Generally, gra<strong>in</strong> products and enriched<br />
cereals are fortified with the synthetic form.<br />
However, the majority <strong>of</strong> women don’t eat<br />
these types <strong>of</strong> foods enough to depend on<br />
them as the ma<strong>in</strong> source <strong>of</strong> folic acid.<br />
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folate rich<br />
foods<br />
Citrus fruits and Juice<br />
Dried beans<br />
Enriched white rice<br />
Dark green vegetables such as asparagus,<br />
sp<strong>in</strong>ach, collard or turnip greens, broccoli,<br />
and okra<br />
Enriched flour and pastas<br />
Baked potatoes<br />
Yeast extract<br />
Pulses<br />
Nuts<br />
Wholegra<strong>in</strong>s<br />
However, these foods are not a permanent<br />
solution for the daily doses <strong>of</strong> folic acid.<br />
<strong>The</strong>se foods are considered a partner to the<br />
supplement. This is ma<strong>in</strong>ly because the body<br />
absorbs all <strong>of</strong> the folic acid <strong>in</strong> the<br />
supplement, but only absorbs some <strong>of</strong> the<br />
folate <strong>in</strong> the enriched foods.<br />
More importantly, folate can be destroyed<br />
when cook<strong>in</strong>g it. Most folates dissolve<br />
easily <strong>in</strong> water. This is why steam<strong>in</strong>g or<br />
microwav<strong>in</strong>g vegetables works better than<br />
boil<strong>in</strong>g them. Overcook<strong>in</strong>g these type <strong>of</strong><br />
foods can destroy the folates that are<br />
conta<strong>in</strong>ed <strong>in</strong>side. (4)(12)<br />
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FOLATE RECIPES<br />
Asparagus & Ricotta Tarts<br />
<strong>The</strong>se stunn<strong>in</strong>g little tarts are perfect for a<br />
romantic night <strong>in</strong>. <strong>The</strong>y are easy to prepare<br />
and use only a few good-quality <strong>in</strong>gredients.<br />
<strong>The</strong> dish conta<strong>in</strong>s a good amount <strong>of</strong> folate,<br />
calcium and vitam<strong>in</strong> K - all essential for baby’s<br />
growth and for your own health.<br />
Prep time: > 15 m<strong>in</strong>utes.<br />
Cook time: 30 m<strong>in</strong>utes<br />
Serves 2<br />
Ingredients:<br />
200g ready-rolled puff pastry<br />
150g ricotta cheese<br />
20g grated parmesan cheese<br />
6 sun-dried tomatoes, f<strong>in</strong>ely chopped<br />
10-12 asparagus spears, trimmed<br />
Method:<br />
Pre-heat the oven to 190°C/170°C (fan).<br />
First, unroll the puff pastry and cut two<br />
rectangles, width-ways. Score another<br />
rectangle <strong>in</strong>side these - leav<strong>in</strong>g a border <strong>of</strong><br />
about 1cm. Be sure not to cut through the<br />
pastry.<br />
L<strong>in</strong>e a bak<strong>in</strong>g tray with parchment (or use the<br />
parchment the pastry was rolled <strong>in</strong>) and place<br />
the pastry rectangles on top. Score a crisscross<br />
pattern around the borders, if you like.<br />
Place the pastry <strong>in</strong> the oven and cook for 15<br />
m<strong>in</strong>utes. Remove from the oven, cool slightly,<br />
and then gently depress the <strong>in</strong>side w<strong>in</strong>dows<br />
with your f<strong>in</strong>gers. While the pastry is cook<strong>in</strong>g,<br />
mix the ricotta with the Parmesan and sundried<br />
tomatoes.<br />
Carefully spread the mixture <strong>in</strong>to the w<strong>in</strong>dows<br />
<strong>of</strong> the pastry - it helps to put little ‘dollops’ <strong>of</strong><br />
the mixture all over - and then top with the<br />
asparagus spears. Us<strong>in</strong>g a pastry brush,<br />
use the oil from your jar <strong>of</strong> sun-dried tomatoes<br />
to glaze the asparagus spears. Place the tarts<br />
back <strong>in</strong>to the oven for a further 15 m<strong>in</strong>utes.<br />
Serve warm or at room temperature, with a<br />
green salad.<br />
Nutritional analysis:<br />
Calories 423, Fat 28g, Carbs 29g , Prote<strong>in</strong><br />
16g, Folate 164µg<br />
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FOLATE RECIPES<br />
Halloumi Burgers<br />
A nice variation from the simple grilled<br />
halloumi, these burgers are a c<strong>in</strong>ch to prepare<br />
and can be done a day <strong>in</strong> advance if<br />
necessary. Sprouts have been <strong>in</strong>cluded<br />
<strong>in</strong> the burger mix for a folate hit, while<br />
cranberries, good for the ur<strong>in</strong>ary system,<br />
provide a h<strong>in</strong>t <strong>of</strong> sweetness.<br />
Prep time: > 15 m<strong>in</strong>utes.<br />
Cook time: 8-10 m<strong>in</strong>utes<br />
Serves 2<br />
Ingredients:<br />
1 block halloumi<br />
5-6 sprouts, very<br />
f<strong>in</strong>ely shredded<br />
2 spr<strong>in</strong>g onions, very<br />
f<strong>in</strong>ely shredded<br />
30g chopped dried<br />
cranberries<br />
1 egg<br />
Small handful dried<br />
breadcrumbs<br />
1 tsp crushed garlic<br />
2-3 tsp cranberry sauce<br />
Method:<br />
R<strong>in</strong>se the halloumi well to remove excess salt<br />
and pat dry with kitchen towel. F<strong>in</strong>ely grate<br />
<strong>in</strong>to a mix<strong>in</strong>g bowl. Add the shredded<br />
sprouts, spr<strong>in</strong>g onions, cranberries,<br />
breadcrumbs, egg and garlic and mix until well<br />
comb<strong>in</strong>ed.<br />
With your hands, check the mixture is right by<br />
tak<strong>in</strong>g a small amount and scrunch<strong>in</strong>g <strong>in</strong>to a<br />
ball - it should just about stick together, with a<br />
little moisture ooz<strong>in</strong>g out.<br />
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If it is too crumbly, add a little more egg. Too<br />
wet, add more breadcrumbs. Bear <strong>in</strong> m<strong>in</strong>d the<br />
mixture will firm up <strong>in</strong> the fridge. Form <strong>in</strong>to<br />
patties and place on a plate, then cover with<br />
cl<strong>in</strong>g film and chill for at least half an hour.<br />
When ready to cook, heat a little olive oil <strong>in</strong> a<br />
fry<strong>in</strong>g pan over a medium heat. Cook the<br />
patties for 3-4 m<strong>in</strong>utes each side - be careful<br />
when you turn them - until golden brown and<br />
heated through. Serve <strong>in</strong> buns with mayo on<br />
the bottom and a spoonful <strong>of</strong> cranberry sauce<br />
on the top, and a<br />
side salad.<br />
Nutritional analysis:<br />
Calories 266, Fat 11g, Carbs 34g, Prote<strong>in</strong> 13g,<br />
Folate 122 µg<br />
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FOLATE RECIPES<br />
Pasta Primavera<br />
A lovely summery dish teem<strong>in</strong>g with fresh<br />
vegetables, this is a c<strong>in</strong>ch to prepare and<br />
cook. <strong>The</strong> broccoli, peas and asparagus are all<br />
good sources <strong>of</strong> folic acid and make this a<br />
perfect lunch or supper for vegetarians. Look<br />
out, also, for fortified pastas on the<br />
supermarket shelves, or just use whole-wheat.<br />
Prep time: 10 m<strong>in</strong>utes.<br />
Cook time: 15 m<strong>in</strong>utes<br />
Serves 2-3<br />
Ingredients:<br />
200g pasta shapes <strong>of</strong> your choice<br />
1 small onion, chopped<br />
6-8 asparagus tips<br />
75g sugar snap peas, trimmed<br />
120g sprout<strong>in</strong>g broccoli, trimmed<br />
75g frozen or freshly-shelled peas<br />
Splash white w<strong>in</strong>e<br />
2 tbsp. crème fraiche<br />
Mixed s<strong>of</strong>t herbs, such as parsley, dill, chives.<br />
Method:<br />
Br<strong>in</strong>g a saucepan <strong>of</strong> water to the boil, and<br />
heat a sauté pan over a medium heat. Add a<br />
splash <strong>of</strong> olive oil to the sauté pan and gently<br />
fry the onions until s<strong>of</strong>tened but not coloured.<br />
Cook the pasta accord<strong>in</strong>g to the pack<br />
<strong>in</strong>structions. When there are only 3 m<strong>in</strong>utes<br />
left <strong>of</strong> cook<strong>in</strong>g time, throw <strong>in</strong> the broccoli to<br />
the same pan.<br />
At this po<strong>in</strong>t, add a splash <strong>of</strong> white w<strong>in</strong>e to the<br />
pan with the onions, and bubble for two<br />
m<strong>in</strong>utes before add<strong>in</strong>g the frozen peas and<br />
crème fraiche. Turn down the heat.<br />
For the f<strong>in</strong>al m<strong>in</strong>ute <strong>of</strong> pasta cook<strong>in</strong>g time, add<br />
the sugar snaps and asparagus. Blanch for one<br />
m<strong>in</strong>ute then dra<strong>in</strong> everyth<strong>in</strong>g through a sieve,<br />
reserv<strong>in</strong>g about half a cup <strong>of</strong> pasta water.<br />
Mix the pasta and veggies <strong>in</strong>to the onion, pea<br />
and crème fraiche mix and stir gently to<br />
comb<strong>in</strong>e. Stir through your chosen herbs, then<br />
serve.<br />
Nutritional analysis:<br />
Calories 440, Fat 3g, Carbs 84g, Prote<strong>in</strong> 24g<br />
Folate 211µg<br />
PAGE 13<br />
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FOLATE RECIPES<br />
Vegetable Grat<strong>in</strong><br />
A very simple dish which is great alone with a<br />
side salad, or as an accompaniment alongside<br />
grilled chicken or fish. This dish is quite high <strong>in</strong><br />
fat, so If you are watch<strong>in</strong>g the calories feel<br />
free to swap to low-fat cream and cheese.<br />
Prep time: > 10 m<strong>in</strong>utes.<br />
Cook time: 35-40 m<strong>in</strong>utes<br />
Serves 2-4<br />
Ingredients:<br />
One medium head broccoli<br />
10-12 sprouts, blemished leaves removed and<br />
halved if large<br />
300ml double cream<br />
150g f<strong>in</strong>ely grated Emmental or cheddar<br />
cheese<br />
10g each parsley and chives<br />
P<strong>in</strong>ch salt and pepper<br />
Method:<br />
Preheat the oven to 170°C<br />
Br<strong>in</strong>g a saucepan <strong>of</strong> water to the boil and<br />
blanch the vegetables for 5 m<strong>in</strong>utes. Dra<strong>in</strong> and<br />
steam dry.<br />
Nutritional analysis:<br />
Calories 631, Fat 48g, Carbs 26g, Prote<strong>in</strong> 23g,<br />
Folate 281 µg<br />
Return to a low heat and pour over the cream.<br />
Stir <strong>in</strong> the cheese and herbs, reserv<strong>in</strong>g a<br />
little cheese for spr<strong>in</strong>kl<strong>in</strong>g over the top.<br />
Season. Tip <strong>in</strong>to an ovenpro<strong>of</strong><br />
dish and spr<strong>in</strong>kle over the rema<strong>in</strong><strong>in</strong>g cheese.<br />
Bake for 30 m<strong>in</strong>utes, or until bubbl<strong>in</strong>g and<br />
lightly golden on the top.<br />
Serve with a mixed salad, or as a side dish.<br />
PAGE 14<br />
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eferences<br />
(1) <strong>Folic</strong> <strong>Acid</strong> for the Prevention <strong>of</strong> Neural Tube<br />
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(2) Identify<strong>in</strong>g women who might benefit from<br />
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pregnancy http://www.ncbi.nlm.nih.gov/pmc/a<br />
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(3) <strong>Folic</strong> acid supplementation before and<br />
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Study<br />
(NEST)http://www.ncbi.nlm.nih.gov/pmc/articl<br />
es/PMC3038155/<br />
(4) <strong>Folic</strong> acid: Why you need it before and<br />
dur<strong>in</strong>g<br />
pregnancy http://www.babycenter.com/0_foli<br />
c-acid-why-you-need-it-before-and-dur<strong>in</strong>gpregnancy_476.bc?page=1<br />
(5) <strong>Folic</strong> acid: <strong>in</strong>fluence on the outcome <strong>of</strong><br />
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/5/1295s.full<br />
(6) <strong>Folic</strong> acid supplementation, dietary folate<br />
<strong>in</strong>take dur<strong>in</strong>g pregnancy and risk for<br />
spontaneous preterm delivery: a prospective<br />
observational cohort<br />
study http://www.biomedcentral.com/1471-<br />
2393/13/160<br />
(7) Effect <strong>of</strong> folate <strong>in</strong>take on health outcomes <strong>in</strong><br />
pregnancy: a systematic review and metaanalysis<br />
on birth weight, placental weight and<br />
length <strong>of</strong><br />
gestation http://www.nutritionj.com/content/11<br />
/1/75<br />
(8) <strong>Folic</strong> acid use <strong>in</strong> pregnant Women present<strong>in</strong>g<br />
to the emergency<br />
department http://www.<strong>in</strong>tjem.com/content/4<br />
/1/38 (9) Patterns and predictors <strong>of</strong> folic acid<br />
supplement use among pregnant women: the<br />
Norwegian Mother and Child Cohort Study<br />
(10) <strong>Pregnancy</strong> Qs &<br />
As https://www.cdc.gov/ncbddd/folicacid/<strong>in</strong>d<br />
ex.html<br />
(11) <strong>The</strong> <strong>Importance</strong> <strong>of</strong> <strong>Folic</strong> <strong>Acid</strong>: Anifa’s<br />
Story http://www.cdc.gov/features/folicacidst<br />
ory/<strong>in</strong>dex.html<br />
(12) <strong>Folic</strong> <strong>Acid</strong> Fact<br />
Sheet https://www.womenshealth.gov/files/do<br />
cuments/folic-acid-factsheet.pdf<br />
(13) Report <strong>of</strong> the National Committee on <strong>Folic</strong><br />
<strong>Acid</strong> Food<br />
Fortification http://www.fsai.ie/uploadedfiles/<br />
folic_acid.pdf<br />
(14) Grow<strong>in</strong>g Up <strong>in</strong> Ireland – Peri-conceptual<br />
<strong>Folic</strong> <strong>Acid</strong> Use In<br />
Ireland http://www.grow<strong>in</strong>gup.ie/fileadm<strong>in</strong>/us<br />
er_upload/documents/Conference/2011/Sessi<br />
on_F_Paper_2_McNally__Bourke__McCrory.pd<br />
f