Can a simple B vitamin like folic acid really prevent serious birth defects? The answer is a resounding yes, but taking the vitamin in the easiest days and weeks of pregnancy is key.
When women find out they are pregnant, staying healthy often becomes a top priority. Making sure they are eating nutritious foods, getting enough rest, remaining active, and generally taking care of themselves comes to the forefront. But one of the most critical times for preventing certain birth defects is before a woman even knows she is pregnant.
Sufficient intake of folic acid (folate) can prevent serious birth defects, so January 7 to 13 marks Folic Acid Awareness Week. The observation offers a timely opportunity for nurses to become aware of their own folic acid intake and to open up discussions with their female patients of child-bearing age.
According to the National Birth Defects Prevention Network (NBDPN), sufficient folic acid intake before pregnancy occurs can “prevent up to 70% of some serious birth defects of the brain and spine, called neural tube defects.” Specifically, the vitamin has protective benefits against spina bifida and anencephaly, which begin to develop in the early weeks of pregnancy, often long before a woman even realizes she is pregnant.
Because approximately half of all pregnancies in the United States are unplanned, raising awareness about the protective benefits of sufficient folic acid intake before a pregnancy happens is essential. Luckily, getting the recommended 400 mcg of folic acid is as easy as taking a daily multivitamin or eating fortified pasta, rice, breads, or cereals (at mealtime or as a snack). Often, one small bowl of a fortified cereal can supply the minimum amount for the whole day.
Women who prefer to get enough folic acid from unfortified sources can turn to dark leafy greens, some juices, and many beans. But they need to be aware of the amounts they need to consume to meet the minimum requirement. According to the National Institutes of Health, these non-fortified foods are top sources of folate: beef liver, boiled spinach, black-eyed peas, asparagus, Brussels sprouts, and romaine lettuce.
According to the NBDPN, babies born to Hispanic women have the highest rates of these birth defects and that, in general, Hispanic women consume less folic acid overall and are less aware of the protective benefits of the vitamin during pregnancy.
For nurses, using Folic Acid Awareness Week to open up a conversation and give patients some easy-to-follow information for preventing these birth defects is worthwhile.
In the largest, most comprehensive, nationwide study to examine the prevalence of allergies from early childhood to old age, scientists from the National Institutes of Health (NIH) report that allergy prevalence is the same across different regions of the United States, except in children 5 years old and younger.
“Before this study, if you would have asked 10 allergy specialists if allergy prevalence varied depending on where people live, all 10 of them would have said yes, because allergen exposures tend to be more common in certain regions of the US,” said Darryl Zeldin, MD, scientific director of the National Institute of Environmental Health Sciences (NIEHS), part of NIH. “This study suggests that people prone to developing allergies are going to develop an allergy to whatever is in their environment. It’s what people become allergic to that differs.”
The research appeared online in February in the Journal of Allergy and Clinical Immunology and is the result of analyses performed on blood serum data compiled from approximately 10,000 Americans in the National Health and Nutrition Examination Survey (NHANES) 2005-2006.
Although the study found that the overall prevalence of allergies did not differ between regions, researchers discovered that one group of participants did exhibit a regional response to allergens. Among children aged 1 to 5 years old, those from the southern US displayed a higher prevalence of allergies than their peers living in other US regions. These southern states included Texas, Oklahoma, Louisiana, Arkansas, Tennessee, Kentucky, Mississippi, Alabama, Georgia, West Virginia, Virginia, North Carolina, South Carolina, and Florida.
“The higher allergy prevalence among the youngest children in southern states seemed to be attributable to dust mites and cockroaches,” explained Paivi Salo, PhD, an epidemiologist in Zeldin’s research group and lead author on the paper. “As children get older, both indoor and outdoor allergies become more common, and the difference in the overall prevalence of allergies fades away.”
The NHANES 2005-2006 not only tested a greater number of allergens across a wider age range than prior NHANES studies, but also provided quantitative information on the extent of allergic sensitization. The survey analyzed serum for nine different antibodies in children aged 1 to 5 years, and nineteen different antibodies in subjects 6 years and older. Previous NHANES studies used skin prick tests to test for allergies.
The scientists determined risk factors that made a person more likely to be allergic. The study found that in the 6 years and older group, males, non-Hispanic blacks, and those who avoided pets had an increased chance of having allergen-specific IgE antibodies, the common hallmark of allergies.
Socioeconomic status (SES) did not predict allergies, but people in higher SES groups were more commonly allergic to dogs and cats, whereas those in lower SES groups were more commonly allergic to shrimp and cockroaches.
By generating a more complete picture of US allergen sensitivity, the team uncovered regional differences in the prevalence of specific types of allergies. Sensitization to indoor allergens was more prevalent in the South, while sensitivity to outdoor allergens was more common in the West. Food allergies among those 6 years and older were also highest in the South.
The researchers anticipate using more NHANES 2005-2006 data to examine questions allergists have been asking for decades. For example, using dust samples obtained from subjects’ homes, the group plans to examine the link between allergen exposure and disease outcomes in a large representative sample of the US population.
NIEHS supports research to understand the effects of the environment on human health. For more information on environmental health topics, visit www.niehs.nih.gov.
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