The popularity of low carb diets makes the message of National Folic Acid Awareness Week more significant than ever, as women of childbearing age may be risking the health of their babies by cutting back on sources of the B vitamin.
"Many women might not understand that by lowering their intake of enriched grains, they could be increasing their risk of having a pregnancy affected by a neural tube defect (NTD)," said Anita Boles, chair of the National Council on Folic Acid (NCFA) and executive director of the National Healthy Mothers, Healthy Babies Coalition.
The CDC and the Institute of Medicine recommend that women of childbearing age take 400 micrograms of folic acid each day to reduce the risk of an NTD-affected pregnancy by 50 to 70 percent.
Since 1998, the FDA has required that breads, cereals, flours, pastas, rice and other grain products are enriched with at least 20 percent of the RDA of folic acid per serving.
This policy has led to a 26 percent decrease in NTD rates, according to the Centers for Disease Control and Prevention (CDC). In Canada , the impact of fortification appears even more significant: research published in BMC Pregnancy and Childbirth showed a decrease of 78 percent in the provinces of Newfoundland and Labrador.
As well as including grains and a variety of other foods in their diet, consumers are advised to take a daily multivitamin containing folic acid. Although it is possible to obtain the RDA from foods such as lentils, chick peas and broccoli, the human body absorbs the synthetic form of folic acid better than the natural form, according to the NCFA.
However 60 percent of women fail to take the recommended daily supplement, says Boles.
Each year approximately 3000 pregnancies are affected with an NTD, of which spina bifida and anencephaly are the most common. Both conditions occur in the very early stages of pregnancy, often before women are aware that they are expecting.
In the case of spina bifida, folic acid deficiency prevents the lower end of the fetus' neural tube closing properly, often resulting in a lesion protruding from an opening in the back and causing disabilities including paralysis, incontinence and learning difficulties.
Anencaphany is a fatal condition which occurs when the upper end of the neural tube fails to close. In such case the brain fails to develop completely or may be absent altogether.
The NCFA's message on the importance of including grains in a healthy diet resonates with that of the new Dietary Guidelines for Americans, which were announced earlier this month.
More than just benefiting women, it seems folic acid could give other sectors of the population a health boost, too. Research has indicated that it may also have an important part to play in reducing the risk of colon, cervical and breast cancers. It may help prevent Alzheimer's and Parkinson's diseases.
As for its ability to prevent cardiovascular disease however, scientific opinion is divided. In 2002 researchers from the UK concluded that folic acid supplements could help keep arteries clear in patients who had undergone angioplasty by reducing levels of the amino acid homocysteine.
But the results of a study published last year in the New England Journal of Medicine indicated that it may actually have the opposite effect.