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Dr K K Aggarwal

Folic Acid Update

By Dr K K Aggarwal
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  • Folic acid (vitamin B9) is a water-soluble B vitamin.
  • It is lost in traditional Indian cooking.
  • Folic acid is essential for DNA repair, cell division and normal cellular growth.
  • Profound deficiency of folic acid during pregnancy is associated with neural tube defects, such as spina bifida, in neonates.
  • Deficiency in adults has been associated with megaloblastic anemia and peripheral neuropathy.
  • In both men and women, low serum folate levels can increase homocysteine levels, which are correlated with elevated cardiovascular risk.
  • Low folic acid levels during pregnancy in women with epilepsy have been associated with fetal malformation and older enzyme-inducing anti-epileptic drugs (AEDs) are known to reduce serum folate levels.
  • The risk of having a pregnancy complicated by a major congenital malformation (e.g., neural tube defect) is doubled in epileptic women taking AEDs compared with those women with a history of epilepsy not taking these agents.
  • Risk is tripled with AED polypharmacy, especially when valproic acid is included.
  • Consensus statements recommend 0.4–0.8 mg of folic acid per day in all women planning a pregnancy. Ideally, this should be started at least 1 month prior to pregnancy, if possible.
  • The guidelines recommend higher daily folic acid doses (4 mg/day) in women with a history of neural tube defects.
  • Enzyme-inducing anticonvulsants, such as phenytoin, carbamazepine, primidone and phenobarbital, are known to decrease folate levels, and valproic acid may interfere with folate metabolism.
  • Other AEDs, such as oxcarbazepine, lamotrigine and zonisamide, do not appear to alter folate levels.
  • Because many pregnancies are unplanned, it is recommended that folic acid supplementation be given routinely to all women of childbearing potential at 0.4 mg/day.

Tips to prevent anemia from becoming severe during pregnancy

By Dr K K Aggarwal
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  1. Eat iron-rich foods such as meat, chicken, fish, eggs, dried beans and fortified grains. The form of iron in meat products, called heme, is more easily absorbed than the iron in vegetables. If you are anemic and you ordinarily eat meat, increasing the amount of meat you consume is the easiest way to increase the iron your body receives.
  2. Eat foods high in folic acid, such as dried beans, dark green leafy vegetables, wheat germ and orange juice.
  3. Eat vitamin C-rich foods such as citrus fruits and fresh, raw vegetables.
  4. Cook in cast iron pots as this can add up to 80% more iron to your food.
  5. Take your prenatal multivitamin and mineral pill which contains extra folate.

Some tips to prevent anemia

By Dr K K Aggarwal
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  1. Eat foods rich in iron. Some iron-rich foods include dark-green leafy vegetables, such as watercress and curly kale, iron-fortified cereals, whole grains, such as brown rice, beans, nuts, meat, apricots, prunes, and raisins.
  2. Include vitamin C-rich foods and drinks in your diet as it will help the body in absorbing iron.
  3. Avoid drinking tea or coffee with meals, as this affects the absorption of iron.
  4. Include enough sources of vitamin B12 and folic acid in your diet.

Folic Acid Update

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Folic Acid Update

  1. Folic acid (vitamin B9) is a water–soluble B vitamin.
  2. It is lost in traditional Indian cooking.
  3. Folic acid is essential for DNA repair, cell division and normal cellular growth.
  4. Profound deficiency of folic acid during pregnancy is associated with neural tube defects, such as spina bifida in neonates.
  5. Deficiency in adults has been associated with megaloblastic anemia and peripheral neuropathy.
  6. In both men and women, low serum folate levels can increase homocysteine levels, which are correlated with elevated cardiovascular risk.
  7. Low folic acid levels during pregnancy in women with epilepsy have been associated with fetal malformation and older enzyme–inducing anti-epileptic drugs are known to reduce serum folate levels.
  8. The risk of having a pregnancy complicated by a major congenital malformation (e.g., neural tube defect) is doubled in epileptic women taking anti-epileptic drugs compared with those women with a history of epilepsy not taking these agents.
  9. Risk is tripled with anti–epileptic drugs polypharmacy, especially when valproic acid is included.
  10. Consensus statements recommend 0.4–0.8 mg of folic acid per day in all women planning a pregnancy. Ideally, this should be started at least 1 month prior to pregnancy if possible.
  11. The guidelines recommend higher daily folic acid doses (4 mg/day) in women with a history of neural tube defects.
  12. Enzyme–inducing anticonvulsants, such as phenytoin, carbamazepine, primidone and phenobarbital, are known to decrease folate levels, and valproic acid may interfere with folate metabolism.
  13. Other AEDs such as oxcarbazepine, lamotrigine and zonisamide, do not appear to alter folate levels.
  14. Because many pregnancies are unplanned, it is recommended that folic acid supplementation be given routinely to all women of childbearing potential at 0.4 mg/day.

Folic Acid Update

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , , | | Comments Off on Folic Acid Update

• Folic acid (vitamin B9) is a water–soluble B vitamin.

• It is lost in traditional Indian cooking.

• Folic acid is essential for DNA repair, cell division and normal cellular growth.

• Profound deficiency of folic acid during pregnancy is associated with neural tube defects, such as spina bifida in neonates.

• Deficiency in adults has been associated with megaloblastic anemia and peripheral neuropathy.

• In both men and women, low serum folate levels can increase homocysteine levels, which are correlated with elevated cardiovascular risk.

• Low folic acid levels during pregnancy in women with epilepsy have been associated with fetal malformation and older enzyme–inducing anti-epileptic drugs are known to reduce serum folate levels.

• The risk of having a pregnancy complicated by a major congenital malformation (e.g., neural tube defect) is doubled in epileptic women taking anti-epileptic drugs compared with those women with a history of epilepsy not taking these agents.

• Risk is tripled with anti–epileptic drugs polypharmacy, especially when valproic acid is included.

• Consensus statements recommend 0.4–0.8 mg of folic acid per day in all women planning a pregnancy. Ideally, this should be started at least 1 month prior to pregnancy if possible.

• The guidelines recommend higher daily folic acid doses (4 mg/day) in women with a history of neural tube defects.

• Enzyme–inducing anticonvulsants, such as phenytoin, carbamazepine, primidone and phenobarbital, are known to decrease folate levels, and valproic acid may interfere with folate metabolism.

• Other AEDs such as oxcarbazepine, lamotrigine and zonisamide, do not appear to alter folate levels.

• Because many pregnancies are unplanned, it is recommended that folic acid supplementation be given routinely to all women of childbearing potential at 0.4 mg/day.

Folic acid update

By Dr K K Aggarwal
Filed Under Wellness | Tagged With: , | | Comments Off on Folic acid update

Folic acid (vitamin B9) is a water–soluble B vitamin.

• It is lost in traditional Indian cooking.

• Folic acid is essential for DNA repair, cell division and normal cellular growth.

• Profound deficiency of folic acid during pregnancy is associated with neural tube defects, such as spina bifida in neonates.

• Deficiency in adults has been associated with megaloblastic anemia and peripheral neuropathy.

• Low serum levels of folate can increase homocysteine levels in both men and women, which are correlated with elevated cardiovascular risk.

• Low folic acid levels during pregnancy in women with epilepsy have been associated with fetal malformation, and older enzyme–inducing anti-epileptic drugs are known to reduce serum folate levels.

• The risk of having a pregnancy complicated by a major congenital malformation (e.g., neural tube defect) is doubled in epileptic women taking anti epileptic drugs compared with those women with a history of epilepsy not taking these agents.

• Risk is tripled with anti–epileptic drugs polypharmacy, especially when valproic acid is included.

• Consensus statements recommend 0.4–0.8 mg of folic acid per day in all women planning a pregnancy. Ideally, this should be started at least 1 month prior to pregnancy if possible.

• The guidelines recommend higher daily folic acid doses (4 mg/day) in women with a history of neural tube defects.

• In addition, enzyme–inducing anticonvulsants, such as phenytoin, carbamazepine, primidone and phenobarbital, are known to decrease folate levels, and valproic acid may interfere with folate metabolism.

• Other anti-epileptic drugs, such as oxcarbazepine, lamotrigine and zonisamide, do not appear to alter folate levels.

• Because many pregnancies are unplanned, most recommend that folic acid supplementation be given routinely to all women of childbearing potential at 0.4 mg/day.

Role of Folate or Folic Acid in Cancer Prevention

By Dr K K Aggarwal
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Several large observational studies have shown a decrease in risk of colorectal and other cancers with dietary folate, while other randomized trials of folic acid supplementation have raised the possibility of increased cancer risk from folic acid supplementation.

In the largest meta-analysis of individual patient data from randomized trials of folic acid for the prevention of cardiovascular disease (10 trials, n = 49,969) and colorectal adenoma (3 trials, n = 2652), during an average of 5.2 years of treatment, there was no significant difference in overall cancer incidence for patients assigned to folic acid or placebo.

There was also no significant effect on the incidence of specific cancers, including cancers of the large intestine, prostate, lung, or breast. (Lancet 2013;381:1029)

Role of Folate Or Folic Acid In Cancer Prevention

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The role of folic acid in cancer prevention is uncertain.

Large observational studies have suggested a decrease in risk of colorectal and other cancers with dietary folate but others randomized trials have raised the possibility of harm.

In the largest meta-analysis of individual patient data from randomized trials of folic acid for the prevention of cardiovascular disease and colorectal adenoma during an average of 5.2 years of treatment, there was no significant difference in overall cancer incidence for patients assigned to folic acid or placebo.

Vollset SE, Clarke R, Lewington S, et al. Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: meta-analyses of data on 50,000 individuals. Lancet 2013.

Role of folate or folic acid in cancer prevention

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Filed Under Wellness | Tagged With: , , | | Comments Off on Role of folate or folic acid in cancer prevention

The role of folic acid in cancer prevention is uncertain.

Large observational studies have suggested a decrease in risk of colorectal and other cancers with dietary folate but others randomized trials have raised the possibility of harm.

In the largest meta-analysis of individual patient data from randomized trials of folic acid for the prevention of cardiovascular disease and colorectal adenoma during an average of 5.2 years of treatment, there was no significant difference in overall cancer incidence for patients assigned to folic acid or placebo.

Vollset SE, Clarke R, Lewington S, et al. Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: meta-analyses of data on 50 000 individuals. Lancet 2013.

Do I Need Multivitamin Tablets?

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1. Multivitamin tablets are not needed unless there is a scarcity of a particular vitamin.

2. If you include all seven colors and six tastes in your food, there is no need for vitamin supplementation.

3. Wheat grass and barley grass juice contain folic acid and vitamin B12.

4. Anything which is green contains vitamin B.

5. Anything which is red contains lycopene.

6. Citrus foods contain vitamin C.

7. All dry fruits contain vitamin E.

8. Sunlight is an excellent source of vitamin D.

9. Carrots contain vitamin A.

10. Folic acid is lost if the food is boiled and the water is discarded.

11. Vitamin D is not absorbed if exposed to sunlight is through glass.

12. Vitamin D is not absorbed through clothes if you are fully-clothed in sunlight.