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 3 . HOW MUCH FOLIC<br />

ACID?<br />

0 8 . HIGHER RISK<br />

GROUPS<br />

0 4 . THE BENEFITS OF<br />



0 5 . WHAT HAPPENS IF<br />

THERE IS<br />


ACID?<br />


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 />

PAGE 01<br />


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 />

PAGE 02<br />


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 />

PAGE 03<br />



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 />


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 />

PAGE 05<br />


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 />

PAGE 06<br />


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 />

PAGE 07<br />


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 />

PAGE 08<br />


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 />

PAGE 09<br />


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 />

PAGE 10<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 />

PAGE 11<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 />

PAGE 12<br />

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 />



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 />



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 />


eferences<br />

(1) <strong>Folic</strong> <strong>Acid</strong> for the Prevention <strong>of</strong> Neural Tube<br />

fects http://pediatrics.aappublications.org/con<br />

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(2) Identify<strong>in</strong>g women who might benefit from<br />

higher doses <strong>of</strong> folic acid <strong>in</strong><br />

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 />

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(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 />

pregnancy http://ajcn.nutrition.org/content/71<br />

/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 />


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