Folate is a vitamin that is responsible for one-carbon methyl transfer in a variety of cellular reactions, including formation of purines and pyrimidines, which make up DNA and RNA. Folate deficiency may result in megaloblastic anemia, as forming red cells fail to divide. As the best source of folate is in green leafy vegetables, folate nutrition may be marginal in many adolescents. Recent epidemiologic evidence suggests that folate supplementation, at levels that are higher than usual dietary intake (200-400 mgday-1), reduced the incidence of neural tube defects (anencephaly and spina bifida) in new-borns. Supplementation needs to be started early in pregnancy, within the first 8 weeks and before most pregnancies are apparent, so should involve most women of child-bearing age. The recent decision to fortify grains and cereals with folic acid in the US will also reduce serum homocysteine levels, lowering the risk of cardiovascular disease.

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