Pregnancy is an exciting time! So much is up in the air and out of your control, but nutrition shouldn’t be. We all need to maintain good nutrition throughout our entire life cycle, but nutrition is especially impactful during preconception and pregnancy. Obviously, nutrition status influences the health of mom and baby, but just as importantly it is an amazing opportunity for a woman to positively shape the health of her baby well into his or her adulthood. For instance, health and nutrition during this time of life can set the stage for whether or not a child is predisposed to diabetes and obesity in early adulthood. In addition, adequate supplementation of key nutrients is instrumental in the prevention of certain birth defects, and this is where enrichment comes into play. 

A Little History…

In the U.S., refined grains have been enriched since 1941. Enrichment is the process used to add vitamins and nutrients back into bread and other grains that have been lost during the manufacturing process, making enriched grains a good source of iron and four B vitamins: thiamin, niacin, riboflavin, and folic acid. All are vital in a variety of biological functions. Thiamin, or B1, aids in normal nervous system functioning. Riboflavin, or B2, promotes healthy vision, provides energy, and aids in healthy skin. Niacin, or B3, helps in digestion and the maintenance of a normal appetite and nervous system. 

Enriching grains with iron, riboflavin, niacin, and thiamin, has resulted in the eradication of pellagra (a disease that affects the skin, digestion, and mind) and beriberi (a condition that can impact the nervous, cardiovascular, and digestive systems) from the United States. And, since 1998, when it became mandatory to add folic acid to enriched grain products, the incidence of certain neural tube defects, such as spina bifida, has dropped by more than 32 percent in the U.S. Thankfully, about 95 percent of the white flour in the U.S. is enriched. 

“What specific vitamins should I look for?”

If you are pregnant or thinking of becoming pregnant, perhaps more than any other vitamin, make sure you have an adequate intake of folic acid. Generally, this means 400 micrograms per day. Folic acid is a B vitamin that can reduce the risk of certain birth defects, such as spina bifida, and it plays an important role in red blood cell production and helps a baby’s neural tube develop in the brain and spinal cord. Birth defects occur within the first 3 to 4 weeks of pregnancy, so it is important to have folic acid in your system during those early stages when a baby’s brain and spinal cord are developing. 

Baby Maybe

Even if you are only thinking about possibly becoming pregnant, pregnancy preparedness makes sense since many times a pregnancy may occur unexpectedly, and there are so many emerging benefits of folic acid. A study in the Journal of American Medical Association found that the use of folic acid supplements by women in Norway in the period four weeks before to eight weeks after conception was associated with a substantially reduced risk of the child having severe language delay at age three. Another study showed that women who took folic acid for at least a year before getting pregnant cut their chances of delivering early by 50 percent or more. 

The CDC recommends that women start taking folic acid every day for at least a month before becoming pregnant, and every day during the pregnancy. The CDC’s general recommendation is that all women of childbearing age take folic acid every day. Evidence suggests that if all women of childbearing age and expectant mothers in their first trimester consumed the recommended 400 micrograms a day of folic acid, 70 percent of neural tube defects in newborn children could be prevented. 

More Benefits of Enrichment

Researchers are learning more and more each day in the prevention of neurodevelopmental disorders with the supplementation of folic acid. For example, when taken before and during pregnancy, folic acid may also help protect the baby against cleft lip and palate, premature birth, low birth weight, miscarriage, and poor growth in the womb. There is even a possibility that adequate folic acid intake reduces the risk of preeclampsia (characterized by high blood pressure) in pregnancy.

Since people often forget to take their vitamins on a daily basis, this is where enrichment can help. For instance, a 1999 study found that 77 percent of low-income women could take in adequate amounts of folic acid through enriched grain products. Since supplements can be costly and are therefore often not taken by women in lower-income households, this is a way for people to afford folic acid supplementation. 

Folic acid may also protect against heart disease, stroke, some types of cancers, Alzheimer’s disease, and depression. For more information on the connection between Folic Acid and these conditions, consult with your healthcare provider. It’s always good to be informed in making good health decisions for yourself and those you love. 

“Mix It Up”

A good mix of whole and enriched grains can offer many benefits. Examples of foods with enriched grains include white bread and rolls, tortillas, rice, pasta, and cereals that are sources of B vitamins, including folic acid, and iron. Whole grains, such as whole wheat bread, brown rice, oatmeal, are also excellent in providing fiber, antioxidants, B vitamins, magnesium, iron, as well as other vitamins, minerals, and phytonutrients—just another way a balanced, well-rounded diet can provide health and well being. 


 Lela Iliopoulos is a Registered Dietitian and Certified Diabetes Educator and an expert in nutrition therapy, health promotion, and education. She is passionate about impacting nutritional health through the practical application of science-based information