Ironing Out the Differences for Calcium and Folate

How do your food choices stack up for three nutrients of concern to women: calcium, iron, and folate? In each pair, which food would you choose?

For more calcium . . .

Column A

Column B

V2 cup frozen yogurt

V2 cup ice cream

1 oz. Cheddar cheese

V2 cup cottage cheese

3 oz. canned tuna

3 oz. canned salmon with bones

1 cup milk

1 cup apple juice

1 slice cheesecake

V2 cup pudding

2 tbsp. yogurt cheese*

2 tbsp. cream cheese

V2 cup lettuce

V2 cup turnip greens

V2 cup tofu (with calcium sulfate)

V2 cup pinto beans

*See "Kitchen Nutrition: Yogurt Cheese"

in chapter 3 for a recipe.

For more iron . . .

Column A

Column B

1 cup fortified breakfast cereal

1 slice whole-wheat toast

3 oz. broiled sirloin steak

3 oz. broiled cod

V2 cup cooked green beans

V2 cup cooked kidney beans

V2 cup cooked zucchini

V2 cup boiled spinach

1 egg yolk

1 egg white

'/3 cup grapes

'/3 cup raisins

2 tbsp. peanut butter

3 oz. broiled chicken breast

1 oz. pumpkin seeds

1 oz. pretzels

For more folate . . .

Column A

Column B

1 cup fortified breakfast cereal

1 bread slice

V2 cup mashed potatoes

V2 cup pasta

6 oz. apple juice

6 oz. orange juice

1 cup raw spinach

1 cup iceberg lettuce

Now score yourself:

For each pair, these foods contain:

  • More calcium—frozen yogurt, Cheddar cheese, canned salmon with bones, milk, pudding, yogurt cheese, turnip greens, tofu (with calcium sulfate)
  • More /ron—fortified breakfast cereal, sirloin steak, kidney beans, spinach, egg yolk, raisins, chicken breast, pumpkin seeds
  • More folate—fortified breakfast cereal, pasta,* orange juice, spinach
  • Most enriched grain products are fortified with folic acid by law; whole-grain products may or may not be.

Give yourself 5 points for each selection you got right—perfect score, 40 points for calcium, 40 points for iron, and 20 points for folate. The higher your score, the more calcium, iron, and folate you likely consume—if these foods really are your "picks" for the day. Tip: Partner eggs and plant sources of iron with meat, poultry, or fish, or with a vitamin C-rich food to enhance its absorption.

To check specific calcium and iron content in these food pairs, see "Counting Up Calcium" and "Counting Up Iron"in chapter 4. Fruits and vegetables are among your best folate sources; assess your fruit and vegetable intake using "How Do Your Fruits and Veggies Stack Up?" in chapter 4. Fortified grain products, some whole-grain products, nuts, legumes, and liver are good folate sources, too.

About twenty-five hundred newborns in the United States are born each year with neural tube defects. Since 1998, when grain products became fortified by law with folic acid (a form of folate), the incidence has gone down significantly. A diet with insufficient folic acid is one cause of neural tube defects.

Even a varied, well-balanced eating plan may not supply enough folate to protect against birth defects. So nutrition experts advise that all women of child-bearing age consume 400 micrograms of folic acid daily from fortified foods, vitamin supplements, or both, in addition to the folate naturally found in food.

  • Eat a variety of foods with naturally occurring folate—for example, citrus fruits and juices; dark-green leafy vegetables; nuts; legumes; and liver.
  • Read food labels to identify foods fortified with folic acid—for example, in most refined grains, such as breads, flour, crackers, cornmeal, farina, pasta and rice. If folic acid is added to breakfast cereals, it's listed on the Nutrition Facts. For fortified foods, the label may carry a health claim—that adequate folate intake may decrease the risk for neural tube defects. If most of your grains are "whole," your food choices may not provide much folate; some whole-grain products are voluntarily folic acid fortified.
  • Consult your doctor or a registered dietitian (RD) about appropriate levels of supplements with folic acid. Taking too much folate (more than 1,000 micrograms a day) can mask the symptoms of pernicious anemia, which can cause nerve damage. (Pernicious

Every Age and Stage of Life: Why a Healthy Weight?

For girls... A healthy weight-not overweight—during childhood offers protection for the long term: protecting them from adult obesity and type 2 diabetes, and helping blood cholesterol and triglyceride levels stay at healthy levels. During the growing-up years, a healthy weight boosts self-esteem, important for emotional, mental, and social development. Overweight increases the chance of early puberty.

For teen and young-adult women ... As with girls, a healthy weight-not overweight-reduces the chances of adult obesity later and helps ensure a healthy pregnancy and nursing. Beyond that, maintaining a healthy weight promotes physical health in other ways: lower risk for high blood cholesterol levels, for type 2 diabetes, and for high blood pressure; less arthritis risk in later life; and perhaps easier breast cancer detection. On the flip side, a healthy weight-not underweight-helps teens and young women develop and maintain strong bones for peak bone mass. For emotional health, a healthy weight feels good and boosts self-esteem.

For women in their child-bearing years... The benefits of a healthy weight mirror those of the teen and young-adult years. In addition, a healthy weight promotes fertility and helps reduce the risk for gallbladder disease.

For pregnant and breast-feeding women . . . Most important, healthy weight gain (not dieting) helps ensure a healthy pregnancy: promotes normal fetal development and improves the chances of a healthy, full-term birth. When maternal weight is healthy, childbirth is easier and safer. Obesity increases the risk for high blood pressure, gestational diabetes, induced labor, and caesarean sections. Maternal obesity may affect a child's health in other ways, too, including increased risk for childhood obesity. During breastfeeding, a healthy weight helps maintain the quality and volume of breast milk. A healthy weight during pregnancy and breast-feeding lowers a woman's risk for obesity later.

For women after menopause... As before, a healthy weight protects against some health problems, including breast cancer, some other cancers, heart disease, and diabetes. Among other benefits, helping to prevent risky abdominal weight gain, as weight shifts after menopause. As always, a healthy weight feels good!

For older women... A healthy weight continues to protect against some cancers, heart disease, and type 2 diabetes. A healthy weight-not underweight-helps bones remain strong, cushions bones and organs from fracture and other injury (in case of a fall), and protects against wasting related to serious illness.

See "Weighing the Risks" in chapter 2 for more reasons!

anemia may result from a vitamin B12 deficiency.) Taking large doses from vitamin pills, not food sources, is the usual reason why symptoms are masked.

Even if pregnant women do consume enough folate, obesity increases the chance of neural tube defects. For more on folate, see chapter 4.

More Prepregnancy Advice

  • Even before pregnancy, refrain from practices that may harm your developing baby: cigarette smoking, drinking alcoholic beverages, and inappropriate drug use. Important stages in your baby's development start right after conception. Before you know you're pregnant, potentially harmful substances may have effects.
  • Discuss over-the-counter and prescription medications you take with your doctor. They may be harmful to your developing baby.
  • Stay physically active or initiate moderate physical activity in your daily lifestyle. That will help prepare you to be "fit" for a healthy pregnancy.
  • Two foodborne risks can affect your baby, even before you conceive: methylmercury and toxoplas-mosis. Refer to chapter 12 to learn how to protect yourself now!

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