Doctors, Religion, and the Poor

I can't figure out if I'm surprised about this or not. ...
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Newswise — Although most religious traditions call on the faithful to serve the poor, a large cross-sectional survey of U.S. physicians found that physicians who are more religious are slightly less likely to practice medicine among the underserved than physicians with no religious affiliation.

In the July/August issue of the Annals of Family Medicine, researchers from the University of Chicago and Yale New Haven Hospital report that 31 percent of physicians who were more religious—as measured by "intrinsic religiosity" as well as frequency of attendance at religious services—practiced among the underserved, compared to 35 percent of physicians who described their religion as atheist, agnostic or none.

Toxic Golf Courses

(Sorry if you like golf)

Man Fertility and I were just in Arizona, where it was so hot (our car thermometer said 125 degrees at one point) that we actually so wilted cacti. Yet, we also so tons of lush, rolling grassy golf courses (with fountains). But, just like when my mom and I got twin "allergic" reactions at a florist, something about the grass made me feel a bit funny. Could it have been the pesticides?

Among the big winners in Bush's proposed rollback of pesticide restrictions? The politically untouchable golf industry, where dangerous chemicals are par for the course AND bad for the ozone layer:

By Jake Tapper

January 31, 2003 | Methyl bromide gas is some pretty nasty stuff.

The toxic pesticide has a habit of affecting non-target organisms as well as the pests it seeks. Human exposure to too much of it can lead to death, respiratory failure, central nervous failure and permanent disabilities; pregnant women exposed to it risk fetal defects. And, according to the Environmental Protection Agency, "methyl bromide contributes significantly to the destruction of earth's stratospheric ozone layer" and for that reason, on Nov. 28, 2000, the U.S. government agreed to a 70 percent reduction of its use this year, with a complete ban to kick in by 2005.

The Bush administration, however, is considering applications for 56 exemptions from this ban and, according to press reports, is planning to grant many of these industries their wish...

One might be inclined to feel some sympathy for the Virginia Tomato Growers, the Sweet Potato Council of California or the Rice Millers' Association. They feed us. But golfers? Specifically, in its application (click here for a PDF copy; requires Adobe Acrobat) the Golf Course Superintendents Association of America wants EPA Administrator Christie Todd Whitman to allow its members to use, from 2005-2007, 734,400 pounds of a chemical so toxic and environmentally damaging it will be banned nearly everywhere else. This exemption is sought so the courses can continue to look pretty.

"Methyl bromide is used on golf courses when they resurface greens," explains GCSAA spokesman Jeff Bollig. "Greens are covered with a tarp sort-of material and they shoot the gas in -- it kills the existing grass so it can be replaced with a better strain."

And the EPA, according to some reports, appears inclined to grant the golf association its wish. Naturally, the environmental community is up in arms. "We don't think that methyl bromide should have a place on the farm, let alone the fairway," says Allen Mattison, spokesman for the national Sierra Club. "There is certainly a better solution than a substance that depletes the ozone layer and causes irreversible environmental harm."

The Bush administration, however, has been able to slowly roll back a series of such restriction in the past few years, with little notice, or outrage, from the public at large.

read more here or just stay away from golf courses...

Western Diet Linked to Breast Cancer in Asian Women

Food for thought:

Newswise — Postmenopausal Asian women who eat a “meat-sweet” or Western diet are at greater risk of developing breast cancer than those who eat a “vegetable-soy” diet, according to a new study. The findings mark the first time an association between a Western diet and breast cancer has been identified in Asian women

The study, published in the July issue of Cancer Epidemiology, Biomarkers & Prevention, involved women in the Shanghai Breast Cancer Study. Eligible cases included all women 25 to 64 years of age who with a new diagnosis of breast cancer from August 1996 to March 1998. Controls were selected from the Shanghai Resident Registry of permanent residents in urban Shanghai. “The issue [of diet] is of particular relevance to women in Asia, for whom breast cancer rates are traditionally low but increasing steadily in recent years,” explained Marilyn Tseng, Ph.D., an associate member in the population science division at Fox Chase Cancer Center in Philadelphia.

The transition in breast cancer risk has been attributed to environmental factors, possibly the incorporation of Western dietary pattern foods into traditional dietary habits as a part of broader, societal socioeconomic changes. However, the association of dietary patterns with breast cancer risk has not been studied previously in Asian women.

Through in-person interviews with the Shanghai study participants and residents of Shanghai, researchers established the existence of two primary dietary patterns—the “meat-sweet” diet and a “vegetable-soy” diet. The “meat-sweet” diet includes various meats—primarily pork but also poultry, organ meats, beef and lamb and with saltwater fish, shrimp and other shellfish as well as candy, dessert, bread and milk. The “vegetable-soy” pattern is associated with different vegetables, soy-based products, and freshwater fish.

Of 1,602 eligible breast cancer cases identified during the study period, in-person interviews were completed for 1,459 (91.1%). In-person interviews were completed for 1,556 (90.3%) of the 1,724 eligible controls.

The “meat-sweet” pattern was significantly associated with increased risk of breast cancer among overweight postmenopausal women. Specifically, high intake of the “meat-sweet” pattern was associated with a greater than twofold increased risk of estrogen-receptor-positive (ER+) breast cancer among these women. The results showed no overall association of breast cancer risk with the “vegetable-soy” pattern.

“Our study suggests the possibility that the “meat-sweet” pattern increased breast cancer risk by increasing obesity, Tseng said. “Low consumption of a Western dietary pattern plus successful weight control may protect against breast cancer in a traditionally low-risk Asian population that is poised to more broadly adopt foods characteristic of Western societies.”

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Also interesting is that my mom and her Asian friends never went through the old "change of life"--i.e., they didn't get all the hot flashes and weird hormonal shifts....hm.....

REVIEW: Larry's Beans Coffee

Look at how hard these guys work to find you the best organic fair trade coffee, ever!

From Larry's Bean's mission statement:

We're out to prove we can sell awesome-tasting coffee beans in a way to make the world a better place. 1. We build fair trade relationships with family farm cooperatives 2. We buy organic, shade-grown coffees whenever possible and support sustainable farming methods. 3. We cultivate relationships that benefit people, animals and the environment.

I personally like their Martin Roast, a nice dark roast but without that scorched-earth taste. Check it out at Larrysbeans.com.

Versatile hemp

I've ranted about hemp before and encouraged y'all to eat hemp products for their EFAs (read here) and its sustainability.

This is one of the best articles I've read explaining (in a nutshell, so to speak) and asininity of why hemp is not grown in the U.S.

From my cyber-bud, The Worsted Witch, bone up on your history here.

Routine Feeding Of Antibiotics To Livestock May Be Contaminating The Environment

Another reason to buy organic meat is to create a demand for it, so we can get away from this horrible industrial farming and their out-of-control use of antibiotics (healthy farm raised animals don't needs prophylactic antibiotics):

Science Daily — It is estimated that between 9 and 13 million kilograms of antibiotics are used annually in the United States for raising livestock, with the majority being used for growth advancement and disease prevention purposes. Large amounts of antibiotics fed to livestock are excreted and end up in animal manure, which is commonly applied to agricultural land to provide crop nutrients. Therefore, food crops grown on manure-altered soils are exposed to antibiotics.

Scientists at the University of Minnesota have been evaluating the impact of antibiotic feeding in livestock production on the environment. This particular study, funded by the United States Department of Agriculture (USDA), evaluated whether food crops accumulate antibiotics from soils spread with manure that contains antibiotics.

Plant uptake was evaluated in a greenhouse study involving three food crops: corn, lettuce, and potato. Plants were grown on soil modified with liquid hog manure containing Sulfamethazine, a commonly used veterinary antibiotic. This antibiotic was taken up by all three crops. Concentrations of antibiotics were found in the plant leaves. Concentrations in plant tissue also increased as the amount of antibiotics present in the manure increased. It also diffused into potato tubers, which suggests that root crops, such as potatoes, carrots, and radishes, that directly come in contact with soil may be particularly vulnerable to antibiotic contamination.

The ability of plants to absorb antibiotics raises the potential for contamination of human food supply. However, Satish Gupta, group leader notes "The adverse impacts of consuming plants that contain small quantities of antibiotics are largely unknown". Consumption of antibiotics in plants may cause allergic reactions in sensitive populations, such as young children. There is also concern that consuming antibiotics may lead to the development of antimicrobial resistance, which can render antibiotics ineffective.

Holly Dolliver, the lead scientist in this study, notes that antibiotics consumed by plants may be of particular concern to the organic farming industry. Manure is often the main source of crop nutrients for organic food production, since regulations prohibit the use of synthetic fertilizers. According to the USDA, producers must manage animal materials in a manner that does not contribute to contamination of crops by residues of prohibited substances, which includes antibiotics. However, manures containing antibiotics are not formally banned or prohibited.

I know industry is going to twist this around to see organic foods ar bad for you, when it's the industrial production that's causing this and other problems like salmonella contamination. Can we stop the insanity? EAT ORGANIC.

Oh, and if you buy meat at Safeway, you might be buying dangerously decomposing crap that's been cosmetically altered, thanks to loopholes provided by the Bush administration! Read here.

"Walk to School" initiative/program/etc.

From Newswise's Back to School issue:

Newswise — National statistics show a reduction in kids’ physical activity along with an increase in poor childhood health and obesity rates. One Winston-Salem elementary school has partnered with Wake Forest University to design a “Walk to School” program, initiated by the Centers for Disease Control and Prevention. Gary Miller, associate professor of Health and Exercise Sciences, worked with his “Health and the Environment” class students to find safe routes for the children and to personally walk with the children – both to and from school as well as during short exercise breaks at the school. Miller’s program is also providing the children with inexpensive pedometers for immediate feedback. The program is looking beyond Winston-Salem, however: Miller’s students are working on guidelines for how other communities can start their own Walk to School programs, and how to find funding for these initiatives.

Us old folks of course remember the ten-mile walk in the snow with no shoes...but I digress. Most of my X and Boomer peers either walked or biked (or took the subway) at least some part of their childhood. Now walking to school is something that has to be instituted by the heavy hand of the CDC (complete with pedometers) instead of a fun, normal spontaneous thing. I just remember a lot of random interactions that occurred during the walks to and from, now everyone is driven in a car.

These things happen in increments...but we need to keep in mind, is this how we want to live? Do we want to continue to allow oil companies to construct for us a lifestyle where you can't even walk anywhere (e.g., no sidewalks) or won't want to? Notice how these superstore centers have sidewalks, but they're made in such a way you really can't comfortably walk between HOME DEPOT and BORDERS without getting run over. You definitely will need to get in the car to cross the street. What gives? [We were also just driving around suburban Tucson--you can see why I'm a bit crabby]

REVIEW: Green This! by Deirdre Imus

I've kind of been waiting for the furor over the "other Imus" to die down so this book can get the attention is deserves.

Call me a long-time admirer of Ms. Imus and her work with children with cancer and then figuring out on her own how big the toxin piece of the puzzle was...and how hospitals are huge repositories of chemicals and mutagens themselves (and don't forget the crappy food that would make anyone sick! We made sure to bring in our kids food AND water).

This book is full of easy and wise ways to green your cleaning and might even give you some insight into whether you overclean--as I used to--buying the marketers' ploys that we are in a war against microbes, must bleach, must ammonia, must KILL!!!! Actually, we're about 10-15% microbes ourselves, so bringing out the chems to kill 'em might not be the smartest of ideas.

I won't go over the tips, but after watching this great documentary Blue Vinyl about how PVCs not only might give you cancer and asthma but also how their manufacture and disposal gives people nearby a second chance to get more cancer...and so why we need to break our addiction to this noxious kind of plastic because the growing demand just means more pollution, etc.

Anyway, I was curious to see how/if Ms. Imus was going to address the issue, and I was more than pleased to see that one of the first things she did in greening Hackensack University Medical Center was to demand non-PVC bumpers and railings, thereby making it less toxic and hopefully starting the demand for these non-PVC products. THIS is the kind of thinking we need to do more of: how to make not just our homes less toxic and screw everyone else, but how can we simply, de-chemicalify, and also demand safer products so the whole world can be safer? Way to go, Deirdre Imus!

GreenFertility gives this two green thumbs up--buy this book and make your family AND the environment healthier.

Meat and fertility

Aha--many times health things we're doing with our son converge with fertility, as it should, as we're just trying to get him healthier, and a healthier person is also more fertile.

We are careful to limit the mount of meat/protein he gets because too much causes an excess of ammonia in his body, and when the ammonia rises, we also see behavioral problems. Not surprisingly, too much ammonia can interfere with fertility.

Here's this from the U.K. Daily mail:

Avoid eating large quantities of red meat, which can increase the amount of ammonia in our bodies. Too much ammonia can interfere with the implantation of the egg in the uterus. Too much rich protein may also increase the body's acidity and affect sperm activity. Sperm are at their most efficient in alkaline conditions.

There plenty more tips in this article, The Fertility Diet, lots of them that I won't repeat because they've already been covered here! But if you want to read more, click here.

Flying and Fertility?

I'm kind of wondering about this because I've had to make 3 cross-country trips and my period had come a week early for the last two cycles...eeek. From the BBC:

Frequent air travellers, such as cabin crew who repeatedly take long-haul flights, risk ill health, a study says.

As well as the obvious jet lag encountered with crossing multiple time zones, an out-of-kilter body clock can trigger psychotic and mood disorders.

The researchers say disrupted sleep and hormone patterns are largely to blame, The Lancet reported.

The Liverpool John Moores University team reviewed over 500 published articles on aviation and health.

They found reports of cabin crew experiencing decreased cognitive performance and mental health problems, including brief episodes of psychosis - loss of contact with reality.

And air hostesses complain of menstrual cycle problems linked with the irregularity of their work.

Read more here.

Immigration May be Bad for your Health

The immigration debate: MAN FERTILITY and I were watching the Daily Show, which had clips of all the horrible things people like Pat Buchanan were saying about immigrants being diseased (recycling age-old, pernicious stereotypes). As always, scaremongering with words like TUBERCULOSIS and LEPROSY, without a shred of fact (leprosy!).

Can we stop being so hateful toward one another? Apparently the communities most fearful of immigration (e.g., places like Parker, CO) are the places that are the most white (NY Times story here)!

Watch the Jon Stewart video here.

And then read, from Newswise:

Newswise — USC study finds immigrants from Mexico in better health than Mexicans-Americans born in the United States. Hardy immigrants mask poor vital signs of American-born Hispanic community, say researchers.

Mexicans-Americans born and raised in the United States are more likely to suffer from conditions such as diabetes, high blood pressure and high cholesterol than those who emigrate from Mexico, according to a new study from the University of Southern California.

The difference may be due to poor nutrition and less physical activity among native-born Mexican-Americans. Also individuals who leave Mexico for the United States may be fitter than the ones who stay behind.

“One possible explanation is that people who immigrate are healthy to begin with and they may also have come here with better health habits,” said Eileen Crimmins, lead author of the study and professor of gerontology at USC. “The generation born here has adopted American traits such as smoking and eating at fast food restaurants that were not as accessible in more traditional parts of Mexico.”

In a comparison of risk factors across ethnic groups, researchers from the USC Davis School of Gerontology and the UCLA School of Medicine found that U.S. born Mexican-Americans are significantly worse off not just than whites but also Mexican-born immigrants. The only group at greater risk for disease than the U.S.-born Mexican-American community is the black population.

The research appears in the current issue of the American Journal of Public Health and addresses a contradiction found in other studies known as the “Hispanic Paradox” – a claim that Hispanics in the United States are healthier than whites despite being poorer and less educated.

...The findings refute the “Hispanic Paradox” and support the hypotheses that people who are not healthy tend to stay in their home country and some immigrants living in America who become sick may return home.

...The conclusion that immigrants are a healthier population group than those living in the United States is reinforced by a second study using NHANES data that focused on immigrants specifically from Mexico. In a study soon to be published in the journal Social Biology, Crimmins’ group also found immigrants born in Mexico that come to the United States are taller and have better childhood nutrition than those who stay in their country of origin. The results indicate that migrants are selected based on health as well as social economic standing.

Endometriosis and Cancer

From Medical News Today:

Women with endometriosis have an increased risk of developing either ovarian, kidney or thyroid cancer, say French researchers at the 23rd Annual Meeting of the European Society of Human Reproduction and Embryology, Lyon, France.

The researchers, led by Dr. Anna-Sofia Melin, Karolinska Institute, Stockholm, Sweden, examined data on 63,630 women who had endometriosis. They found that endometriosis was linked to a higher risk of developing certain types of tumor. They also found that the number of children a woman has had does not seem to influence her cancer risk, even if she has had no children.

Dr Melin said "It could be that defects in the immune system allow the endometriosis to grow and also might allow cancer cells to grow in different parts of the body. Maybe the treatment of endometriosis can influence cancer development. We do not know yet."

Dr. Melin and team doubt that the fertility problems brought on by endometriosis raise cancer risk.

The scientists found endometriosis raised the risk of developing the following types of tumors:

-- Ovarian tumors - 37% greater risk
-- Endocrine tumors - 38% greater risk
-- Kidney tumors - 36% greater risk
-- Thyroid tumors - 33% greater risk
-- Brain tumors - 27% greater risk
-- Malignant melanoma - 23% greater risk
-- Breast cancer - 9% greater risk
Surprisingly, women with endometriosis seem to have a 29% lower risk of developing cervical cancer.

Dr. Melin said "Our hope is that doctors in general start to view the endometriosis disease as a serious disease that causes a lot of suffering to the patient and also may lead to cancer."

What is Endometriosis?

It is a medical condition caused by the lining of the womb growing elsewhere in the body, such as the ovaries, fallopian tubes and abdominal cavity - other areas can be affected, such as the bladder, bowel, vagina, cervix and vulva. It affects about 15% of women of reproductive age - in advanced cases it can leave women infertile.

The misplaced tissue develops into lesions or growths which respond to the menstrual cycle, as does the tissue of the uterine lining - on a monthly basis the tissue builds up, breaks down and sheds. The blood from the misplaced tissue, however, has no way of leaving the body. The patient experiences internal bleeding, inflammation, bowel problems, infertility and scar tissue formation.

It is a painful, chronic disease which affects 5.5 million women/girls in Canada/USA.

Symptoms of Endometriosis?

-- Painful period
-- Pain before period
-- Painful sex
-- Infertility
-- Fatigue
-- During periods urination is painful
-- During periods bowel movements are painful
-- Nausea, diarrhea, constipation
-- Yeast infection

p.s. acupuncture is a good therapy for endometriosis.

Pre-implantation Genetic Screening May not Improve Outcomes

While we're on the subject of fertility treatments, here's one on preimplantation genetic screening (PGD), a popular new treatment to make sure your kid is "perfect" before you even implant him/her (someone recently told me to try this--no lie):

July 5, 2007 — In women of advanced maternal age, preimplantation genetic screening significantly reduces, rather than increases, the rates of ongoing pregnancies and live births after in vitro fertilization, according to the results of a large, multicenter, randomized trial published in the July 5 issue of The New England Journal of Medicine.

"Pregnancy rates in women of advanced maternal age undergoing in vitro fertilization (IVF) are disappointingly low," write Sebastiaan Mastenbroek, MSc, from University of Amsterdam, the Netherlands, and colleagues. "It has been suggested that the use of preimplantation genetic screening of cleavage-stage embryos for aneuploidies may improve the effectiveness of IVF in these women."

This double-blind trial compared 3 cycles of IVF with and without preimplantation genetic screening in women aged 35 through 41 years. The main endpoint was ongoing pregnancy at 12 weeks of gestation, and secondary endpoints were biochemical pregnancy, clinical pregnancy, miscarriage, and live birth....

"Preimplantation genetic screening did not increase but instead significantly reduced the rates of ongoing pregnancies and live births after IVF in women of advanced maternal age," the authors write. "These results argue strongly against routinely performing preimplantation genetic screening as an adjunct to IVF in this group of women."

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N Engl J Med. 2007;357:9-17, 61-63.

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Hmm, I don't know for sure, but something tells me this is an "extra" that probably costs extra money, too!

How Safe are Fertility Treatments?

Some food for thought from ABC news (even though this story is from 2004 it's still very relevant, like one commenter said, everything old becomes new again in the health world):

The lucrative $4-billion-a-year infertility treatment business that consists of controversial drugs and experimental techniques is for the most part unregulated. Each year, thousands of women seek out infertility treatments as the solution to their infertility difficulties, however researchers expressed concerns over the industry's lack of safety and inability to keep up with the quickly growing industry. In one case, a couple dished out $30,000 and endured several months of a grueling drug regimen and the end result was no baby. The couple stated that it is a common practice for the doctors to stress the positives of the procedure and downplay the possible negatives. They also said the doctors usually required an immediate payment and didn't give an option for a payment plan. Statistics have shown that 73 percent of assisted reproduction treatments were unsuccessful in producing a baby. These results prompted some serious questions over the safety and lax regulation of the industry. Possible Negative Effects of the Procedures Enlarged ovaries Thinning of the uterine lining Multiple gestation pregnancies Other concerns that have been raised by experts center on the possible link between the infertility treatments and cervical cancer; however these studies have been inconclusive. The effects on the children conceived through assisted reproduction have also stirred concerns such as the potential of being having an increased susceptibility rate to disease.

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You can also read Waiting for Daisy, written by Peggy Orenstein, a journalist who "did it all" and experienced many of the icky health endangering things described above.

SSRIs may cause bone loss

When I was at an artists' colony (not the one I was just at) I was having a conversation with about 15 people and it turned out I was the ONLY writer/artist not on SSRIs--prozac, paxil, zoloft, etc. Believe me, I'm as depressive as you can get (stereotypical writer, etc.) but fooling with my brain scares me.

Here's another blip I got from Newswise, a journalists' only site (funny, how all this breaking news never seems to make it to the main stream):

The class of antidepressant medications known as selective serotonin reuptake inhibitors may be associated with an increased rate of bone loss in older men and women, according to two articles in the June 25 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Selective serotonin reuptake inhibitors (SSRIs) treat depression by inhibiting the protein that transports serotonin, a neurotransmitter involved in sleep and depression, according to background information in the articles. This protein has recently been discovered in bone as well, raising the possibility that SSRIs may affect bone density and the risk of fracture. SSRIs account for about 62 percent of antidepressant prescriptions in the United States, and are often prescribed to the elderly...

And, here's an essay in Slate Magazine of one writer's misadventures with paxil--sounds really scary, esp. the part about the "sparks." Luckily, he stopped it before he lost his mind and/or broke his hip. Read it here.

Happy Fourth!

Folic Acid can mask B12 deficiency

I got this from Newswise, a journalists'-only news service that broadcasts breaking health news before it gets out to the general public.

Folate, or its synthetic form, folic acid, is good for brain health. But there’s concern that this brain booster could mask deficiencies in vitamin B-12, which can result in mental decline and other nerve problems. The July issue of Mayo Clinic Health Letter covers why it’s important to have enough of both.

Numerous studies have determined that high levels of folate intake, up to 800 micrograms (mcg) a day, may help ward off cognitive decline, possibly lower the risk of Alzheimer’s disease, and even improve mental sharpness in areas such as memory and mental processing speed.

Folate is also important during pregnancy for the developing fetus, which is why the Food and Drug Administration in 1998 mandated folic acid fortification of grain products sold in the United States.

Vitamin B-12 plays an essential role in red blood cell formation, cell metabolism and nerve function. Where there’s a deficiency, symptoms include persistent tingling in the hands and feet, confusion and forgetfulness.

An estimated 15 percent of older adults are deficient in vitamin B-12. This deficiency can be caused by age-related changes in the digestive tract, which blunt the body’s ability to digest and absorb vitamin B-12 from food. Vegetarians who avoid all animal products and people who have digestive diseases such as celiac disease or Crohn’s disease may also be at increased risk of vitamin B-12 deficiency.

While folic acid offers benefits, there are concerns about how it chemically reacts with vitamin B-12 within the body. It’s suspected that high folic acid intake can correct the anemia — but not the nerve and cognitive deterioration — that would normally occur with vitamin B-12 deficiency. Without the indication of anemia, vitamin B-12 deficiency may not be suspected and neurological deterioration may continue unabated.

More study is needed to fully explore the relationship between folate and vitamin B-12 and how it may affect brain health. Until then, the safest bet is to ensure intake of adequate amounts of both. Most older adults can do this by taking a multivitamin supplement that contains 100 percent of the recommended daily allowance of both folate and vitamin B-12. For folic acid, that’s 400 mcg a day and for vitamin B-12, it’s 2.4 mcg a day.

A healthy diet that includes daily servings of fortified breads, grains or cereals and a wide variety of fresh and natural foods such as fruits, vegetables, beans and nuts can boost daily intake of folate or folic acid to the higher levels that may benefit brain health.

Sadly, a lot of folate is lost in the processing of grains, and the cheap folate they pour back on grains may not be the most absorbable form.

Too little folate may put pregnant women in danger of having a fetus with neural tube defects. But there is also some fear that you can get too much folate between taking supplements and eating fortified grains, but since I don't eat grains in general, this is not an issue for me. Since most doctors probably don't ask about your diet (although they probably should), bring it up before you check with your healthcare provider about supplementation. I try to eat a lot of veggies, beans, and nuts. My doc at the Alan E. Beer center has me on precription-only Folgard (generic: Folcaps), a nice combo of b12, folic acid, and b6 (b6 is also helpful for morning sickness).

ALSO, miso (fermented soy or other legumes) when made in the traditional way in wood caskets produces its own b12 in the action of the lacto-fermentation (I have an article coming out in Natural Health Magazine on the health benefits of artisanally fermented foods), another amazing way nature provides what we need. Vegetarians or people like me who don't eat a ton of meat might want to check into miso for a little extra b12 action.