So wobrɛ bere nyinaa? Momma yensua biribiara fa mogya a ɛtɔ kɔ nipadua mu a folate nni mu ho!

So wote nka nso sɛ woabrɛ da mũ nyinaa, a wuntumi nyɛ hwee? Anaasɛ ɛtɔ da bi a wote nka sɛ wo nipadua reyɛ awɔw na ɛyɛ den kakra sɛ wobɛhome? Eyinom nyɛ nneɛma a ɛba kwa kɛkɛ, ebia wo nipadua no nni aduannuru a wɔfrɛ no folate, a ebia ɛde mogya a ɛho ayɛ na, kyerɛ sɛ, mogya a ɛtɔ kɔ nipadua mu no reba. Ɛnnɛ, momma yɛnka nea mogya a ɛtɔ kɔ nipadua mu a folate nnim yɛ, nea enti a ɛba, ne sɛnea yɛbɛkwati ho asɛm.

Dɛn ne Folate Deficiency Mogya a Wɔyare no? Momma yɛnte ase kɛkɛ!

Sɛ yɛbɛka no tiawa a, mogya a ɛtɔ kɔ nipadua mu a folate nni mu yɛ mogya mu yare a ɛnam folate anaa vitamin B9 a enni wo nipadua mu nti. Nea ɛba wɔ eyi mu ne sɛ mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ wo nipadua mu no sua sen sɛnea ɛte daa na mogya mu nkwammoaa kɔkɔɔ a ɛwɔ hɔ no dɔɔso wɔ ɔkwan a ɛnteɛ so. Susuw ho hwɛ, mogya mu nkwammoaa kɔkɔɔ yi de mframa pa kɔ yɛn nipadua mu nyinaa. Enti sɛ saa nkwammoaa yi so tew, ɛyɛ akɛse, anaa entumi nyɛ adwuma yiye a, mframa pa dodow a nipadua no nya no so tew. Bere kɔ so no, mframa pa a wunni yi ne nea ɛma wote nka sɛ woabrɛ, woyɛ mmerɛw, na wo ho yɛ nwini.

Dɛn nti na mogya a ɛtɔ kɔ nipadua mu ba bere a folate nni mu no? Dɛn na ɛkɔ so wɔ nipadua no mu?

Wunim sɛnea wɔhyehyɛ yɛn mogya mu nkwammoaa kɔkɔɔ no? Wodi kan fi ntini mu nkwammoaa a ɛwɔ nnompe mu ntini a ɛwɔ yɛn nnompe mu no mu. Saa mogya mu nkwammoaa kɔkɔɔ yi nyin nkakrankakra na ɛka yɛn mogya ho, na ɛde mframa pa kɔ nipadua no akwaa ne ntini biara mu.

Ɛha yi, aduannuru bi a wɔfrɛ no folate ho hia na ama mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw no ayɛ yiye. Ɛte sɛ nea wode semɛnte resi ofie. Enti, sɛ wo nipadua no nnya folate a ɛdɔɔso a, wo nnompe mu ntini no rentumi mma mogya mu nkwammoaa kɔkɔɔ a ɛfata. Mmom no, ɛma mogya mu nkwammoaa kɔkɔɔ bi a ɛsõ a ɛnyɛ ne kwan so a wɔfrɛ no ``megaloblasts.''

Esiane sɛ saa ``megaloblastic'' nkwammoaa yi sõ yiye nti, ebinom mpo mfi nnompe mu ntini no mu nkɔka mogya no ho. Nkwammoaa a ɛka bom no ntra ase nkyɛ te sɛ mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw. Wowuwu ntɛmntɛm. Ɛno nti na mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ nipadua no mu so tew, na ɛde mogya a ɛtɔ kɔ nipadua mu ba, a ɛkyerɛ sɛ mogya nni nipadua no mu. So wote ase?

So mogya a ɛtɔ kɔ nipadua mu no ahorow afoforo wɔ hɔ?

Yiw, mogya a ɛtɔ kɔ nipadua mu no yɛ tebea a abu so a nnipa pii betumi anya. Efi mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw a enni hɔ. Nneɛma pii na ɛde mogya a ɛtɔ kɔ nipadua mu ba:

• Mogya mu nkwammoaa kɔkɔɔ akɛse a ɛnyɛ ne kwan so (eyi nso fi folate a enni hɔ a yɛreka ho asɛm no).
• Mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw a wɔyɛ no so tew.
• Mogya mu nkwammoaa kɔkɔɔ a mmerɛbo ne akyi berɛmo sɛe no dodo.
• Hemoglobin, protein a ɛwɔ mogya mu nkwammoaa kɔkɔɔ mu a ɛde mframa pa kɔ mu no dodow a ɛso tew.
• Hemoglobin a ɛnyɛ adwuma yiye, a ɛkyerɛ sɛ entumi nnye oxygen yiye.
• Mogya mu nkwammoaa kɔkɔɔ a ɛpae wɔ mogya no mu.

Wɔfrɛ mogya a ɛtɔ kɔ nipadua mu a mogya mu nkwammoaa kɔkɔɔ akɛse a ɛnyɛ ne kwan so de ba no ``macrocytic anemia``. Eyi mu biako ne ``megaloblastic anemia``. Nea edidi so yi hyɛ saa ``megaloblastic anemia`` yi ase:

• Folate a enni mogya mu a ɛma mogya tu
• Vitamin B12 a enni mogya mu a ɛma mogya tu
• Mogya a ɛtɔ mogya a ɛsɛe ade

Nea ɛka eyi ho no, mogya a ɛtɔ kɔ nipadua mu no ahorow afoforo a nnipa pii ate ho asɛm ne:

• mogya a ɛtɔ kɔ nipadua mu a dade a enni nipadua mu
• Sickle cell mogya a ɛtɔ kɔ nipadua mu

Folate a wonnya nni abu so dɛn?

Folate a enni nipadua no mu nyɛ nea abu so saa wɔ aman a wɔanya nkɔso mu. Nea enti a ɛte saa ne sɛ wɔde folate ka nnuan pii ho wɔ saa aman no mu. Sɛ nhwɛso no, wɔ United States no, ɛyɛ ahyɛde sɛ wɔde folate bɛka nnuan ho fi 1998. Nea enti a ɛte saa ne sɛ folate ho hia yiye ma abofra no nyin wɔ awotwaa mu.

Nnuruyɛfo ahu sɛ folate a enni nipadua mu no betumi de awo mu dɛmdi ahorow bi aba, titiriw ntini mu yare ne tebea bi a wɔfrɛ no spina bifida. Ɛno nti na wɔ aman pii mu no, wɔde folate ka nnuan pii a yedi ho, titiriw aburow ne aburow.

Hena na ɔwɔ asiane kɛse sɛ obenya mogya a ɛtɔ kɔ nipadua mu a folate nni mu?

Nnipa bi wɔ hɔ a ɛda adi sɛ wobenya saa tebea yi. Hwɛ sɛ wotɔ saa kuw yi mu anaa:

• Mmea a wɔadi mfe a wobetumi awo: Folate a wohia no dɔɔso titiriw ma mmea a wɔreyɛ nhyehyɛe sɛ wobenyinsɛn, bere a wɔyem, ne wɔn a wɔma nufu no.
• Nnipa a wɔnom nsa boro so: Nsã sɛe tumi a nipadua no tumi twetwe aduannuru.
• Nnipa a wɔadi boro mfe 60.
• Nnipa a wɔn sikasɛm mu yɛ den: Efisɛ ɛyɛ den sɛ wobenya aduan a ɛkari pɛ.
• Ɛnanom a wɔyem ne wɔn a wɔma nufu.

Dɛn na ɛde mogya a ɛtɔ kɔ nipadua mu a folate nni mu ba?

Nea enti titiriw ne sɛ yennya folate a ɛdɔɔso mfi nnuan a yedi mu. Sɛ ɛno da nkyɛn a, nneɛma afoforo wɔ hɔ a ɛmma nipadua no ntumi nnye folate anaasɛ mfa nni dwuma yiye:

• Nsa a wɔde di dwuma ɔkwammɔne so (`Asanom a wɔde di dwuma ho haw`).
• Wɔreyɛ dialysis ayaresa esiane asaabo a entumi nyɛ adwuma yiye nti.
• Nyarewa a ɛma aduan mu yɛ den, sɛ nhwɛso no, Crohn yare ne celiac yare.
• Nnuru bi a wɔde di dwuma bere tenten (sɛ nhwɛso no, wɔ akisikuru, akisikuru, nnuru bi a ekum ɔyare mmoawa, ne nnuru a ɛma nipadua no tumi ko tia nyarewa).
• Tebea horow a wonya fi awo mu te sɛ ``Hereditary folate malabsorption`` (a nipadua no tumi a ɛtwetwe folate no so tew fi awo mu).

Dɛn ne eyi ho sɛnkyerɛnne? Woyɛ dɛn hu no?

Ɛtɔ mmere bi a, mogya a ɛtɔ kɔ nipadua mu a folate nni mu betumi aba a enni sɛnkyerɛnne biara. Ebia wo duruyɛfo no behu bere a woreyɛ wo mogya mu nhwehwɛmu ahu biribi foforo nkutoo.

Nanso, sɛ sɛnkyerɛnne ahorow no da adi a, ebia nea ɛka ho ne:

• Ɔbrɛ a wɔte nka bere nyinaa (`ɔbrɛ`): Ɛte sɛ nea ɔbrɛ no nkɔ bere a woada mpo akyi.
• Sɛ́ wobɛte nka sɛ woayɛ ɔkwasea na woayɛ mmerɛw bere a woreyɛ da biara da dwumadi ahorow no.
• Adwene a ɛyɛ basaa, te nka sɛ ne ti ayɛ hare.
• Wora a ɛyɛ mmerɛw (`pallor`): Mmeae te sɛ anim, anofafa, ne nsateaa te sɛ nea ɛyɛ fitaa.
• Sɛ wote nka sɛ wo koma rebɔ ntɛmntɛm, wobɛte nnyigyei bi a ɛrebɔ wɔ wo moma so, anaasɛ wobɛte nka sɛ wo koma rehuruw (koma a ɛbɔ).
• Ɔhome a ɛyɛ den (dyspnea): Ɔhome a ɛyɛ tiaa wɔ nnwuma nketenkete mpo mu.

Ɔkwan bɛn so na wohu yare yi pɛpɛɛpɛ ?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn. Wo duruyɛfo bɛyɛ nipadua mu nhwehwɛmu na wabisa w’ayaresa ho abakɔsɛm ne wo sɛnkyerɛnne ahorow ho asɛm. Esiane sɛ mogya a ɛtɔ kɔ nipadua mu a folate nni mu ho sɛnkyerɛnne te sɛ tebea afoforo pii nti, ebia ebehia sɛ woyɛ mogya mu nhwehwɛmu mpɛn pii na ama woahu sɛ eyi te saa anaa.

Mogya mu nhwehwɛmu ahorow yi mu atitiriw ne:

• Mogya dodow a edi mũ (CBC): Eyi hwehwɛ nneɛma pii mu, te sɛ mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa fitaa, ne mogya mu nkwammoaa dodow a ɛwɔ wo mogya mu, ne hemoglobin dodow.
• Peripheral blood smear (PBS): Nea ɛka eyi ho ne sɛ wobɛfa wo mogya no bi na wode afiri a wɔde hwɛ nneɛma nketenkete ahwɛ. Eyi ma wuhu sɛnea mogya mu nkwammoaa no te ankasa, sɛ́ ɛyɛ akɛse anaa nketewa, ne sɛ ebia nneɛma bi a ɛnteɛ wɔ hɔ a.
• Reticulocyte dodow: Reticulocytes yɛ mogya mu nkwammoaa kɔkɔɔ a wonnyinii. Saa nhwehwɛmu yi hwɛ sɛ wo nnompe mu ntini no reyɛ mogya mu nkwammoaa kɔkɔɔ a ɛdɔɔso anaa.

Nhwehwɛmu ahorow yi ka ho no, wo duruyɛfo no nso bɛhwɛ sɛnea wo mogya mu folate dodow te. Wɔtaa susuw eyi wɔ unit ahorow a wɔfrɛ no `nanograms per milliliter` (`ng/mL`) mu.

• Nea enni mu: Ennu nanogram 2 wɔ mililita biara mu (`< 2 ng/mL`).
• Ɔhye: Nanogram 2 ne 4 ntam wɔ mililita biara mu (`2 ng/mL - 4 ng/mL`).
• Ɛdɔɔso: Ɛboro nanogram 4 wɔ mililita biara mu (`> 4 ng/mL`).

Esiane sɛ vitamin B12 a wunni ne folate a enni wo mu taa tumi bom nti, oduruyɛfo no bɛhwɛ vitamin B12 dodow a wowɔ nso.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Asɛmpa no ne sɛ, ayaresa wɔ hɔ ma eyi, na edi yiye paa.

Ayaresa titiriw ne sɛ wɔde vitamin B9 a wɔde ma.Wɔtaa de eyinom ma sɛ nnuru a wɔde fa ano nom. Wɔ nnipa binom a ɛyɛ den ma wɔn sɛ wɔbɛmene nnuru no fam no, wobetumi de ama wɔn nso sɛ aduru a wɔde twitwiw wɔn, anaasɛ wɔde nkyene fa ntini mu (IV). Ebia ɛho behia sɛ wɔnom saa nnuru a wɔde ka aduan ho yi bere nyinaa asram pii.

Ebia wo duruyɛfo nso bɛkamfo akyerɛ sɛ wɔnyɛ nsakrae wɔ w’aduan mu. Sɛ aduruyɛ mu tebea bi a ɛda adi na ɛde folate a enni nipadua no mu ba a, ɛho hia sɛ wɔsa saa tebea no nso.

So wobetumi asiw mogya a ɛtɔ kɔ nipadua mu a folate nni mu ano?

Yiw, akyinnye biara nni ho sɛ ebetumi aba. Ɛnyɛ den sɛ wobɛkwati tebea yi sɛ wohwɛ nneɛma yi so a:

• Nya folate dodow a wubenya da biara da, denam nnuan a wudi so anaasɛ denam aduan a vitamin B9 (folic acid) wom a wobɛnom so.
• Tew nsa dodow a wonom so, anaa gyae nom koraa. Nsã a wɔnom boro so no mma nipadua no ntumi nnye aduannuru a ɛho hia, a folate ka ho.
• Sɛ wowɔ aduruyɛ mu tebea biara a ɛmma wo nipadua ntumi nnye folate anaasɛ mfa nni dwuma a, wo ne wo duruyɛfo nka ho asɛm.

Folate (vitamin B9) dodow ahe na yehia da biara?

Vitamin B9 a yenya fi awosu mu fi aduan mu no, wɔfrɛ no folate. Wɔfrɛ vitamin B9 a wɔde ka aduan ho anaasɛ ɛwɔ vitamin nnuru mu no folic acid. Folate dodow a yehia da biara no gyina nneɛma pii so:

• Mfe a woadi: Bere a worenyin no, folate a wuhia no yɛ kɛse.
• Aduan fibea: Yɛn nipadua no twe folic acid yiye sen folate a efi aduan mu.

Wɔde micrograms (mcg) kyerɛ Da biara da Mmoa a Wɔkamfo Kyerɛ (RDAs), a wɔde Dietary Folate Equivalents (DFE) susuw. Ebia eyi bɛyɛ te sɛ nea ɛyɛ basaa kakra, nanso ɛnyɛ den.

• `1 mcg` folate a efi aduan mu no ne `1 mcg DFE` yɛ pɛ.
• Sɛ́ ebia wubenya folic acid a wɔde ka aduan ho anaasɛ efi vitamin pills a wɔde ka aduan ho no mu no, folic acid 1 mcg ne DFE 1.67 mcg yɛ pɛ (a ɛkyerɛ sɛ nipadua no twetwe pii).
• Folic acid 1 mcg a efi vitamin pills a wɔnom bere a yafunu da mpan mu no ne DFE 2 mcg (a nipadua no twetwe yiye mpo) yɛ pɛ.

Sɛ nhwɛso no, sɛ wofa multivitamin a `200 mcg` folic acid wom wɔ yafunu a hwee nni mu a, wobetumi abu ho akontaa sɛ `400 mcg DFE` (200 mcg x 2 = 400 mcg).

Sɛ wɔkyekyem pɛpɛɛpɛ a, ɔpanyin bi hia DFE 400 mcg da biara. Mmea a wɔyem hia DFE 600 mcg, na ɛnanom a wɔma nufu hia DFE 500 mcg. Ɛyɛ papa sɛ wubebisa wo duruyɛfo sɛ ɔmma wo dodow a ɛfata ma wo.

Nnuan bɛn na folate pii wom?

Nea eye ne sɛ, nnuan pii wɔ hɔ a ɛma wonya folate fibea pa. Bɔ mmɔden sɛ wode eyinom bɛka w’aduan ho:

• Nam: Nantwinam mmerɛbo (eyi pii wɔ hɔ, nanso ɛsɛ sɛ wususuw srade a ɛwɔ mogya mu nso ho) .
• Nnuadewa ne nhabannuru a ɛyɛ ahabammono: Nnuadewa a ɛyɛ ahabammono te sɛ spinach, kale, collard greens, asparagus, Brussels sprouts, avocado, broccoli.
• Nnuan a wɔahyɛ no den: Aburow bi (anɔpa aduan), aburow, paanoo, pasta, paanoo esiam, atoko a wɔayam. (Hwɛ nea wɔakyerɛw so no mu hwɛ sɛ wɔde folic acid aka ho anaa.)
• Beans: Asaabo mu bankye, asaabo mu bankye.
• Nnuadewa: Atoko, walnut.
• Nnuaba: Citrus nnuaba te sɛ akutu ne tangerine ne ne nsu.

Kae: Folate betumi asɛe bere a wɔanoa saa nnuan yi akyɛ, te sɛ bere a wɔanoa wɔ nsu mu no. Enti noa kakraa bi sɛnea wubetumi, anaasɛ fa ka w’aduan ho sɛ wubetumi adi a ɛnyɛ den (wɔahohoro ho yiye) a.

Sɛ wɔsa tebea yi a, wɔbɛsa?

Ɛda adi kɛse sɛ yiw! Mpɛn pii no, mogya a ɛtɔ kɔ nipadua mu a folate nni mu no ayaresa di yiye kɛse. Wɔ asram kakraa bi akyi bere a nnipa dodow no ara afi ase de vitamin B9 ma no, wofi ase yɛ mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw bio, na wɔn yare no ho sɛnkyerɛnne no tu mpɔn nkakrankakra.

Bere bɛn na ɛsɛ sɛ wo ne oduruyɛfo kasa fa mogya a ɛtɔ kɔ nipadua mu a folate nni mu ho?

Hwɛ hu sɛ wobɛhwehwɛ aduruyɛ mu afotu wɔ nsɛm te sɛ eyinom mu:

• Sɛ wunnim folate dodow a wuhia da biara, anaasɛ worenya nea ɛdɔɔso a.
• Sɛ wowɔ mogya a ɛtɔ kɔ nipadua mu ho sɛnkyerɛnne (te sɛ ɔbrɛ, mmerɛwyɛ, ahome a ɛyɛ tiaa).
• Sɛ wowɔ aduruyɛ mu tebea foforo a ebetumi ama woanya folate a.
• Sɛ wɔadi kan ayɛ wo mogya a ɛtɔ kɔ nipadua mu a enni folate ho yare na wote nka sɛ wo sɛnkyerɛnne ahorow no resan aba a.
• Sɛ woreyɛ nhyehyɛe sɛ wubenyinsɛn, anaasɛ woanyinsɛn dedaw a. Eyi ho hia paa!

Ebetumi ayɛ basaa kakra sɛ wubehu sɛ wowɔ ɔhaw bi wɔ wo mogya mu nkwammoaa ho. Nanso kae sɛ, sɛnkyerɛnne yɛ ɔkwan a wo nipadua fa so ka kyerɛ wo sɛ biribi anyɛ yiye. Ebetumi aba sɛ wuhia aduan a ɛkari pɛ, anaasɛ ebetumi ayɛ aduruyɛ mu tebea bi a ɛhyɛ wo ase. Wo duruyɛfo ne wo bɛyɛ adwuma de ahu nea ɛde ba. Wɔbɛkyerɛw vitamin B9 a wɔde ma ne ayaresa afoforo nso sɛ ɛho hia a. Sɛ wosa yare no yiye na wudi wo duruyɛfo akwankyerɛ akyi a, ɛda adi kɛse sɛ wo yare no ho sɛnkyerɛnne no bɛkɔ anim.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti nneɛma bi a ɛsɛ sɛ yɛma ɛtra yɛn adwenem fi nea yɛaka ho asɛm no mu ni:

• Folate (vitamin B9) yɛ aduannuru a ɛho hia a wɔde yɛ mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw.
• Folate a enni nipadua no mu betumi ama mogya mu nkwammoaa kɔkɔɔ akɛse a ɛnyɛ ne kwan so (`megaloblasts`) ayɛ, na ɛde mogya a ɛtɔ kɔ nipadua mu aba.
• Sɛ wuhu sɛnkyerɛnne ahorow te sɛ ɔbrɛ, mmerɛwyɛ, honam ani a ɛyɛ fitaa, ne ahome a ɛyɛ den sɛ wobɛhome a, kɔ oduruyɛfo nkyɛn.
• Fa nnuan a folate wom (atoko, nhabannuru a ɛyɛ ahabammono, nnuaba, nnuan a wɔde folate aka ho) ka w’aduan ho.
• Ɛsɛ sɛ wɔn a wɔyem, wɔn a wɔma nufu, ne mmea a wɔrebɔ mmɔden sɛ wobenyinsɛn no hwɛ yiye titiriw wɔ folate ho. Nom folic acid nnuru sɛnea wo duruyɛfo akyerɛ wo no.
• Mpɛn pii no, wobetumi de ayaresa asa tebea yi koraa.

Enti, hwɛ wo nipadua so yiye. Di aduan a ɛkari pɛ. Sɛ wowɔ ɔhaw bi a, nsuro sɛ wo ne oduruyɛfo bɛkasa. Apɔwmuden a wobɛkɔ so atra hɔ no ne ade a ɛho hia sen biara!

` Folate, mogya a ɛtɔ kɔ nipadua mu, vitamin B9, mogya a enni nipadua mu, mogya mu nkwammoaa kɔkɔɔ, aduannuru a enni nipadua mu, nyinsɛn akwahosan