Photo: Globefox at Wikimedia

In the early 1920s, hematologist Lucy Wills studied a blood disorder called prenatal macrocytic anemia, which was causing impoverished pregnant textile workers in India to develop symptoms including fatigue and heart problems – and could even cause death. Could she find a cure – or prevent it all together? Well, where there’s a Lucy Wills – there’s a way! She was able to reverse the disorder by supplementing the women’s diets with a yeasty spread called Marmite. It was later shown that the key molecule in the Marmite, the “Wills factor” was folate. Folic acid supplementation has since become standard for pregnant women, and saved the lives of countless mothers and children.

Wills was born in England in 1888. She attended a British boarding school called Cheltenham College for Young Ladies (one of the first such schools to teach girls science and math) and In 1911 she graduated from Cambridge University with degrees in geology and botany. She then received medical training at the London School of Medicine for Women.

She decided to go into research and, in the 1920s and 1930s she traveled to India to investigate a public health crisis; pregnant textile workers in Bombay were developing a condition wherein their red blood cells were becoming abnormally large and “diluting” the blood’s ability to transport oxygen. She searched extensively for a bacterial culprit, but couldn’t find one. But she did find one connection – it seemed that only poor women were becoming ill. She wondered if a dietary factor could be involved, so she carefully recorded their diets.

She fed a group of monkeys the same diet and one developed similar symptoms – but if she supplemented the monkey’s diet with a yeast-based spread called Marmite, the monkey got better. She didn’t know at the time what it was in the Marmite that saved the monkey (or the rats she tested) but she had identified a dietary connection and found a cheap cure and prevention strategy.

Scientists subsequently followed up on Wills’ work and found that the “magic ingredient” in the Marmite (the “Wills factor”) was folate. Folate is the chemical name for a group of related molecules (including the more stable synthetic version folic acid) that serve important roles in metabolism (building new biological molecules and breaking down and recycling old ones) – it’s required for making DNA, proteins, and more. Everyone needs folate (and our bodies can’t make it) but pregnant women have extra need for it since they have to build molecules for 2!

A folate deficiency can cause problems to a growing embryo as well – it’s needed for proper development of the nervous system and insufficient folate can lead to incomplete neural tube closure – the neural tube is the precursor to the nervous system and if it doesn’t close all the way, problems like spina bifida and anencephaly can result. Neural tube closure happens in the 1st month of pregnancy, before most women even know they’re pregnant – so, for preventing neural tube defects, it’s not enough to just tell pregnant women to take a folic acid supplement. So many governments started requiring enriched grains to be fortified with folic acid as well.

Wills was incredibly active – her pastimes included cross-country skiing, mountain climbing, and bike riding – which no doubt came in handy as she trekked around the world saving the lives of women and children. Wills died in 1964, but her legacy lives on.

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