Folic acid is a synthetic form of folate, in both cases it is a name for vitamin B9. Folate is very important for humans and especially for pregnant women, because it fundamentally contributes to the prevention of congenital disorders of the child. In the article, you will find out more about the sources of folate, its benefits and other interesting information related to vitamin B9.
Folic acid – Folate – Vitamin B9
Folic acid is a well-known name for one of the B-group vitamins, more specifically vitamin B9. Another name is folate, but folate and folic acid are not exactly the same. Folate is a form of vitamin B9 found naturally in foods and folic acid is its synthetic form. The term folate is a generic name and refers to several forms of vitamin B9, including folic acid, tetrahydrofolate (THF) or dihydrofolate (DHF). Folic acid is a synthetic form of folatepresent in nutritional supplements or enriched foods. Whether folate or folic acid, their effects on the body are the same. Taking folic acid is especially recommended for pregnant women, but the benefits of vitamin B9 do not end there. In addition to supporting pregnancy, it is also useful for depression or memory loss. [1] [33] [34]
The importance of folate for the human body was discovered by Dr. Lucy Wills in 1931. The scientist demonstrated that brewer’s yeast can prevent anemia during pregnancy. Folate and its importance have therefore been known for almost 100 years. [31]
Functions of folate in the body
Folate is important for the body for several reasons, it helps the function of cells and tissue growth. It is useful for the prevention of anemiabecause it contributes to the production of red blood cells, but together with vitamins B12 and C it promotes the breakdown, use and production of new proteins. Last but not least, it contributes to the production of DNA, which is responsible for genetic information. [32]
Natural sources of folic acid
Folic acid is found in the form of folate in a variety of foods and is part of many nutritional supplements. It is a component of multivitamins, b-complexesand you can also buy it in a separate form. If you prefer natural sources of vitamin B9, you will find several examples in the table supplemented by its content [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13]:
| FOLATE CONTENT IN 100 G | |
|---|---|
| Liver (chicken, raw) | 588 μg |
| Chickpeas (raw) | 557 μg |
| Liver (beef, raw) | 290 μg |
| Pea (ripe, log, raw) | 274 μg |
| Liver (pork, raw) | 212 μg |
| Spinach (raw) | 194 μg |
| Pea (green, raw) | 65 μg |
| Broccoli (raw) | 63 μg |
| Brussels sprouts (raw) | 61 μg |
| Cabbage (raw) | 43 μg |
| Cabbage (red, raw) | 18 μg |
Benefits of taking folic acid
Folic acid and pregnancy
The consumption of folic acid is most popular thanks to its importance before and during pregnancy, as it prevents congenital defects of the brain and spinal cord. The child’s congenital defects occur in the first trimester, more precisely in the first 3-4 weeks of pregnancy. For this reason, it is important to take folic acid not only during pregnancy, but at least one month before getting pregnant. [15]
Congenital defects of the central nervous system have a common name – neural tube defects (NTD). These are abnormalities in the brain, spinal cord or spine that occur during embryogenesis – the development of the embryo. During fetal development, the brain, spine, and spinal cord are formed from the neural tube. The above-mentioned defects occur due to the failure of the process of closing it. Simply put, defects occur when a certain part of the tube is not closed, which can result in, for example, a hole in the spinal cord. Neuroepithelium is subject to neuronal deficiency and degeneration because it is exposed to the environment. [17] [18]
Intake of folic acid before and during pregnancy is a prevention against the development of most of these defects. It should also be added that the exact reasons for neural tube defects are not known. However, the risk of these errors increases with obesity, certain medication for seizures or poorly controlled diabetes. [19]
Complications associated with adequate neural tube development are not the only problems during pregnancy that folic acid supplementation can solve. It is important to reduce the potential risk of heart irregularity, cleft palate, or premature birth. The consumption of folic acid is therefore useful in preventing several of the complications associated with optimal fetal development. Although it is not a universal remedy for these disorders, its role is certainly not negligible. [16]
We know that reading about serious defects in a child’s development is challenging and unpleasant. However, there is no cure for congenital neural tube defects, although there is treatment to prevent further complications. Nerve damage is permanent, and if folic acid can reduce the risk of its development, its awareness-raising is crucial. [19]
Folic acid and cardiovascular diseases
The effect of folic acid does not end in promoting optimal fetal growth during pregnancy. It can also be beneficial in the prevention of heart and vascular diseases. These are associated with high levels of homocysteine, with folate playing an important role in its metabolism. In addition to folic acid, vitamin B6 and B12 also control the normal levels of homocysteine in the blood. The hypothesis of reducing the risk of heart disease has been investigated and appears to have an impact on the risk of stroke. The results of a study showed that the consumption of folic acid in women with a risk of heart disease did not reduce the risk. There are several conclusions from studies showing that homocysteine levels decreased, but without affecting the risk of cardiovascular disease. The consumption of folic acid and other B-group vitamins has a positive effect on the risk of stroke,unfortunately, this probably does not apply to other cardiovascular problems. [20] [21] [22]
The effect of folic acid on cancer
Several scientific studies suggest the effect of folate on certain types of cancer, such as lung, pancreatic, breast or bladder cancer. The effect of folate on carcinogenesis has not yet been precisely scientifically verified. According to some evidence, folate is beneficial in suppressing the early stages of certain types of cancer. However, after the development of preneoplastic lesions, higher doses of folic acid had the opposite effect and, conversely, supported its course. Although the appropriate use of folic acid may have a positive effect in certain cases, it is also necessary to further investigate and understand the relationship between folic acid and cancer. [20]
Autism spectrum disorders and folic acid
Autism, or more specifically autism spectrum disorder, has several symptoms. These are problems with communication and “functioning” with people, but they are also characterized, for example, by repetitive behavior. Some observational studies point to a link between the lower risk of autism spectrum disorder in children and folic acid consumption before and during pregnancy. Although further research is needed to confirm and validate the conclusions, scientific evidence suggests a possible link between folic acid intake and the risk of this disorder. As a result, scientists are not yet able to unequivocally confirm the direct impact, but we may see better evidence in the future. [20]
Folic acid deficiency
As with other micronutrients, if folic acid is insufficient in the diet, it can also lead to its deficiency. In addition, it can cause another complication,which is anemia. It is a condition associated with low levels of red blood cells. Anemia causes a low hemoglobin content, which can result in a lack of oxygen to organs and tissues. You can boost folate levels in your body by changing your diet or supplementing the folic acid. [27] [28]
The best way to verify the level of folic acid in your body is to see a doctor and have a blood test. Although the signs of folate deficiency are less clear, we still show the symptoms of folate deficiency and anemia [27] [35]:
Symptoms of folate deficiency:
- fatigue
- swelling of the tongue and mouth ulcers
- gray hair
- growth problems
Symptoms of anemia:
- fatigue and weakness
- shortness of breath
- pale skin
- irritability
Folate deficiency can be the result not only of an incomplete diet, but also of other factors [27] [29] [30]:
- Excessive alcohol consumption – causes problems with its absorption and excessive urinary excretion of folate.
- Malabsorption – insufficient absorption of folate caused by diseases affecting the digestive tract, such as celiac disease or Crohn’s disease.
- Drug Use – Folate deficiency may be due to the use of certain medications to treat epilepsy.
- Genetics – even a genetic mutation can be a reason for deficiency because it prevents the conversion to a usable form – methyl folate.
Recommended doses of folic acid
Folic acid is one of the B-group vitamins, its intake is important, but at the same time it does not need to be exaggerated. It is true that dietary folate intake has no adverse effects, but intake above 800 μg in people under 18 and 1000 μg in adults can “mask” vitamin B12 deficiency. In the case of folic acid supplementation, remember that the daily limit is 1000 μg. At the same time, it is interesting that folic acid is compulsorily added to foods in several countries around the world. For example, in the USA, 140 μg of folic acid is added per 100 g of enriched cereal grain products. The reason is to provide 100-200 μg of folic acid per day for women of childbearing age. Mandatory programs to enrich foods with folic acid are also available in Canada, Chile, or South Africa. [23] [24] [25]
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In the US, it is less of a problem to exceed the daily recommended dose of folic acid because it enriches cereals. Some cereals even contain 400 μg of folic acid per serving. So if you consume cereals and a multivitamin with 400 μg of folic acid, you can easily reach 800 μg. Folic acid intake is important for each of us, but its high doses are associated with an increased risk of cancer. For this reason, we present an overview of the recommended dose of vitamin B9 by age and during pregnancy and lactation [24] [26]:
| RECOMMENDED DAILY DOSE OF FOLIC ACID | |
|---|---|
| Up to 6 months | 65 μg |
| 7 – 12 months | 80 μg |
| 1 – 3 years | 150 μg |
| 4 – 8 years | 200 μg |
| 9 – 13 years | 300 μg |
| Over 14 years | 400 μg |
| During pregnancy | 600 μg |
| During breast-feeding | 500 μg |
Ultimate facts about folic acid
Folic acid is an important vitamin, not only for women during pregnancy. At the end of the article, we therefore selected some interesting facts about vitamin B9 that everyone should know, not just pregnant women [14]:
- Folic acid can be found in several types of vegetables and legumes. You can support its intake by consuming foods enriched with vitamin B9. A great breakfast tip is enriched cereals and orange juice.
- 0.4 mg of folic acid per day reduces the risk associated with certain types of cancer, heart disease and stroke.
- Every year, 4,000 children with neural tube defects (NTD) are born in the United States. By taking 0.4 g of folic acid daily for at least a month before pregnancy and during the first trimester, up to 70% of these cases could have been prevented.
- Excess folic acid is also dangerous for women, so the daily dose should not exceed 1 mg per day. High doses are associated with the problem of diagnosing vitamin B12 deficiency.
- The risk group also includes women with obesity, gestational diabetes or women exposed to high temperatures during the first trimester.
- In addition to preventing neural tube defects, folic acid is useful for cell division and organ formation in developing children.
Folate is an important micronutrient especially for supporting the proper development of the fetus. However, adequate intake of vitamin B9 is important for each of us. Available sources suggest that better folate awareness can at least partially prevent congenital disorders. Did you find the article interesting and do you also consider awareness of folate and folic acid important? Feel free to support the article by sharing.
[1] FOLIC ACID – https://www.webmd.com/vitamins/ai/ingredientmono-1017/folic-acid
[2] B vitamins and folic acid – https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/
[3] Spinach, raw – https://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2626/2
[4] Cabbage, raw – https://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2371/2
[5] Cabbage, red, raw – https://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2373/2
[6] Broccoli, raw – https://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2356/2
[7] Brussels sprouts, raw – https://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2362/2
[8] Chickpeas (garbanzo beans, bengal gram), mature seeds, raw – https://nutritiondata.self.com/facts/legumes-and-legume-products/4325/2
[9] Peas, green, raw – https://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2520/2
[10] Peas, split, mature seeds, raw – https://nutritiondata.self.com/facts/legumes-and-legume-products/4353/2
[11] Chicken, liver, all classes, raw – https://nutritiondata.self.com/facts/poultry-products/666/2
[12] Pork, fresh, variety meats and by-products, liver, raw – https://nutritiondata.self.com/facts/pork-products/2195/2
[13] Beef, variety meats and by-products, liver, raw – https://nutritiondata.self.com/facts/beef-products/3468/2
[14] Top 10 Facts About Folic Acid Your Women Patients Should Know – https://www.health.ny.gov/publications/1340/
[15] Folic Acid and Pregnancy – https://www.webmd.com/baby/folic-acid-and-pregnancy#1
[16] Adam Felman – https://www.medicalnewstoday.com/articles/219853
[17] About Neural Tube Defects (NTDs) – https://www.nichd.nih.gov/health/topics/ntds/conditioninfo
[18] Nicholas D.E. Greene, Andrew J. Copp - Neural Tube Defects – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486472/
[19] Neural Tube Defects – https://medlineplus.gov/neuraltubedefects.html
[20] Folate – https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/
[21] Folate (folic acid) – https://www.mayoclinic.org/drugs-supplements-folate/art-20364625
[22] Jillian Kubala - Folic Acid: Everything You Need to Know – https://www.healthline.com/nutrition/folic-acid
[23] Krista S. Crider, Lynn B. Bailey, Robert J. Berry - Folic Acid Food Fortification—Its History, Effect, Concerns, and Future Directions – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257747/
[24] Megan Ware - Why is folate good for you? – https://www.medicalnewstoday.com/articles/287677
[25] Folate and Cancer – https://www.oncologynutrition.org/erfc/healthy-nutrition-now/folate-and-cancer
[26] Beth Kitchin - Folic Acid and Cancer: Too Much of a Good Thing? – https://www.uab.edu/shp/nutritiontrends/nutrition-know-how/consumer-concerns/folic-acid-and-cancer
[27] Anemia – https://www.webmd.com/a-to-z-guides/understanding-anemia-basics#1
[28] Causes - Vitamin B12 or folate deficiency anaemia – https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/causes/
[29] Folate deficiency – https://medlineplus.gov/ency/article/000354.htm
[30] Ananya Mandal - Folic Acid Biology – https://www.news-medical.net/health/Folic-Acid-Biology.aspx
[31] Folic acid in diet – https://medlineplus.gov/ency/article/002408.htm
[32] Claire Sissons - Folate vs. folic acid: What to know – https://www.medicalnewstoday.com/articles/327290
[33] What is the difference between folate and folic acid? – https://www.webmd.com/diet/qa/what-is-the-difference-between-folate-and-folic-acid
[34] What Is Folic Acid Deficiency Anemia? – https://www.webmd.com/a-to-z-guides/folic-acid-deficiency-anemia#1