Folic acid or folate or vitamin B9 is a member of the B-complex family of vitamins; it works with other B vitamins, particularly vitamin B12. Although it is present in many foods, folic acid can be easily lost and its deficiency is thought to be the most common vitamin deficiency in the western world. Folic acid is the most oxidised form of folate, and the form in which vitamin B9 is taken as a supplement or used as a fortificant.
Folic acid is important during periods of rapid growth; it is essential for cell division, the production of healthy red blood cells and the metabolism of proteins and sugars. It is vital during the early stages of pregnancy as it reduces the risk of neural tube defects (spina bifida for example) during early pregnancy and avoid abnormal development (The neural tube is the structure that develops into the baby’s brain and spinal cord. Spina bifida – a condition in which the baby spinal cord does not develop properly in the womb).
Folate is involved in the transmission of the genetic code to offspring and is therefore vital during the early stages of pregnancy to ensure the development of a healthy baby.
Common deficiency symptoms:
– Folate deficiency anaemia
– Cracked lips
– Depression
– Lack of energy
– Poor appetite
Conditions associated with deficiencies
– Birth defects – folic acid is crucial for formal development of the spine and spinal cord during the first three months of pregnancy. Women who intend to become pregnant are advised to take a daily supplement of 400mcg of folic acid before conception and for the first three months of pregnancy to reduce the risk of spina bifida, a congenital condition in which part of the bony spine that helps to protect the spinal cord does not develop properly.
– Anaemia – folic acid supplements help to produce healthy red blood cells and thus prevent tiredness and fatigue. However, high amount of folic acid can hide the symptoms of pernicious anaemia until irreversible brain and nerve damage have occurred. According to the NHS, taking 1000 micrograms (1mg) or less of folic acid supplement is unlikely to cause any harm.
– Osteoporosis – folic acid helps to maintain strong bones.
– Heart problems– folic acid helps to lower levels of the amino acid homocysteine, which is thought to damage the arteries and increase risk of heart disease.
Food sources
Folate is a water-soluble vitamin that is naturally present in some foods, added to some foods especially flour and cereals (fortification) and available as a dietary supplement. Folic acid found in many foods can be easily destroyed: up to two-thirds of folic acid can be lost in cooking, especially when boiling foods.
Natural food sources include liver (but avoid this during pregnancy), fortified breakfast cereals, broccoli, cauliflower, brussels sprouts, black eyed and kidney beans, green leafy vegetables such as spinach, kale and cabbage, citrus fruits, tomatoes, peanuts, chickpeas, eggs, banana and avocado.
Most people should be able to get the amount of folate they need by eating a varied and balanced diet. In the UK, the NHS recommend a daily intake of 200 micrograms of folate. If you’re pregnant, trying for a baby or could get pregnant, it is recommended that you take a 400 micrograms folic acid supplement daily until you are 12 weeks pregnant.
References
https://www.hsph.harvard.edu/nutritionsource/folic-acid/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731688/
https://www.nhs.uk/conditions/spina-bifida/
https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-b/
https://www.gov.uk/government/news/folic-acid-added-to-flour-to-prevent-spinal-conditions-in-babies