Folate Health Benefits – Why You Should Take Folate (6 min.)

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While most of us know folate is key in preventing birth defects for women of childbearing years, we may not be aware that it is used for several vital functions in the body for both men and women. From naturally occurring folate to food products fortified with folic acid to the universally metabolized form of folate, it’s important to understand the benefits and risks of each type.

Naturally occurring folate is commonly found in leafy green vegetables (such as spinach and kale), avocado, citrus, eggs, broccoli, and beans. Surprisingly, naturally occurring folate in food is 20 to 50 percent less bioavailable when compared to synthetic folic acid. Folate is the natural form of vitamin B9, not to be confused with its synthetic vitamin B9 sister, folic acid, though they are often misused interchangeably. While folic acid is used in many fortified foods and dietary supplements, folate is used in DNA synthesis and repair, cellular division, protein synthesis, red blood cell production and maturation and the metabolism of the immune system. For women of childbearing age, folic acid is essential because it can help prevent congenital disabilities in the baby’s brain and spinal cord.

In 1998, the U.S. Food and Drug Administration (FDA) mandated that companies add folic acid to enriched bread, flour, cornmeal, pasta, rice and other grain products. In  016, the FDA allowed manufacturers to add folic acid to corn masa flour voluntarily. The FDA mandate has helped to increase folic acid intake among most Americans, thereby decreasing the number of babies born with neural tube defects.

Folate Health Benefits

Many health benefits can be gained from taking folate, which includes:

• Decrease cancer risk. A study conducted in 2018 showed folate deficiency significantly increased one’s risk of developing many types of cancers.
• Decrease symptoms of depression, especially in women. The methylfolate form in Cooper Complete multivitamins may increase the effectiveness of antidepressants.
• Reduce homocysteine in the body. Hom cysteine is a sulfur-containing amino acid in the blood that can cause artery damage, blood clots and cardiovascular disease. Higher levels are associated with stroke, colon cancer, and Alzheimer’s disease. Folate, in combination with vitamin B12, can help regulate homocysteine levels. Researchers at The Cooper Institute studied the effect of a multivitamin on homocysteine. They found that a multivitamin that includes folic acid and vitamin B12 favorably influences homocysteine levels in the blood.
• Folate increases brain health and seems to improve some measures of cognitive function in older adults with mild cognitive impairment.
• Create new cells in the body for fetal development. Women in their childbearing years must consume enough folate daily for optimal fetal development. Studies have shown that women should begin folic acid supplementation before conception to improve folic acid benefits and potentially reduce infertility issues. Increasing levels of folic acid before conception reduces the incidence of neural tube defects such as spina bifida and anencephaly. The CDC notes that the first trimester is the most significant need for folic acid during pregnancy. Specifically, they mention that congenital disabilities of the brain and spine (anencephaly and spina bifida) happen in the first few weeks of pregnancy, often before a woman finds out she’s pregnant.” Women in their childbearing years need to consistently take 400 mcg of folic acid daily, as 35 percent of all pregnancies in the United States are unplanned.

Folate Health Risks

While folate offers tremendous health benefits, taking too much folic acid (rather than folate in the 5-MTHF form) can contribute to significant health issues such as:

• Taking 800 mcg to 1 mg of folic acid daily may increase cancer risk, particularly colorectal and prostate cancer.
• Increased risk for kidney damage.
• Taking too much folate can mask symptoms of vitamin B12 deficiency. This deficiency can damage parts of the nervous system, particularly in the legs (also called peripheral neuropathy). This is a particular concern for older adults, as vitamin B12 becomes difficult to absorb with age.

Daily Needs Of Folic Acid

Most supplement labels list folate in micrograms (mcg) of dietary folate equivalents (DFEs). The measurement is used because folate found naturally in foods is less absorbable than in supplements and fortified foods. Less is needed because folic acid in fortified foods, vitamins, and supplements is better absorbed than naturally occurring folate. The National Institutes of Health reports:

• 1 mcg DFE =  1 mcg naturally-occurring food folate
• 1 mcg naturally-occurring food folate = 0.6 mcg folic acid from supplements and fortified foods

The CDC’s recommended daily intake of folic acid is 400 mcg DFE for adults. As members of the b vitamin family, Folic acid and folate are water-soluble, which means your body cannot store them for more than a day.

Food Sources of Folate

Folate (vitamin B9) is naturally present in vegetables (especially dark leafy greens), fruits, nuts, beans, and legumes. Folate is represented as micrograms (mcg) of dietary folate equivalents (DFEs). Here  is the amount of folate in common foods:

• 1/2 cup cooked spinach: 131 mcg DFE
• 1/2 cooked medium-grain white rice: 90 mcg DFE
• 1 cup shredded romaine lettuce: 64 mcg DFE
• 1 slice fortified white bread: 50 mcg DFE
• 1/2 cup cooked turnip greens: 32 mcg DFE
• 3 ounces cooked halibut: 12 mcg DFE

Folate Health Benefits: What Supplement Form Is Best?

While many adults consume high levels of synthetic folic acid from fortified bread, pasta, rice and other grain products, Cooper Complete multivitamins provide 333 mcg DFE (200 mcg 5-MTHF) of the naturally occurring universally metabolized form of folate. This active form of folate is called 5-MTHF, the main naturally occurring form in food. The 5-MTHF form of folate is universally absorbable as it is directly usable by the body without enzymatic activation steps that some people genetically cannot naturally generate.

Estimates suggest as many as 60 percent of the population doesn’t convert folic acid into the active form of folate the body uses – 5-methyltetrahydrofolate or 5-MTHF for short, due to a mutation in one of the enzymes involved in the metabolism of folic acid. Unlike synthetic folic acid, 5-MTHF can immediately be used by the body without needing additional conversion via the enzyme 5, 10-methylenetetrahydrofolate reductase (MTHFR). The 5-MTHF form of folate also does not appear to mask the anemia associated with vitamin B12 deficiency and presents no risk of accumulating unmetabolized folic acid. Supplements, including Cooper Complete multivitamins, bypass this inefficiency by including folic acid already in the most efficient (5-MTHF) form. This ensures the best absorption by the body.

As a reminder, your physician understands your health profile best, so it’s important to talk to them about which supplements are best for you.

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Cooper Complete November 9, 2020