Folic Acid Keeps Your Brain, Heart and Babies Healthy

by Jason Machowsky
bigstock-Spinach-leaves-in-a-wooden-pla-44027485 BLOG

In honor of National Folic Acid Awareness Week, Sports Dietitian Jason Machowsky explains how to get the folic acid/folate you need.

Folic acid, or folate, is an essential B-vitamin that supports many of our body’s processes – from cell division to making DNA.  Through its interactions with vitamin B6, vitamin B12, and other nutrients, folate plays an essential role in:

  • Red blood cell formation
  • Cardiovascular health by regulating homocysteine levels
  • Maintain good mental health via S-adenosylmethionine (SAMe)
  • Growth and development of the fetus during pregnancy
  • Regulation of other cell production in the skin, nerves and bone

How Much Folate You Need

Whole foods contain folate – which is what your body ultimately uses.  Folate can be found in a wide range of foods including vegetables, leafy greens, fruits, dried beans, peas and nuts (a comprehensive list is shown below).  Folic acid is the synthetic form of folate, and is found in supplements and fortified foods – usually cereals, breads, etc.  Research has shown that folic acid supplements are effective for increasing folate levels and decreasing symptoms related to folate deficiency.

However, be aware that the body absorbs supplemental folic acid much more than food-based folate – which can lead to overdosing – so be careful when determining how much of a supplement to take.  When in doubt, speak with a physician or nutrition professional.  Because of this, the NIH developed the “Dietary Folate Equivalent” (DFE) to denote how much folate you need each day.

1 mcg DFE = 1 mcg food folate

1 mcg DFE = 0.6 mcg folic acid from fortified foods or dietary supplements consumed with foods

1 mcg DFE = 0.5 mcg folic acid from dietary supplements taken on an empty stomach

The daily need for folate in adults is 400 mcg DFE per day.  Exceptions are 600 mcg DFE per day for pregnant women and 500 mcg per day when breastfeeding.

Symptoms of Folate Deficiency

Folate deficiency usually occurs in conjunction with a deficiency of other nutrients and can result in a number of conditions including childbirth complications, megaloblastic anemia (and associated weakness, fatigue, headache, difficulty concentrating, etc.), elevated homocysteine levels and changes in the skin, hair, fingernails, mouth and tongue.  Inadequate folate levels have also been associated with certain cancers, cardiovascular disease, stroke, dementia, depression and decreased cognitive function.

Populations at Risk

Populations at risk for deficiency include those with alcohol dependence, women of childbearing age, pregnant women and those with malabsorptive disorders such as tropical sprue, celiac disease, inflammatory bowel disorder or those with decreased gastric acid (chronic use of acid reflux medication).

Pregnancy and Lactation: An Extra Need for Folate

While 400 mcg DFE is the average daily adult folate requirement, these needs are significantly increased during pregnancy (600 mcg DFE) and breastfeeding (500 mcg DFE).  Women of childbearing age who are considering becoming pregnant should make sure their folate intake is adequate before trying to conceive.  While adequate folate intake is associated with healthier gestational age and less congenital defects, its strongest evidence involves the prevention of neural tube defects.

Folate Toxicity (Overdose)

There is an upper limit for folic acid intake from supplements and fortified foods – 1,000 mcg DFE in adults.  Neurologic symptoms and increased risk of certain cancers are associated with chronic overdosing.

Source Mcg DFE per serving Percent of Daily Value, as per   the FDA
½ cup boiled spinach 131 33
½ cup cooked medium-grain
white rice(fortified)
90 23
4 spears of boiled asparagus 89 22
½ cup boiled brussels sprouts , from frozen 78 20
1 cup shredded romaine lettuce 64 16
½ cup raw avocado 59 15
½ cup cooked, chopped broccoli,from frozen 52 13
½ cup canned kidney beans 46 12
1 ounce dry roasted peanuts 41 10
¾ cup orange juice 35 9

Certain foods, such as breakfast cereals, pastas, and breads, are often enriched to increase their folic acid content, so check the labels!

References:

http://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

http://nutrition.highwire.org/content/129/4/779.full

http://www.mayoclinic.org/drugs-supplements/folate/background/HRB-20059475

http://www.nlm.nih.gov/medlineplus/folicacid.html#cat1

http://ndb.nal.usda.gov/

Jason Machowsky is a sports dietitian, certified strength and conditioning specialist, and certified personal trainer at the Tisch Performance Center. He has an undergraduate degree from Cornell University and a masters degree from Columbia University.

Topics: Featured, Nutrition, Rehabilitation and Fitness
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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