Folate

Why do we need folate?

Folate is a generic term given to a group or family of B vitamins. Folic acid is the most stable form of folate, but occurs only rarely naturally in foods. Folic acid is used in vitamin supplements and fortified food products.
During pregnancy, for the fetus to grow properly, folate is needed to make DNA, among a wide range of metabolites.

A baby’s spinal cord, spine, brain and skull all develop from the neural tube, which is formed in the very early days of pregnancy, between seventeen and thirty days after conception. The neural tube then closes, due to the presence of the right proteins at the right time and in the right place. This process is triggered by DNA.

Spina bifida and anencephaly, the two most common neural tube defects, occur when the tube does not close properly, exposing the baby’s brain or spinal cord to amniotic fluid.
All women of reproductive age are at risk of giving birth to babies with neural tube defects. About 95% of these defects occur in babies whose mothers have no family history of these defects. Women who have already given birth to one child with a neural tube defect are more likely to give birth to another baby with these problems in future pregnancies.

These defects happen very early in pregnancy, well before most women realize they are pregnant. Since most women do not have complete control over when they will become pregnant, all women of reproductive age should get enough folate, even if they are not planning to become pregnant. Not all neural tube defects are preventable through improving folic acid dietary intake.

 

What happens if we don’t get enough folate?

Worldwide, 250,000 babies are born each year with serious birth defects of the spine (spina bifida) or brain (anencephaly).
In spina bifida, the baby’s backbone and spinal cord do not develop normally and may be exposed through an opening in the child’s back. Some 80 to 90 percent of babies born with spina bifida survive, but with some degree of disability, often severe. Children with spina bifida may live with paralysis of the legs; hydrocephalus (‘water on the brain’); learning disabilities; and decreased bowel and bladder control.

With anencephaly, the child’s brain does not fully develop or is completely absent. Anencephaly is always fatal. It often leads to miscarriage, but even full-term babies die soon after birth.

Folic acid may also protect the heart.
A 14-year study of about 44,000 men in the United States has demonstrated that those with the highest intakes of folate had a 30% lower risk of (ischemic) stroke than those with the lowest intakes.
The American Heart Association has noted 48,000 fewer deaths from stroke and ischemic heart disease since the mandatory fortification of grain products with folic acid in the United States. These improvements could not be explained by changes in other risk factors .

 

What are the best sources of folate and folic acid?

Foods that are rich in folate are:

  • leafy, green vegetables, like spinach and broccoli
  • legumes and dried beans
  • nuts
  • citrus fruits

To prevent birth defects associated with folate deficiency, women must consume 400 micrograms of synthetic folic acid daily for one month before becoming pregnant, as well as for the first trimester of pregnancy. Since many pregnancies are unplanned, all women of reproductive age should consume this amount of synthetic folic acid daily by means of a dietary supplement, or a fortified food.

When taken in this way, folic acid reduces the risk of neural tube defects by 50% to 70%.

 

1) Nutriview 2004/2:7, www.nutrivit.org