Finding Folate
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Finding Folate

folate in fortified cereal The B vitamin folate, also called folic acid, is a water-soluble vitamin. Water-soluble vitamins are stored in the body in very limited amounts, and are excreted through the urine. Therefore, it is a good idea to have them in your daily diet. Folate is considered a crucial vitamin before and during pregnancy. Research has shown that folate deficiencies during pregnancy can lead to neural tube birth defects in babies. Folate fortification of certain foods, including flour, rice, and cornmeal, became mandatory in 1998.

Functions

Folate's functions include:

  • Helping amino acid metabolism and conversion
  • Aiding in the conversion of homocysteine to methionine (elevated blood levels of homocysteine have been associated with an increased risk of heart attack)
  • Producing and maintaining new cells
  • Making DNA and RNA, the building blocks of cells
  • Preventing changes to DNA that may lead to cancer
  • Making red blood cells and preventing anemia
  • Assisting in the manufacture of neurotransmitters, chemicals that regulate sleep, pain, and mood

Recommended Intake:

Age Group (in years)Recommended Dietary Allowance
FemalesMales
1 - 3150 mcg150 mcg
4 - 8200 mcg200 mcg
9 - 13300 mcg300 mcg
14 - 18400 mcg400 mcg
Pregnancy, 14 - 18600 mcgn/a
Lactation, 14 - 18500 mcgn/a
19 - 50400 mcg400 mcg
Pregnancy, 19 - 50600 mcgn/a
Lactation, 19 - 50500 mcgn/a
51 - 69400 mcg400 mcg
70 +400 mcg400 mcg

Folate Deficiency

Folate deficiency is one of the most common vitamin deficiencies. It can occur for a variety of reasons, including:

  • Need is increased, as with pregnancy
  • Dietary intake is lacking
  • Body is excreting more than usual
  • Medications interfering with the body's ability to use folate include:
    • Anti-convulsant medications—(eg, hydantoins)
    • Metformin
    • Sulfasalazine
    • Triamterene
    • Methotrexate

Symptoms of folate deficiency include:

  • Megaloblastic anemia (shown by blood tests)
  • Irritability, hostility
  • Weakness
  • Weight loss
  • Apathy, forgetfulness
  • Anorexia, loss of appetite
  • Dyspnea (shortness of breath)
  • Sore tongue, glossitis (inflammation of tongue)
  • Headache
  • Heart palpitations
  • Paranoid behavior
  • Gastrointestinal tract disturbances
  • Diarrhea

Folate Toxicity

The tolerable upper intake level (UL) for folate from dietary sources and supplements combined is 1,000 mcg. Folate itself is essentially nontoxic. Large doses of folate can mask symptoms of a vitamin B12 deficiency. Although folate supplementation will alleviate the megaloblastic anemia caused by the B12 deficiency, the neurologic damage caused by the B12 deficiency will continue undetected.

Major Food Sources

FoodServing size Folate content
(mcg)
Chicken liver, simmered3.5 oz770
Fortified breakfast cereal3/4 cup 100-400
(check Nutrition Facts label)
Soy flour1 cup260
Beef liver, braised3.5 oz217
Chickpeas, canned1 cup160
Pinto beans, canned1 cup144
Spinach, boiled1/2 cup131
Lima beans, canned1 cup121
Papaya1 medium116
Avocado1medium113
Wheat germ, toasted1/4 cup102
Asparagus, boiled4 spears85
Orange juice, fresh8 fl oz75
Spinach, raw1/2 cup54
Whole wheat flour1 cup53
Green peas, boiled1/2 cup50
White rice, long-grain1/2 cup45
Orange, navel1 medium44
Peanuts, dry roasted1 oz41
Wheat flour1 cup40
Broccoli, boiled1/2 cup39
Tomatoes, sun-dried1 cup37
Tomato juice, canned6 oz35
Peanut butter, crunchy2 T29
Cashews, dry roasted1 oz20
Banana1 medium20
Bread, whole wheat1 slice15

Health Implications

Populations at Risk of Folate Deficiency

The following populations may be at risk of folate deficiency and may require a supplement:

  • Pregnant women: Folate is critical for the production and maintenance of new cells. This is especially important during pregnancy—a period of rapid cell division.
  • People who consume excessive amounts of alcohol: Folate deficiency has been observed in alcoholics. Alcohol interferes with the absorption of folate and increases excretion by the kidneys. In addition, many alcoholics tend to have diets low in essential nutrients, like folate.
  • People on certain medications (see Folate Deficiency above): Certain medications can interfere with the body's ability to use folate. Check with your doctor about supplementation if you are on a medication that may affect your folate status.
  • People with inflammatory bowel diseases: Malabsorption of folate can occur with inflammatory bowel diseases.
  • The elderly: Many elderly have low blood levels of folate, which can occur from low intake of the vitamin or problems with absorption.

Birth Defects

In 1991, a landmark study found a relationship between folate and birth defects. Subsequent research has supported the finding that adequate folate intake during the period before and just after conception protects against a number of neural tube defects, including spina bifida and anencephaly.

The crucial period is before and very early after conception—a time when most women do not know they are pregnant. Therefore, the recommendation is that all women of childbearing age make sure they have a folate intake of at least 400 mcg.

Heart Disease

Homocysteine is an amino acid. Most amino acids found in the body are building blocks of protein or muscle. However, homocysteine is not a component of protein. It is formed as a step in the production of another amino acid, methionine. The conversion of homocysteine to methionine requires a number of vitamins, including folate, B6, and B12. A deficiency of any one of these vitamins can cause the level of homocysteine in the blood to rise, which is theorized to increase your risk of heart attack or stroke.

Tips for Increasing Your Folate Intake:

To help increase your intake of folate:

  • Spread a little avocado on your sandwich in place of mayonnaise
  • Drink a glass of orange juice or tomato juice in the morning
  • Add spinach to your scrambled eggs
  • Slice a banana on top of your breakfast cereal
  • Sprinkle some toasted wheat germ on top of pasta or a stir-fry
  • Throw some chickpeas or kidney beans into a salad
  • If you take a vitamin supplement, make sure it contains folate

RESOURCES:

American Dietetic Association
http://www.eatright.org

Food and Nutrition Information Center, US Department of Agriculture website.
http://www.nal.usda.gov/fnic

CANADIAN RESOURCES:

Canadian Council on Food and Nutrition
http://www.ccfn.ca

Dietitians of Canada
http://www.dietitians.ca/

References:

Dietary supplement fact sheet: folate. National Institutes of Health website. Available at: http://ods.od.nih.gov/factsheets/folate.asp. Accessed May 13, 2008.

Duyff RL. The American Dietetic Association's Complete Food & Nutrition Guide. 3rd Ed. Hoboken, NJ: John Wiley and Sons, Inc.;2006.

Facts about dietary supplements. National Institutes of Health website. Available at: http://www.nih.gov/.

Food and Nutrition Information Center, US Department of Agriculture website. Available at: http://www.nal.usda.gov/fnic/.

The Nutrition Desk Reference. Keats Publishing; 1995.



Last reviewed April 2008 by Maria Adams, MS, MPH, RD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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