Folate, also known as Vitamin B9, is a water-soluble nutrient with a significant role in numerous bodily functions. It is fundamental for the creation of DNA and other genetic material, processes central to cell growth and division throughout life. This nutrient is broadly categorized into two forms: folate, which occurs naturally in various foods, and folic acid, a synthetic version often found in supplements and enriched food products.
The body processes these forms differently, yet both contribute to meeting the body’s requirements for Vitamin B9. Natural folate is metabolized in the small intestine into its active form, 5-methyltetrahydrofolate (5-MTHF), which the body can immediately utilize. In contrast, folic acid undergoes enzymatic conversions in the liver and intestines to become 5-MTHF, a process that can be slower and less efficient for some individuals.
Recommended Daily Intake
The amount of folate recommended daily varies depending on a person’s age and life stage, measured in micrograms (mcg) of Dietary Folate Equivalents (DFE). This unit accounts for the differing absorption rates of natural folate and synthetic folic acid, with folic acid being more efficiently absorbed. For instance, 240 mcg of folic acid and 400 mcg of natural folate are both considered equivalent to 400 mcg DFE due to this absorption difference.
Infants from birth to 6 months require 65 mcg DFE per day, increasing slightly to 80 mcg DFE for those aged 7–12 months. As children grow, their needs increase, with 150 mcg DFE for 1–3 year olds, 200 mcg DFE for 4–8 year olds, and 300 mcg DFE for 9–13 year olds. Adolescents aged 14–18 years and adults 19 years and older generally need 400 mcg DFE daily.
Specific populations have higher requirements due to increased physiological demands. Pregnant individuals are advised to consume 600 mcg DFE each day to support fetal development. For breastfeeding individuals, the recommendation is 500 mcg DFE daily. These guidelines ensure adequate folate levels.
Consequences of Folate Deficiency
A lack of sufficient folate can lead to several health complications, primarily affecting the body’s ability to produce healthy cells. One of the main issues arising from inadequate folate intake is megaloblastic anemia. This condition is characterized by the production of abnormally large, immature, and fewer red blood cells that are less effective at carrying oxygen throughout the body.
Symptoms include persistent fatigue, weakness, and shortness of breath. Other signs of folate deficiency can involve open sores on the tongue or changes in skin and hair pigmentation.
For individuals who can become pregnant, adequate folate intake is important, especially before and during early pregnancy. Insufficient folate levels during this period increase the risk of neural tube defects (NTDs) in newborns. NTDs are birth anomalies affecting the brain and spinal cord, such as spina bifida, where the spinal cord does not close properly. Since the neural tube closes early in pregnancy, often before a person knows they are pregnant, consistent folate intake is advised for all individuals of childbearing age.
Risks of Excessive Folate Intake
While folate is an important nutrient, consuming too much of the synthetic form, folic acid, can pose certain risks. A Tolerable Upper Intake Level (UL) has been established for folic acid from fortified foods and supplements for adults, set at 1,000 mcg per day. This upper limit does not apply to folate obtained naturally from food sources, as excessive intake from whole foods is generally not associated with adverse effects.
A main concern with high folic acid intake is its potential to mask the symptoms of a Vitamin B12 deficiency. If a Vitamin B12 deficiency is masked by high folic acid intake, the anemia might improve, but the underlying neurological damage associated with untreated B12 deficiency can progress unnoticed.
Untreated Vitamin B12 deficiency can result in severe and irreversible neurological damage. This risk highlights the importance of distinguishing between folate and Vitamin B12 deficiencies, particularly when considering folic acid supplementation. Consultation with a healthcare provider can help determine appropriate intake levels and monitor for potential deficiencies.
Obtaining Daily Folate
Meeting daily folate requirements can be achieved through a balanced diet rich in both naturally occurring folate and foods fortified with folic acid. Many everyday foods are excellent sources of natural folate. Leafy green vegetables like spinach, kale, and romaine lettuce are rich in folate. Other vegetables such as asparagus, Brussels sprouts, and broccoli also provide folate.
Legumes including beans, lentils, peas, peanuts, and sunflower seeds provide natural folate. Fresh fruits, especially citrus varieties like oranges, are also sources. Organ meats, such as beef liver, are another source of natural folate.
Many countries have implemented food fortification programs, adding folic acid to staple foods. Common examples of fortified foods include enriched breads, flours, cornmeal, pasta, rice, and breakfast cereals. While a varied diet is encouraged, healthcare providers may recommend folic acid supplements, particularly for women of childbearing age, to ensure adequate intake.