Nutrition focus: Folate (Vitamin B9)


Folate comes for the Latin word, follium, which means leaf. So you can guess which foods are high is folate ~ yep, leafy greens!

Folate is important for:

  • Development of red blood cells
  • Reduction of homocysteine, an inflammatory amino acid. Homocysteine becomes elevated with deficiencies of vitamin B6, B12 and folate.
  • Supports development and function of the nervous system.

Development of the nervous system is a particularly important function of folate. Deficiency of folate will lead to a defect in closure of the neural tube which is the embryonic form of the spinal cord and brain.  The neural tube closes in the first 4-6 weeks of pregnancy so the sufficient folate in the body is needed before and during the first 4-6 weeks of pregnancy.  An example of a neural tube defect (NTD) is spina bifida.  Another example is anencephaly which is incompatible with life. 

It was discovered as far back as 1965 that deficiencies of folate would lead to neural tube defects.  Of the neural tube defects that occur, 95% occur in families with no history of these birth defects.  Over half of pregnancies are unplanned, so deficiency of folate prior to conception and during early pregnancy is particularly concerning.   All women of childbearing age should consume 400 microgams of folate daily.

Wait, we have been discussing folate.  What is folic acid?

Folic acid is the synthetic and more stable form of folate.  Folic acid is more easily absorbed than folate.  However, folic acid must be metabolized to the biolocially active tetrahydrofolate.  Since folic acid must be metabolized and converted to an active form, this conversion is somewhat limited.  So, high intakes of folic acid can lead to high blood levels of unmetabolized folic acid.  High unmetabolized folic acid levels have been associated with:

  • An increased risk of cancer
  • Can mask B12 deficiency
  • Decreases the level and activity of natural killer cells thereby compromising our bodies own natural immunity.

Public health educational efforts were made to increase the consumption of folate but this did not reduce the incidence of NTDs.  In 1998, all enriched grains were mandated to be fortified with folic acid.  This includes breakfast cereals, flour, cornmeal, rice and pasta.  This added about 140 micrograms of daily folic acid intake to the average American adult's diet.  This intervention alone decreased the incidence of NTDs by 50% and in families with a history of NTDs, the subsequent occurence of such defects, decreased by 71%.  Impressive!!  

However, high intakes of folic acid fortified foods and supplements beyond 1000 micrograms should be avoided.

So, it is all a delicate balance of folate and folic acid.  As with many vitamins and minerals, there is no concern about the vitamin level found naturally in foods for folate. Folate in foods is accompanied by a myriad of other nutrients that modulate their own effects. 

Which foods are naturally high in folate?

  • Fresh green veggies:  high cooking temperatures will lead to a loss of folate in the food
  • Liver
  • Citrus fruits:  oranges, papaya, grapes, grapefruit, bananas, canteloupe and strawberries
  • Beans and lentils
  • Nuts and seeds

Children need to eat about 150-300 micrograms of folate or folic acid daily.  All people 14 years and older, need 400 micrograms daily and ideally, women of childbearing age, should take in about 800-1000 micrograms of folate or folic acid.  


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