Folate or folic acid

Folic acid, also known as folate, is a B-vitamin that can be found in some enriched foods and vitamin pills. Adequate levels of folic acid, in the form of folate, can be obtained by eating natural sources such as:

• Leafy dark green vegetables
• Legumes (dried beans and peas)
• Citrus fruits and juices such as orange juice
• Most berries

If women have enough of it in their bodies before pregnancy, this vitamin can decrease the risk for neural tube defects (NTDs), which are birth defects of the baby's brain (anencephaly) or spine (spina bifida).

For many women, an easy way to be sure you're getting enough folic acid is to take a vitamin with folic acid in it. The U.S. Public Health Service recommends that all women who could possibly become pregnant get 400 micrograms (or 0.4 mg) of folic acid every day. This could prevent up to 70% of some types of serious birth defects. But to do this, women need folic acid before they get pregnant.

Folic acid also plays a role in the DNA repair process.

The difference between folic acid and folate

There are two important differences between folic acid and folate:

1. Where they are found. Folic acid is the synthetic form of the vitamin that is used in supplements and fortified foods. Folate is found naturally in foods, such as beans and other legumes, leafy green vegetables and orange juice.
2. How the body uses them. While the body almost completely uses synthetic folic acid, it only partially uses natural folate.

Listed below are some examples of foods that contain folic acid. The recommended daily value (RDV) of folic acid for a woman of childbearing age is 400 micrograms.

Neural Tube Defects (NTD)

Neural tube defects, or NTDs, are birth defects that affect the neural tube, the structure that becomes the brain and spinal cord. Neural tube defects, including spina bifida and anencephaly, are a common birth defect.

• Approximately 2,500 infants are born each year in the U.S. with an NTD. About half of these children are thought to have developed this defect due to inadequate folate intake by the mother. Other NTDs have different causes that are not well understood.
• Spina bifida is a condition in which the spinal cord is exposed. A majority of babies born with spina bifida grow to adulthood with varying degrees of disability, ranging to problems with bowel and bladder control, and paralysis. Many may require a series of operations and other treatments.
• In anencephaly, infants die shortly after birth because most or all of the brain is absent.
• There are several different types of NTDs. Spina bifida and anencephaly account for 90 percent of all NTDs. Encephalocele accounts for the remaining 10 percent.

 Since NTDs develop very early in pregnancy (18-30 days after conception), often before a woman knows she is pregnant, it is essential that adequate intake of folic acid be maintained throughout the childbearing years. Oral contraceptives reduce folate levels significantly. Women who have been "on the pill" need to boost their folate status if they are planning a pregnancy (Larsen, 1999).

Other diseases and folic acid

Some research has shown that folic acid may also

• prevent birth defects of the heart, limbs and face.
• Some studies show that folic acid may help protect women and men from
• heart disease,
• cervical and colon cancer and
• possibly breast cancer.
• In one study, after four weeks of folic acid supplementation, blood vessels became more flexible and their ability to dilate improved. Researchers concluded that folic acid can reduce cardiovascular risk (Title et al, 2000). Folic acid supplements helped reduce heart disease risk in patients suffering from an inherited tendency to high cholesterol. They stated that “Folic acid supplementation significantly improved endothelial dysfunction in patients with coronary atherosclerosis”.
• A folic acid deficiency has been implicated in a wide variety of disorders from
• Alzheimer's disease to
• atherosclerosis,
• heart attack, stroke,
• osteoporosis,
• depression,
• dementia,
• cleft lip and palate,
• hearing loss, and of course,
• neural tube defects (Larsen, 1999).

Folic acid and DNA

Antioxidants alone may not enough to protect our DNA. Some research points to the B vitamin folic acid as equally or perhaps more important than antioxidants in ensuring proper DNA replication. Folic acid deficiency has been implicated in a wide variety of disorders from Alzheimer's disease to atherosclerosis, heart attack, stroke, osteoporosis, cervical and colon cancer, depression, dementia, cleft lip and palate, hearing loss, and of course, neural tube defects. The list of conditions involving a folic acid deficiency is growing day-by-day, as is clinical evidence that most of these conditions can be reversed by supplementation.

Folic acid is essential for the synthesis of adenine and thymine, two of the four nucleic acids that make up our genes, DNA and chromosomes. Folic acid is also required for the proper metabolism of the essential amino acid methionine. Methionine is converted to homocysteine and back to methionine in a process requiring folic acid (tetrahydrofolate) and vitamin-B12 (cobalamin) as a catalyst. It may be metabolized into cysteine in a process catalyzed by vitamin-B6 (pyridoxine). Cysteine is a vital link in the synthesis of glutathione, one of our most important antioxidants. A high blood level of homocysteine has been found to be highly detrimental to health and is invariably accompanied by a low level of folic acid. High homocysteine levels increase the risk of coronary heart disease, the risk of heart attacks, strokes, and peripheral vascular disease (Kang et al, 1986), (Moustapha and Robinson, 1999). A homocysteine level of more than 11.2 micromol/L confers a five-fold increase in heart attack risk as compared to the risk at 7.2 micromol/L or less (Verhoef, et al, 1996).

Folic Acid dosage levels and associated B vitamin requirements

Folic acid uses the catalysts vitamins B12 and B6 to carry out its functions effectively, so it is best to supplement with a combination of the three. Dosage recommendations for folic acid vary between 0.4 mg/day and 10 mg/day or more depending on the severity of the deficiency and the health problem to be overcome. The RDA for adults is now 0.4 mg/day and 0.6 mg/day for pregnant women. Recommendations for vitamin B12 generally range from 0.5 to 1.0 mg/day and for vitamin-B6 from 10 to 250 mg/day (Larsen, 1999).

Reference Sources

• http://www.wholehealthmd.com/refshelf/substances_view/1,1525,10004,00.html
• http://www.marchofdimes.com/professionals/690_1403.asp
• http://www.yourhealthbase.com/folic_acid.htm