Folate vs Folic Acid: What You Need to Know for a Healthy Pregnancy
If you're pregnant or planning to conceive, you're probably familiar with the importance of getting enough folate (vitamin B9) for the healthy development of your baby.
Folate is essential for cell growth and division, and it plays a critical role in the formation of the neural tube, which develops into the brain and spinal cord. Inadequate folate intake during pregnancy can lead to neural tube defects, such as spina bifida, as well as other birth defects, including cardiovascular complications, cognitive dysfunction, low birth weight, and cancer.
But did you know that not all forms of folate are created equal? In fact, there's a significant difference between folate, folic acid, and folinic acid in terms of its bioavailability and effectiveness in the body.
Folate is the naturally occurring form of vitamin B9 that is found in foods such as leafy greens, legumes, fruit, and liver. However, mammals cannot synthesize folate on their own and rely on dietary intake or supplementation to maintain normal levels. During pregnancy, the demand for folate increases as it supports the growth of the placenta and foetus, making it a critical nutrient for a healthy pregnancy. Folic acid is a synthetic and oxidized version of folate that does not exist in nature. It was introduced into food fortification and dietary supplements in the US in 1997 as a cheaper alternative to folate. However, folic acid must be metabolized differently from folate to become biologically active. The process of conversion from folic acid to the active form of folate is slow and easily reaches saturation, inhibiting its absorption. This means that high doses of folic acid remain unmetabolized, which can mask B12 deficiencies and may have further detrimental physiological effects. Moreover, recent studies suggest that very high doses of folic acid supplementation during pregnancy may have adverse consequences on infant neurodevelopment. It’s essential to choose the right form of folate supplementation during pregnancy.
Methylfolate (or 5-methyltetrahydrofolate) is the most bioavailable form of folate and is the most effective and safest alternative to synthetic folic acid. 5-MTHF is a biologically active form of folate that is readily converted to tetrahydrofolate (THF), the active coenzyme form of folate, without requiring additional enzymatic action. Folinic acid, a 5-formyl derivative of THF, is another naturally occurring form of folate that is found in food and is also easily converted to THF. Unlike folic acid, folinic acid is unaffected by certain pharmaceuticals. While Methylfolate, 5-MTHF, and folinic acid are more expensive than folic acid, they are worth the investment, as they offer better bioavailability and effectiveness in the body. When choosing a prenatal vitamin or folate supplement, make sure to read the label carefully and opt for products that contain Methylfolate or folinic acid instead of folic acid.
In addition to supplementation, you can also increase your folate intake by eating a diet rich in folate-rich foods such as:
Green leafy vegetables
Legumes
Fruit
Sprouts
Liver
The recommended daily intake of folate for women of childbearing age is 400ug/day, but supplementing with approximately 600mcg of folate/day is recommended during preconception, pregnancy, and breastfeeding.
If you’re pregnant or trying to conceive, make sure you optimise your folate intake from food sources and consider supplementing with methylfolate or folinic acid instead of synthetic folic acid. Understanding the difference between folate and folic acid can make a significant difference in the health and well-being of both mother and baby.
UNTIL NEXT TIME, BE WELL
YOURS IN GREAT HEALTH,
References:
Branum, A. M., Bailey, R., & Singer, B. J. (2013). Dietary supplement use and folate status during pregnancy in the united states. The Journal of Nutrition, 143(4), 486-492. https://doi.org/10.3945/jn.112.169987
Ferrazzi, E., Tiso, G., & Di Martino, D. (2020). Folic acid versus 5- methyl tetrahydrofolate supplementation in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 253, 312-319. https://doi.org/10.1016/j.ejogrb.2020.06.012
Scaglione, F., & Panzavolta, G. (2014). Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica, 44(5), 480-488. https://doi.org/10.3109/00498254.2013.845705
Plumptre, L., Masih, S. P., Ly, A., Aufreiter, S., Sohn, K., Croxford, R., Lausman, A. Y., Berger, H., O'Connor, D. L., & Kim, Y. (2015). High concentrations of folate and unmetabolized folic acid in a cohort of pregnant canadian women and umbilical cord blood. The American Journal of Clinical Nutrition, 102(4), 848-857. https://doi.org/10.3945/ajcn.115.110783
Valera-Gran, D., García De La Hera, Manuela, Navarrete-Muñoz, E. M., Fernandez-Somoano, A., Tardón, A., Julvez, J., Forns, J., Lertxundi, N., Ibarluzea, J. M., Murcia, M., Rebagliato, M., Vioque, J., Infancia Medio Ambiente INMA, & Infancia y Medio Ambiente (INMA) Project. (2014). Folic acid supplements during pregnancy and child psychomotor development after the first year of life. JAMA Pediatrics, 168(11), e142611. https://doi.org/10.1001/jamapediatrics.2014.2611