Importance of Folic Acid for Overall Health and Pregnancy

Folic Acid is a B vitamin, specifically B9. It is an essential nutrient required by the body to create healthy new cells. While we hear about it mostly in regards to pregnancy, it is important to understand that the need for folic acid goes even beyond this. Folic acid is essential for the body to create red blood cells which in turn prevents anemia. It is also plays an important role in the metabolism of homocysteine, an amino acid. The recommended dietary allowance (RDA) for all men and women 14 and older is 400 mcg.

Men often don’t realize this as the benefits to pregnant women are more publicized, but any human being is in need of proper amounts of folic acid to insure the body is able to create new red blood cells to nourish the body with oxygen. The recommendation is to either get this amount by using a dietary supplement or eating foods fortified with folic acid. Folic acid is the synthetic version of folate and appears to be absorbed by the body (also known as bioavailable) much better than the folate occurring naturally in food.

One mcg of food folate (also called 1 DFE - Dietary Folate Equivalent) is equal to 0. 6 mcg of synthetic folic acid. This means that to meet the RDA from food alone, a woman or man would have to eat food naturally containing about 667 mcg per day (400/0. 6 ) which might prove difficult. Folic Acid is especially important to pregnant women. Women that have sufficient Folic Acid in their diet before and after they conceive, have a 50-70% less chance of having a baby with a brain or spine defect such as spina bifida or anencephaly . 1) Because of this the recommended dietary allowance for pregnant women is higher than for a woman that is not pregnant. The RDA for pregnant women is 600 mcg as opposed to 400 mcg. Any woman of childbearing age should be taking between 400 mcg - 600 mcg per day as about half of all pregnancies are unplanned. If a woman does not start supplementation until she is pregnant she has already lost some of the benefits, though starting it as soon as possible is still better than continuing with no supplementation. After her child is born she should continue supplementing as the RDA is 500 mcg during lactation.

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By consuming adequate folic acid while breastfeeding, a woman is providing her child with folic acid through her breast milk while still having enough to nourish her own body. There is continued study into other possible benefits of folic acid. One area of study is whether folic acid aids in prevention of heart disease. The studies have specifically looked at the amino acid homocysteine. Folic acid is known to break down homocysteine in the body. High levels of homocysteine in the blood are related to a higher risk of heart disease, but this hasn’t conclusively been shown to be a cause of heart disease.

Because of the lack of evidence the American Heart Association (AHA) is not at this time considering hyperhomocysteinemia (too much homocystein) a major risk factor for cardiovascular disease. AHA’s recommendation is to try and get the recommended allowance from fruits, vegetables and fat free or low fat dairy products. They say that supplements should only be used when the diet does not supply enough. Evidence is clear for folic acid supplementation reducing homocystein levels but is still lacking on whether homocystein will lower risk for cardiovascular disease. 2) Another area of study is folic acid’s role in reducing risk of certain forms of cancer. Low levels of folic acid in the blood have been linked to colon cancer, but it is too early to say if folic acid supplements can reduce risk of colon cancer. Other cancers that have been studied in relation to folic acid are breast, ovarian, pancreatic, esophageal, and stomach. Some have shown benefits to supplementation, but the results were not reproduced in subsequent studies, so at this time there is no recommendation for supplementation of folic acid to reduce risk of cancer.

The American Cancer Society similar to the AHA recommendation is to eat a healthful diet with plenty of fruits and vegetables that contain folic acid along with other vitamins. Folic acid plays many important roles in the body. There is no doubting that it is essential. The reason that we need a constant stream of it is because it is not stored in large quantities in the body. It is water soluble. Fat soluble vitamins are stored for longer in our system. When ingested, the body uses what it can and the rest comes out in urine, in very little time the body will need more.

We discussed how pregnant women get a proven benefit, and studies continue on its role in reducing risks of other diseases, but regardless of what additional benefits are found, it is clear that without folic acid in our bodies, we would not be alive. Folic acid aids in the production of red blood cells and the synthesis of DNA and RNA. Folate even has a role in the digestive system! It works with vitamins B12 and C to help the body digest and synthesize proteins. Lastly, folic acid helps tissues grow and cells function, it is an integral part of the body working as it should.

You might wonder what would happen if you stopped consuming folic acid in the form of supplements or foods. One consequence that is quite likely under these conditions is folate-deficiency anemia. This type of anemia occurs when red cell production slows and the body no longer has a sufficient amount. Without enough red blood cells, oxygen cannot travel around the body quick enough. In a severe form, where the body is not making enough red blood cells over a period of time, the heart can start to malfunction. To compensate for the lack of oxygen getting to the body, the heart will start to beat faster in an attempt to correct the situation.

Over a period of time this can cause congestive heart failure and even death. Shorter term symptoms would be fatigue, headaches, and pallor. Recovering completely from anemia can take several months. (3) The good news however is that folic acid is readily available. Beef Liver is a good meat source of folic acid with about 185 micrograms in 3 ounces. While liver is a great source, there are luckily many others for those of us that are not liver fans. Other natural sources are black eyed peas and spinach. Both have about 100 mcg of folate per 1/2 cup.

Other vegetable sources are great northern beans (90 mcg), asparagus (85 mcg in 4 spears), vegetarian baked beans (60 mcg in 1 cup), broccoli (50 mcg in 1/2 cup), romaine lettuce (40 mcg in 1/2 cup), and avocado (45 mcg in 1/2 cup). If you prefer fruits, some examples of fruit sources are oranges, cantaloupe, papayas and bananas. A serving of each of these provides between 25-30 mcg of folic acid. Besides folate occurring naturally in foods, some foods are fortified as a result of the folic acid fortification regulations published by the Federal Drug Administration (FDA) Foods that are folic acid fortified include cereal, pasta, and bread.

Some cereals have 100% recommended daily value of 400 micrograms in 3/4 cup. One bowl of some cereals could provide your daily requirement of folic acid! Other cereals are fortified but to a lesser degree having about 100 mcg per 3/4 cup. Rice and breads are often fortified as well. One half cup of rice has 65 mcg of folic acid, while one slice of bread has 25 mcg. One of the latest news stories highlighted that folic acid was recently studied in its relation to academic success. Swedish researchers found that teens with higher levels of folic acid circulating did better academically than those with lower folic acid levels.

The study noted that while there is no scientific evidence that taking folate supplements will be beneficial for teens, the results of this study show that there is a relationship. (4) Fruits and vegetables are certainly important in a diet, but in addition to healthful food, there seems to be clear evidence that a daily supplement or deliberate consumption of folic acid fortified foods will ensure you are reaching the RDA and allowing your body to function to its highest capacity. The Upper Limit recommendation is 1000 mcg, so there should be low concern if you, for example, have a day with high folate foods plus a supplement.

Toxicity related to folic acid is very rare. While I always understood that folic acid was important to take as a supplement for pregnant women, I now understand much more deeply the importance it has for everyone. Before born, a baby is using folic acid to assist in development of the brain and spine. As a teen, there might be an academic benefit to having higher folate levels. Research has also pointed towards the elderly being less likely to have dementia and Alzheimer’s with proper folate intake.

Throughout life, folate contributes to development and functioning of the brain and day in and day out folate helps your body function.

Sources

http://www. cdc. gov/ncbddd/folicacid/about. html

http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Homocysteine-Folic-Acid-and-Cardiovascular-Disease_UCM_305997_Article. jsp

http://www. mayoclinic. com/health/anemia/DS00321/DSECTION=complications

 http://www. nlm. nih. gov/medlineplus/news/fullstory_114147. html Sample Menu

While I am now convinced that a folic acid supplement is the best way to ensure adequate consumption of folic acid, the below menu is assuming I am not regularly taking a folic acid supplement. the menu doesn’t include all food I would eat, just those that have folic acid. Breakfast: 1 cup Cherrios - 50% RDA = 200 mcg Lunch: 1/2 cup Success White Rice (fortified) - 20% RDA = 80 mcg 4 Asparagus spears - 22% RDA = 85 mcg Snack: 1 banana - 8% RDA = 30 mcg Dinner: 2oz Barilla medium shells - 30% RDA = 120 mcg Total: 515 mcg Another simple choice is to have 1/3 cup of All Bran Buds for breakfast. This has 400 mcg! 100% of daily recommended value.

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