Finding Folate
The B vitamin folate , also called folic acid, is a water-soluble vitamin. Water-soluble vitamins are stored in the body in very limited amounts, and are excreted through the urine. Therefore, it is a good idea to have them in your daily diet. Folate is considered a crucial vitamin before and during pregnancy. Research has shown that folate deficiencies during pregnancy can lead to neural tube birth defects in babies.
Functions
Folate's functions include:
- Helping amino acid metabolism and conversion
- Aiding in the conversion of homocysteine to methionine
- Producing and maintaining new cells
- Making DNA and RNA, the building blocks of cells
- Preventing changes to DNA that may lead to cancer
- Making red blood cells and preventing anemia
- Assisting in the creation of neurotransmitters (chemicals that regulate sleep, pain, and mood)
Recommended Intake:
Age Group (in Years) | Recommended Dietary Allowance | |
---|---|---|
Females | Males | |
1 - 3 | 150 mcg | 150 mcg |
4 - 8 | 200 mcg | 200 mcg |
9 - 13 | 300 mcg | 300 mcg |
14 - 18 | 400 mcg | 400 mcg |
Pregnancy, 14 - 18 | 600 mcg | n/a |
Lactation, 14 - 18 | 500 mcg | n/a |
19 - 50 | 400 mcg | 400 mcg |
Pregnancy, 19 - 50 | 600 mcg | n/a |
Lactation, 19 - 50 | 500 mcg | n/a |
51 - 69 | 400 mcg | 400 mcg |
70 + | 400 mcg | 400 mcg |
mcg=microgram
Folate Deficiency
Folate deficiency is a common vitamin deficiencies. It can occur for a variety of reasons, including:
- Need is increased, as with pregnancy
- Dietary intake is lacking
- Body is excreting more than usual
-
Medications interfering with the body's ability to use folate include:
- Anti-convulsant medications—(eg, hydantoins)
- Metformin
- Sulfasalazine
- Triamterene
- Methotrexate
Symptoms of folate deficiency include:
- Megaloblastic anemia (shown by blood tests)
- Irritability, hostility
- Weakness
- Weight loss
- Apathy, forgetfulness
- Anorexia , loss of appetite
- Sore tongue, glossitis (inflammation of tongue)
- Headache
- Heart palpitations
- Paranoid behavior
- Gastrointestinal tract disturbances
- Diarrhea
Folate Toxicity
The tolerable upper intake level (UL) for folate from dietary sources and supplements combined is 1,000 mcg in adults. The upper limit is lower in children (double the recommended daily amount for each age). Folate itself is essentially nontoxic. Large doses of folate can mask symptoms of a vitamin B12 deficiency. Although folate supplementation will alleviate the megaloblastic anemia caused by the B12 deficiency, the neurologic damage caused by the B12 deficiency will continue undetected.
Major Food Sources
There is a variety of foods that contain folate. Some foods, like cereal, rice, flour, and cornmeal are fortified with folate. Here is a list of major food sources and their folate content.
Food | Serving Size |
Folate Content
(mcg) |
---|---|---|
Chicken liver, simmered | 3.5 ounces | 770 |
Fortified breakfast cereal | 3/4 cup |
100-400
(check Nutrition Facts label) |
Soy flour | 1 cup | 260 |
Beef liver, braised | 3.5 ounces | 217 |
Chickpeas, canned | 1 cup | 160 |
Pinto beans, canned | 1 cup | 144 |
Spinach, boiled | 1/2 cup | 131 |
Lima beans, canned | 1 cup | 121 |
Papaya | 1 medium | 116 |
Avocado | 1medium | 113 |
Wheat germ, toasted | 1/4 cup | 102 |
Asparagus, boiled | 4 spears | 85 |
Orange juice, fresh | 8 fluid ounces | 75 |
Spinach, raw | 1/2 cup | 54 |
Whole wheat flour | 1 cup | 53 |
Green peas, boiled | 1/2 cup | 50 |
White rice, long-grain | 1/2 cup | 45 |
Orange, navel | 1 medium | 44 |
Peanuts, dry roasted | 1 oz | 41 |
Wheat flour | 1 cup | 40 |
Broccoli, boiled | 1/2 cup | 39 |
Tomatoes, sun-dried | 1 cup | 37 |
Tomato juice, canned | 6 oz | 35 |
Peanut butter, crunchy | 2 tablespoons | 29 |
Cashews, dry roasted | 1 ounce | 20 |
Banana | 1 medium | 20 |
Bread, whole wheat | 1 slice | 15 |
Health Implications
Populations at Risk of Folate Deficiency
The following populations may be at risk of folate deficiency and may require a supplement:
- Pregnant women—Folate is critical for the production and maintenance of new cells. This is especially important during pregnancy—a period of rapid cell division.
- People who consume excessive amounts of alcohol—Folate deficiency has been observed in alcoholics . Alcohol interferes with the absorption of folate and increases excretion by the kidneys. In addition, many alcoholics tend to have diets low in essential nutrients, like folate.
- People on certain medications (see Folate Deficiency above)—Certain medications can interfere with the body's ability to use folate. Check with your doctor about supplementation if you are on a medication that may affect your folate status.
- People with inflammatory bowel diseases—Malabsorption of folate can occur with inflammatory bowel diseases.
- The elderly—Many elderly have low blood levels of folate, which can occur from low intake of the vitamin or problems with absorption.
Birth Defects
In 1991, a landmark study found a relationship between folate and birth defects. Subsequent research has supported the finding that adequate folate intake during the period before and just after conception protects against a number of neural tube defects, including spina bifida and anencephaly.
The crucial period is before and very early after conception—a time when most women do not know they are pregnant. Therefore, the recommendation is that all women of childbearing age make sure they have a folate intake of at least 400 mcg.
Tips for Increasing Your Folate Intake:
To help increase your intake of folate:
- Spread a little avocado on your sandwich in place of mayonnaise
- Drink a glass of orange juice or tomato juice in the morning
- Add spinach to your scrambled eggs
- Slice a banana on top of your breakfast cereal
- Sprinkle some toasted wheat germ on top of pasta or a stir-fry
- Throw some chickpeas or kidney beans into a salad
- If you take a vitamin supplement, make sure it contains folate
RESOURCES:
American Dietetic Association
http://www.eatright.org
Food and Nutrition Information Center, US Department of Agriculture
website.
http://www.nal.usda.gov/fnic
CANADIAN RESOURCES:
Canadian Council on Food and Nutrition
http://www.ccfn.ca
Dietitians of Canada
http://www.dietitians.ca/
References:
Dietary supplement fact sheet: folate. National Institutes of Health website. Available at: http://ods.od.nih.gov/factsheets/folate.asp. Accessed April 15, 2010.
Duyff RL. The American Dietetic Association's Complete Food & Nutrition Guide. 3rd Ed. Hoboken, NJ: John Wiley and Sons, Inc.; 2006.
Facts about dietary supplements. National Institutes of Health website. Available at: http://www.nih.gov/.
Food and Nutrition Information Center, United States Department of Agriculture website. Available at: http://www.nal.usda.gov/fnic/.
The Nutrition Desk Reference. Keats Publishing; 1995.
Last reviewed April 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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