Folate, a water-soluble vitamin, is the natural form of vitamin B9. Folate is also a generic term for a family of compounds.
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Vitamin B9 is water soluble
Sources of vitamin B9:
Folate is found in a range of food sources. It was named after green foliage, and its principle source is dark leafy green vegetables, such as asparagus, cabbage, broccoli, Brussels sprouts, peas, cauliflower, beets, citrus, dried beans and other legumes. However, wheat bran, whole grain foods, seeds and nuts are also good sources, as are poultry, liver and fortified foods.
Folate is essential for brain development and function and plays a role in the synthesis, repair, and function of DNA, RNA (the genetic material found in all cells). The vitamin also plays an important role in preventing neural damage to a developing foetus, and is therefore essential for women who are, or are aiming to get pregnant.
Clinical trials have shown that when individuals take the three vitamins folate, B6 and B12, their homocysteine levels are lowered; however, cardiovascular events do not reduce. On the other hand, this regimen lowers the risk of age-related macular degeneration in these individuals i.e. protects the eyes.
Vitamin B9 deficiency:
People who eat poorly or drink too much alcohol may have folate deficiency. It is the most common vitamin deficiency—even in developed countries, such as the USA—and in the UK one in five young women are deficient in the vitamin B9 folate.
A deficiency in folate will affect every cell that divides, especially those that replicate rapidly, such as red blood cells, the immune system and the digestive tract. This can cause anaemia, a diminishing immune system and digestive dysfunction, respectively. Gross folate deficiency, which impairs DNA replication, leads to megaloblastic anaemia. It also affects the neurological system, particularly in developing babies.
If a woman has insufficient levels of folate just before, and during the early stages of, pregnancy the risk of having a baby with a neural tube defect (NTD) increases significantly. NTD is a serious malformation of the spine, skull or brain, such as spina bifida or anencephaly—a devastating birth defect, where the baby develops without a brain. In fact, on average two women in Britain will terminate their pregnancy every day, and two women will give birth to an affected child every week due to NTDs.
Folate supplements and folic acid:
To address the problems related to folate deficiency, folic acid has been added to breads, cereals, flours, corn meal, pastas, rice, and other grain products since 1998 in many countries including the USA. In the UK this is still under consideration. As a result, the average intake of folic acid has risen, and the incidence of NTDs has fallen by up to 50% in countries where folic acid fortification is mandatory.
Folic acid is the main synthetic form of vitamin B9, and is included in supplements and food fortification. Folic acid has no biological activity unless it is converted into folates, and though it has many of the same biological effects as folate, it is more absorbable and is therefore more effective, dose for dose. Folate deficiency may therefore be treated using folic acid formulations, which are available for injection as well as oral use.
Important to note:
We must bear in mind, however, that nutrients added to foods are not as effective as those found naturally in them. As folate leaches out when food is prepared in boiling water and degrades when foods are heated, a diet containing fresh or undercooked vegetables is recommended.
Some evidence suggests that the metabolism of folic acid differs from folate, and may have toxicities under certain circumstances. High levels of folate is, however, well tolerated in the body, but a major consequence of too much folate is that you may not notice that you actually have a vitamin B12 deficiency.
Folic acid has been studied for reduction in the prevalence of a number of diseases. The only well-established benefit of folic acid supplementation is the reduction in the prevalence of NTDs, probably because folate is required for cell division. This has been shown in multiple observational studies and confirmed by randomized trials. Folate, or folic acid, should therefore be routinely recommended to all women of childbearing age.
Return to the list of B vitamins.