Chances are, you’ve heard a thing or two about folic acid. Known for its importance in healthy fetal development and preventing anemia, this popular little vitamin has been pumped into daily supplement preparations and used to fortify foods since its laboratory creation in 1943. With folate deficiency among the most widespread nutrient insufficiencies in America at one time, these calculated additions were intended to augment critical nutritional gaps throughout the population. Yet, what many fail to realize in this heroic public health attempt is that synthetic folic acid is not the same as folate, the helpful compound that naturally occurs in foods. With new evidence suggesting that excessive folic acid supplementation might be unnecessary and even harmful, it seems it may be time to reconsider this plan.

Why Is Folate So Important?

Folate is a general term for a group of water soluble B-Vitamins, referred to as B9. The natural folates found in whole foods are intricate compounds that are broken down into more basic, functional forms within the mucosa of the small intestine. Tetrahydrofolate (THF) is the primary form of folate used by the body to support numerous biological processes including red blood cell production and the creation of mood regulating neurotransmitters dopamine, serotonin and norepinephrine. Folate is also critical to the synthesis of choline, a gene-regulating compound that is required to make phospholipids (cell membrane fats) and the neurotransmitter acetylcholine. Folate is therefore essential for the brain and nervous system, lipid metabolism, cardiovascular function and DNA health.

While vital for men and women of all ages, obtaining sufficient dietary folate is particularly important for women of childbearing age as plentiful stores are needed to meet increased demands during pregnancy. Folate is required for the production of new DNA, which serves as the blueprint of the growing life in the womb. It is also necessary for the production of red blood cells, which occurs rapidly during pregnancy as a woman’s blood supply expands to nourish the fetus. Studies have shown that appropriate folate intake prevents neural tube defects (developmental issues with the brain and spinal cord), increases birth weight, and may also prevent spontaneous abortion and deformities of the mouth, face and heart.

Folic Acid: An imposter?

Folic acid is the synthetic form of folate. It is a laboratory created, oxidized compound that is added into supplements and fortified foods such as commercial breads and baked goods. Although often used interchangeably with the term “folate,” there are some notable differences between these two compounds that are not to be overlooked. Because folic acid is not naturally occurring and thus not readily recognized by the body, it undergoes conversion into THF (the usable form of folate) in the liver instead of in the small intestine where most nutrients are absorbed. Because the liver lacks the enzymes needed to fully make the conversion from folic acid to THF, not all of the folic acid can be changed over to the form the body requires. In fact, research shows that the body is only able to absorb 200 mcg of accessible folate per single dose of folic acid in healthy volunteers, with the possibility of even more limited availability on long-term exposure and for certain health compromised individuals. Some experts suggest that the remaining un-metabolized folic acid left over from this process enters systemic circulation at unnaturally high rates, causing some significant health consequences in the long-term. Recent studies have suggested a link between high synthetic folic acid intake from fortified foods, beverages and supplements with increased risk of cancer, cardiovascular events and a higher incidence of wheezing and asthma in children. 

Real Food Sources of Folate

The current RDAs for folate are 200 mcg for children, 400 mcg for adults and 600-800 mcgs for women who are pregnant or planning to become pregnant. These figures are based on the amount needed to maintain healthy red blood cell counts and on urinary markers that indicate the amount being processed by the body. However, these recommendations are also based on the assumption that only half of the folic acid or folate consumed will actually be absorbed. This is a highly variable statistic by person that is strongly influenced both by the quality of folate and on the individual’s zinc status. For the average person in America, 65% of dietary folate intake comes from synthetic folic acid. Commercial flours and cereals are required to be enriched with 700 mcgs of folic acid per pound and multivitamins generally contain 400 mcgs (with prenatal vitamins at about 800 mcgs). Given the numerous sources of folic acid, a person on the Standard American Diet can easily consume over 1,500 mcgs per day, although the tolerable upper limit is 1,000 mcgs per day.

Instead of tallying away at micrograms and chowing down on "enriched" slices of bread, it is far better to incorporate folate-rich foods into your diet. Afterall, this is what people inherently did before the creation of synthetic folic acid. High quality food sources of folate include:

• Dark Leafy Green Vegetables (romaine lettuce, spinach, collard greens)
• Liver
• Egg Yolks
• Legumes (soaked garbanzo, pinto, lima and kidney beans)
• Seaweed
• Sunflower Seeds
• Avocado
• Mushrooms

Including animal sources regularly is of particular importance as research suggests that folate and B12 are best taken together, as they are synergistically absorbed. Nourishing Traditions offers many tasty recipes for liver, however if you do not find organ meats to be palatable, pure desiccated liver is an accessible way to get raw liver into your diet in capsule or powder form. When including legumes and seeds, it is important to soak them overnight in filtered water with prior to using, as this will neutralize the anti-nutrients and enzyme inhibitors they contain to allow for the full absorption of folate. Alternatively, use a source of commercially soaked and sprouted seeds. If you are pregnant, plan on becoming pregnant, or require additional folate for other health reasons, it is important to work with your health care practitioner to find the best sources for your body.

Learn More:

Nourishing Traditions Book of Baby & Child Care

The little known (but crucial) difference between folic acid and folate 

The Perfect Health Diet by Paul and Shou-Ching Jaminet

*All articles and information on this website are for educational purposes only. They are not to be regarded or relied upon as medical advice. These statements have not been evaluated by the Food and Drug Administration.