Folate: Scientifically-backed benefits you should know about

Vitamin B9 is an essential vitamin needed by the body to form ribonucleic acid (RNA), deoxyribonucleic acid (DNA), and proteins. Deoxyribonucleic acid contains genetic instructions for all organisms’ reproduction, growth, functioning and development. Since DNA encodes the instruction manual for all living organisms, it is recognised as one of the most important molecules in living organisms and cells [1]. 

Folate, a water-soluble, natural form of vitamin B9, is found naturally in many foods. When sold as a supplement, it is produced as folic acid. Only 50% of folate naturally found in foods is absorbed by the body. In contrast, 85% of folic acid found in supplements is absorbed in the body. 

The benefits of folate or folic acid have been well documented in the literature. Here are some benefits that could promote longevity and better health: 

Homocysteine breakdown 

Homocysteine is an amino acid that, when present in high amounts, can increase the risk of heart disease, stroke, and blood vessel disorder. High levels of homocysteine increase the risk of blood clot formation and damage in the walls of your arteries [2]. Once the lining of the arterial walls, called the endothelium, and the smooth muscles are altered or destroyed due to high homocysteine levels, this can trigger cardiovascular problems. 

Homocysteine breakdown

A deficiency in folate or Vitamin B9 is associated with high levels of homocysteine in the blood. Folate plays a crucial role in homocysteine breakdown and preventing cardiovascular diseases caused by elevated haemoglobin levels. Hence, supplementation with vitamin B9 or folic acid or eating foods rich in folate can help ward off cardiovascular diseases, stroke and blood clots. 

Prevention of congenital abnormalities 

The Centers for Disease Control and Prevention recommends that women of reproductive age or those planning to get pregnant should take 400 micrograms (mcg) of folic acid daily apart from consuming food rich in folate [3]. Intake of folate or folic acid can prevent the development of significant congenital defects in the baby’s spine, such as spina bifida or in the baby’s brain, such as anencephaly. 

Folic acid is needed to form the neural tube when the baby is developing during the first trimester or early in pregnancy. The early spine and brain are formed from the neural tube. Since significant congenital disabilities of the brain or spine develop during the first 3-4 weeks of pregnancy or after conception, it is critical that women have sufficient folic acid in their bodies to prevent these defects. 

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Production of healthy red blood cells 

Vitamin B9 is needed by the body to make red blood cells. When you don’t have enough red blood cells, this can lead to anaemia. 

Anaemia occurs when you don’t have sufficient red blood cells to bring oxygen to different organs, tissues and cells in the body. Oxygen is crucial in metabolism; when your body does not get enough oxygen, it cannot work correctly. 

When you have low levels of folic acid, this can cause the abnormal production of red blood cells. Low folic acid can lead to megaloblastic anaemia. This type of anaemia produces red blood cells that are oval-shaped, not round, and larger than average. There are also fewer numbers of these cells. These cells have a short lifespan compared with normal red blood cells. 

Folate-deficiency anemia develops when: 

  • There is an insufficient intake of foods that are high in folate. 
  • Drinking too much alcohol 
  • Suffering from celiac disease 
  • Taking certain medicines, such as those used to treat seizures 
  • Pregnant since the developing baby requires more folic acid
  • A person could not absorb folic acid 

Symptoms of folate-deficiency anemia include the following: 

  • Diarrhea 
  • Lack of energy or tiring easily 
  • Irritability or being grouchy 
  • Decreased appetite 
  • Pale skin 
  • Smooth and tender tongue 

Folic acid may prevent dementia and improve cognitive functions 

Observational studies [4,5] have shown a positive and significant association between high levels of homocysteine and increased incidence of Alzheimer’s disease and dementia. 

High homocysteine levels can affect the brain by reducing blood flow to the brain and nerve cells. Since folate is needed to break down homocysteine, low folate levels have been shown to increase the risk of dementia. However, clinical trials [4] failed to establish if supplementation with folic acid can improve cognition or reduce the risk of dementia. 

The clinical trials were conducted for shorter periods, while dementia takes years to develop. Hence, it is necessary to conduct longer clinical trials to see the effects of supplementation with folic acid and determine which doses are adequate for improving cognitive function. 

Folic acid may prevent dementia and improve cognitive functions

Folate intake may prevent certain types of cancer 

Folate is essential in the growth of cells and DNA production. It is believed that high doses of folic acid plays can suppress certain types of cancer and prevent the progression of established cancers. 

Observational studies [6,7] show that individuals who take higher than average amounts of folic acid supplements or folate from their diets for 15 years have a lower risk of breast cancer and colon cancer. Interestingly, the observational study on breast cancer [7] revealed that high folic acid supplements reduced breast cancer risk in those who consume at least one alcoholic drink daily. 

Notably, alcohol inactivates the circulating folate in the blood and interferes with its proper metabolism. It would appear that taking high levels of folate or folic acid supplements, even when drinking one alcoholic drink per day or less, could still have protective effects against breast cancer. 

While studies [6] reveal that folic acid supplementation may prevent colon cancer, the relationship between folic acid or folate and colon cancer risk is complicated. Some studies suggest that very high doses of folic acid may not protect against colon cancer. Instead, it can increase the risk of developing more polyps or pre-cancerous growths in the colon. Hence, you must consult your doctor before taking any vitamin supplementation when you have cancer. 

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Folic acid, hair and nail growth 

A literature review [8] has shown that folic acid is associated with a reduced risk of alopecia or gradual hair loss. Although alopecia is linked to zinc deficiency, it is also found to be due to a lack of other B vitamins and minerals, including folate or folic acid. Hence, supplementation with folic acid could help prevent hair loss and promote growth. Further, proper intake of folic acid is associated with less greying of the hair. 

Besides healthy hair, intake of folic acid is also associated with strong and healthy nails. It has been shown that a deficiency in folate or folic acid results in brittle and rigid nails. It is well known that folate increases the production of new cells and the formation of red blood cells. These cells, which include hair and nail cells, are essential in maintaining healthy hair and nails. 

What are the food sources rich in folate? 

Food sources rich in folate include the following: 

  • Sunflower seeds
  • Peanuts 
  • Beans 
  • Seafood
  • Whole grains 
  • Fresh fruits, fruit juices 
  • Eggs 
  • Fortified foods and supplements 
  • Liver
  • Dark green leafy vegetables such as broccoli, Brussels sprouts, asparagus, lettuce, and spinach

Apart from food sources fortified with folic acid, you can take supplements of vitamin B9 to boost the level of folic acid in your blood. This is essential in preventing anaemia due to a deficiency of vitamin B9 or in improving overall health. 

What is the recommended dose of folic acid? 

For pregnant women or those planning to get pregnant, it is recommended that intake should be 400 mcg per day. However, this dose may increase to 600 mcg for pregnant women with a history of giving birth to infants with spinal or brain defects and 500 mcg for lactating women. 

Adults should aim for 400 mcg of folic acid each day. However, for those who regularly drink alcohol, it is advised that they take 600 mcg of folic acid each day since alcohol has been shown to impair the absorption of folic acid. The tolerable maximum daily dose for folic acid is 1000 mcg. 

Folate from food and folic acid from supplements could boost overall health by reducing the risk of cardiovascular diseases, increasing the production of red blood cells, preventing folic acid-related anemia and preventing the risk of specific cancer and dementia. 

Longevity is achievable through eating a proper diet and taking supplements such as folic acid, especially when your diet is insufficient to give you natural folate. 

Increasing the length of lifespan and health span would ensure that individuals can enjoy their life even in old age. A healthy lifespan does not mean that individuals are free from diseases. However, an individual can manage long-term conditions and prevent complications through a healthy diet and lifestyle. 

Increasing folic acid supplementation to the allowable range of 400-600 mcg per day would help you achieve your goal of a healthier life span. Achieving longevity is within reach through selecting appropriate folic acid supplements. 

Talk to your doctor before taking the folic acid supplements to ensure you take the right amount. For those with certain forms of cancer, such as colon cancer, it is always best to consult with your doctor to ensure that you take the appropriate dosage and prevent any adverse effects. 

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[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822018/
[2] https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-14-6 
[3] https://www.cdc.gov/ncbddd/folicacid/about.html 
[4] https://content.iospress.com/articles/journal-of-alzheimers-disease/jad171042
[5] https://www.sciencedirect.com/science/article/abs/pii/S1064748112600347 
[6] https://www.acpjournals.org/doi/pdf/10.7326/0003-4819-129-7-199810010-00002
[7] https://jamanetwork.com/journals/jama/article-abstract/189712
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/ 

The information included in this article is for informational purposes only. The purpose of this webpage is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.