Folate, also known as Vitamin B9 is an essential compound required by the human body for a variety of processes. These include the ability to produce and repair DNA as well as preventing certain forms of anaemia. Furthermore, it has been found to be particularly important prior to conception and during pregnancy. As it significantly reduces the risk of neural tube defects leading to conditions such as Spina Bifida, where the spine does not fuse correctly prior to birth.
In addition, both dietary folic acid and folate act to reduce plasma homocysteine, a compound that some believe to be independently associated with cardiovascular disease. According to the NHS, adults require 200 micrograms of folate per day although this demand increases during pregnancy. It can be acquired through diet where it is found naturally in significant quantities in dark leafy green vegetables such as spinach, brussel sprouts and broccoli amongst others.
It can also be supplemented, but there are some differences between the different forms of folate in regards to bioavailability that should be noted. Bioavailability refers to the proportion of the substance that enters circulation after ingestion. Three forms of folate are commonly used: folic acid, 5-methyltetrahydrofolate (5-MTHF) (also known as methylfolate) and folinic acid.
Folic acid and folinic acid are sparsely found in nature and is more commonly commercially produced and used as a food-fortification substance compared to 5-MTHF which is found in a variety of foods, as well as certain supplements. Bioavailability of some of these compounds has been found to be genotype dependent, with some individuals who do not absorb a great deal of folic acid compared to others.
This issue does not appear to be present in respect to 5-MTHF. Attempts to overcome this limitation by providing a greater dose of folic acid may present as of yet to be quantified risks, by increasing plasma levels of unmetabolised folic acid in individuals who absorb it well. As well as the risk of potentially masking the symptoms of vitamin B12 deficiency.
As such, without intimate knowledge of one’s genome as is often the case, if deficiency is found and one wishes to correct it via supplementation; 5-MTHF; the form found commonly in foods (non-fortified) would be the preferred form of folate to use.
Scaglione, F. and Panzavolta, G., 2014. Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica, 44(5), pp.480-488.
Brouwer, I.A., van Dusseldorp, M., West, C.E. and Steegers-Theunissen, R.P., 2001. Bioavailability and bioefficacy of folate and folic acid in man. Nutrition research reviews, 14(2), pp.267-294.
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