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Naturopath
Studies confirm that folic acid plays an important role for our body, especially when cells need to grow quickly, such as in infancy, adolescence or during pregnancy. The acid has a direct effect on our mental and emotional well-being and helps to form our genetic material, such as DNA and RNA. A deficiency leads to poor immune defense, developmental disorders or digestive problems.
Vitamin B9 or folate or folic acid is one of the eight B vitamins. All B vitamins support the body in converting carbohydrates into glucose, which is required for energy production. These B vitamins, often referred to as the vitamin B complex, are also involved in the utilization of fats and proteins. B vitamins are needed for a healthy liver as well as healthy skin, hair and eyes. They also support healthy nerve function. Folic acid is the synthesized form of vitamin B9 and is available as a supplement or in specially fortified foods. Folate, on the other hand, occurs naturally in food.
All B vitamins are water-soluble. This means that the body cannot store them.
Folic acid is essential for healthy brain function and plays an important role in our mental and emotional well-being. It supports the formation of DNA and RNA, i.e. genetic material, and is particularly needed at times when cells and tissue are growing rapidly. This is particularly the case in infancy, adolescence and during pregnancy. Folic acid and vitamin B12 work hand in hand in the formation of red blood cells and ensure that the iron available in the body is properly utilized.
Vitamin B9, together with vitamins B6 and B12 and other nutrients, controls the blood level of the amino acid homocysteine. High homocysteine levels are associated with heart disease. However, it is not yet known whether a high homocysteine level is the cause of heart disease or merely serves as a marker.
Folate deficiency can be a serious problem. In industrialized countries, however, it occurs far less frequently than other nutrient deficiencies. In 2006, the US Department of Agriculture conducted an analysis of available data and concluded that most people in the US have sufficient folate intake, but that some population groups are at risk of deficiency.
On average, U.S. adults consume between 454 and 652 µg of folate (including natural folate from foods and folic acid from supplements and fortified foods) daily. The average intake for children is between 385 and 674 µg. The recommended daily requirement for adults is approx. 400 µg, for children roughly 300 µg.
Please note that some people are at a higher risk of folate deficiency than others. The following groups in particular should pay attention to their folate intake:
The German Nutrition Society (DGE) recommends the following daily intakes of folic acid or folate, depending on age and if there is an increased requirement due to special circumstances such as pregnancy and breastfeeding:
Age:
Folate or folic acid in micrograms per day
Up to 4 months
60_µg
Up to 12 months
80 µg
Up to 4 years
120 µg
Up to 7 years
140 µg
Up to 10 years
180 µg
Up to 13 years
240 µg
From 15 years
300 µg
Pregnant women
550 µg
Breastfeeding
450 µg
According to this recommendation, the basic requirement no longer changes fundamentally from around the age of 15. However, you should bear in mind that these are only rough guide values in order to prevent a pronounced deficiency.
However, your individual requirement may well be higher and therefore no longer be covered by the current DGE information. Stress, severe physical or mental strain as well as illnesses and some medications consume larger amounts of folic acid, making it difficult to obtain sufficient amounts through diet alone.
In addition, the recommendations may differ. For example, the Food and Drug Administration of the United States of America recommends the following intake levels:
Infants
100_µg
Infants up to four years
200 µg
Children from the age of four, teenagers and adults
400 µg
800 µg
Compared to the DGE recommendations, these are considerably higher. This already makes it clear that the general information can only serve as a guide. Ultimately, only an examination can provide information about the individual's sufficient intake.
Folate is found in many plant foods. The best way to meet your daily requirement is to eat at least five portions of whole foods such as fruit and vegetables. Green vegetables (such as nutrient-rich Brussels sprouts, broccoli and peas), especially all types of green leafy vegetables, as well as beans and citrus fruits are excellent for preventing folate deficiency. Some animal foods such as liver and poultry also contain folate.
In general, the easiest way to prevent a folate deficiency is to eat a balanced and healthy diet. However, studies show that the ability to absorb folate from food differs significantly from person to person. Many different factors play a role in folate absorption, such as zinc levels and the health of the kidneys, liver and intestines.
Pregnant women with an inadequate intake of folic acid are more likely to give birth to children with birth defects than other women. The daily requirement of folic acid for a pregnant woman is 600 µg. Women who want to have children should make sure they get at least 400 µg of folic acid per day. Neural tube defects occur shortly after conception, before a woman even knows she is pregnant. Prenatal vitamin supplements contain the daily requirement of folic acid for pregnant women.
Studies show that women who take folic acid supplements before conception and in the first trimester of their pregnancy can reduce the risk of having a child with neural tube defects by 72 to 100 percent. Other studies suggest that folic acid supplements offer no further benefit for the prevention of spina bifida in times of folic acid-enriched cereal products.
Folic acid may help to reduce the risk of miscarriage. However, the evidence for this is not clear.
Studies on child development show that early intake of folic acid before or around the time of conception reduces the risk of autism in children. In other studies, scientists came to the conclusion that the intake of folic acid in the early stages of pregnancy is associated with a lower risk of language development disorders in children at the age of three. Still other research suggests that low folate levels during pregnancy are associated with a higher risk of emotional problems in children.
"When should I start taking it?"
Some experts recommend taking folic acid up to six months before the planned conception, others consider three months to be sufficient.
"I'm already pregnant. What now?"
If you are already pregnant, start taking it now. Do not worry about the time you have missed. The important thing is that you start taking it as soon as possible.
"How long should I take folic acid?"
The recommendation is to take folic acid daily during the first twelve weeks of your pregnancy. If you wish to continue taking it after this period, this is also possible. You can also make sure your diet is rich in folic acid by eating plenty of green leafy vegetables. (This contains many other important nutrients for the healthy development of your baby).
And if you want to take dietary supplements specifically for pregnant women throughout your pregnancy, this is also not a problem. In this case, make sure that you take a preparation that is specially designed for pregnant women, as not all vitamins can be taken in high doses during pregnancy.
"I've been pregnant for more than 12 weeks. What now?"
Research shows that taking folic acid in the early stages of pregnancy can reduce the risk of neural tube defects and spinal cord malformations in the unborn child. However, it is not the case that every baby is born with these defects whose mothers have not taken folic acid. Sufficient intake merely reduces the risk.
Therefore, you should not worry. Talk to your midwife or gynecologist and ask them whether you should take a multivitamin or what changes you should make to your diet to ensure that your baby develops healthily.
"What if I forget to take it?"
Don't worry in this case either. You can build up a solid foundation by taking it regularly. If you forget to take it once or even several days in a row, it is very unlikely that this will have a negative effect on your baby's development. Simply return to a daily intake of the preparation and do not take more than intended to make up for missed days.
Several large-scale studies have investigated the role that folic acid plays in the prevention of high blood pressure. The results have shown that the risk of high blood pressure can be reduced by taking folic acid.
A study, the results of which were published in the American Medical Association (JAMA), showed that women with high blood pressure were able to significantly reduce their blood pressure by taking folic acid. Taking more than 1000 µg of folic acid daily was associated with a 46 percent reduction in high blood pressure in the women involved.
Folic acid can protect the heart in many ways. First of all, some evidence suggests that sufficient folic acid in the diet can reduce the risk of heart disease. However, these observations are based on population studies and not on more conclusive clinical trials.
Many studies show that people with high homocysteine levels are around 1.7 times more likely to suffer from coronary heart disease and 2.5 times more likely to have a stroke than people with normal levels. B vitamins, especially B9, B6 and B12, can lower homocysteine levels.
So if you are concerned about this and want to reduce your risk of heart disease, make sure you get enough B vitamins and eat a healthy diet. In some cases, your doctor may recommend a supplement to lower your homocysteine levels.
Some studies have concluded that folic acid supplements can slow down the progression of age-related hearing loss in seniors with high homocysteine levels and low dietary folate intake. It is not yet known whether healthy seniors also benefit from taking them.
A large study found that women who took 2,500 µg folic acid daily together with 500 mg vitamin B6 and 1,000 µg cyanocobalamin (vitamin B12) were able to reduce their risk of developing AMD, an eye disease that can lead to vision loss.
It is not entirely clear whether folic acid can alleviate depression. In some studies, between 15 and 38 percent of subjects with depression had low folate levels. Those with the lowest levels tended to be the most severely affected by depression. In one study, the situation did not improve for those affected even after taking antidepressants. These all had low folic acid levels. A placebo-controlled double-blind study came to the conclusion that taking 500 µg of folic acid daily resulted in the antidepressant Prozac responding better in women, but apparently not in men.
A diet rich in folic acid appears to protect against the development of some types of cancer, including
However, this observation is based on population studies which show that those who consume enough folate in their diet are less likely to develop the types of cancer mentioned. Scientists are not yet able to explain why folate can help prevent cancer. Some believe that folic acid keeps DNA healthy and prevents mutations that contribute to the development of cancer. It is best to eat a balanced and healthy diet and make sure you eat foods rich in folate. In this way, you can protect your body from a whole range of diseases.
A low folate intake leads to an increased risk of developing breast cancer, especially in women who consume alcohol. Regular consumption of alcohol - more than 1.5 to 2 glasses per day - is associated with a higher risk of breast cancer. In a large-scale study of more than 50,000 women, scientists concluded that adequate folate intake can reduce the risk of breast cancer associated with alcohol consumption.
The terms "folate" and "folic acid" are often used synonymously, but their meaning differs slightly.
Folate is easily and naturally absorbed and utilized by the body. This occurs in the small intestine. Folic acid was only introduced in the 1940s and requires a special enzyme called dihydrofolate reductase, which is only sparsely present in the body.
Regardless of the risk associated with an excessive intake of folic acid, it is generally agreed that the consumption of folate-rich foods makes an important contribution to an individual's health.
Good sources of folate are for example ...
These pulses contain 180 µg of folate per portion. They are also high in protein and fiber and low in fat. Lentils are therefore an excellent substitute for meat. Buy them dried from a health food store. At home, rinse them thoroughly in a sieve to remove all dust, dirt and residue. Cook them for 15 to 20 minutes and season them with turmeric or ginger, for example. Serve the lentils with rice or add them to soups and stews. If you don't have time to cook them, you can use canned lentils. Rinse them well before eating. This allows you to reduce the salt content by around 30 percent.
A handful of spinach contains around 100 µg of folate. It also contains phytonutrients such as beta-carotene and lutein, which offer protection against many types of cancer. Sweat the spinach with a little garlic and serve with potatoes or an egg white omelette.
This cruciferous vegetable is a true superfood. Broccoli has impressive antioxidant properties that offer protection against cancer, as well as additional soluble and non-soluble fiber that aids digestion. In addition, one portion of cooked broccoli contains 50 µg of folate.
Beans are versatile, healthy and very inexpensive. All types of beans provide women with plenty of folic acid, which promotes healthy development of the baby in the womb. Black beans, split peas, kidney beans, white beans, soybeans and cooked lentils are all rich in folic acid. You can meet your recommended daily requirement with a small portion of beans a day - regardless of the variety. One portion of kidney beans provides 46 µg of folic acid, while one portion of quail beans covers 75 percent of your daily requirement. One portion of dried soybeans contains 174 µg of folic acid for 388 calories. One portion of black-eyed peas covers 26 percent of your daily requirement of folic acid (104 µg). Cook beans and lentils together with meat, shallots, spinach and simple spices for a tasty and healthy dish.
These spears contain few calories, no fat or cholesterol, but lots of potassium and fiber. Four stalks of cooked asparagus provide 85 µg of folate. Only use firm, fresh asparagus with a closed tip and, if possible, spears of a similar diameter so that they cook evenly. The larger the diameter of the spears, the more tender the asparagus. Cut off the woody end and cook the spears in boiling water for five to eight minutes.
This sweet fruit contains plenty of vitamins A and C and is a good source of folate. A quarter of a melon contains about 25 µg. Ripe melons sound hollow when you tap them with the flat of your hand. In addition, the skin of the fruit should not be damaged or have any soft spots. The rind (under the net structure) should be yellow or cream-colored. If it is green, the melon is not ripe. Smell the melon. A slightly sweet smell indicates a ripe fruit. If it smells very strong, the melon is already overripe.
Eggs have a high nutrient density with few calories. They are a good source of protein and contain almost every essential vitamin, including 24 µg of folate (in large eggs). Keep hard-boiled eggs in the fridge. This way you always have a healthy snack to hand. Or eat a poached egg for breakfast along with your toast with avocado spread - for that extra dose of folate.
Seeds such as pumpkin seeds, sesame seeds, sunflowers and linseed provide healthy folate. A handful of sunflower seeds provides 83 µg of folic acid; two tablespoons of linseed 54 µg. The seeds also contain beneficial fats and essential nutrients such as vitamins A and E, as well as omega-3 fatty acids and cancer-preventing lignans. Add a handful to your smoothies, oatmeal or breakfast cereal, or enjoy them plain or roasted.
Many people do not know that peanuts are also an excellent source of folate. 80 grams contain 106 µg of folic acid, covering 25 percent of an adult's daily requirement. Peanuts also provide zinc, copper, protein and magnesium.
Both turkey and beef liver contain a lot of folic acid. 100 grams of turkey liver contain significantly more than the recommended daily amount, namely 691 µg. 85 grams of beef liver provide 215 µg of folate. Pregnant women can therefore cover their daily requirement of folic acid with just one portion of liver. Excellent fillings and sauces can be prepared from liver.
Mint not only adds flavor to dishes, but also provides essential vitamins and minerals. One tablespoon of dried mint contains 10 µg of folic acid, about three percent of the daily requirement. Prepare refreshing drinks with mint and add it to your water, lemonade or tea. Or add it to your salad.
Avocados are one of the best sources of folic acid. One fruit contains 162 µg of folate, i.e. around 41 percent of the daily requirement. Avocados also provide potassium, vitamin C, fatty acids, phosphorus and antioxidants. Enjoy them on bread, in salads or as a dip.
Bananas contain plenty of folic acid and can be safely consumed by pregnant women. A medium-sized banana provides 23.6 µg of folic acid or six percent of the daily requirement, as well as fiber, protein and potassium. But the best thing is, you can enjoy a banana anytime and anywhere. So nothing stands in the way of an extra portion of folic acid in between meals.
If you have difficulty meeting your daily folate requirement, tomato juice may be the solution. A glass of tomato juice (180 ml) contains 36 µg folate or nine percent of your daily requirement. If you don't like the taste of pure tomato juice, spice it up with a little pepper or Tabasco sauce.
The colorful fruit is not only very rich in nutrients, but also extremely tasty. One small papaya contains 58 µg of folate, i.e. around 14 percent of the daily requirement. In addition to folic acid, papaya provides plenty of vitamins A and C as well as potassium and phosphorus. The fruit is equally suitable for desserts and savory dishes.
Oranges not only provide plenty of vitamin C. They also have plenty of folate. One medium-sized orange provides the body with 29 µg of folic acid. Commercial orange juice is also often fortified with folic acid. 180 ml of orange juice contains up to 35 µg of folic acid.
Dark green leafy vegetables are among the healthiest foods on the planet. You can quickly boost your folic acid levels with spinach, cabbage, rocket, kale, lettuce and stalked vegetables. A plateful covers your daily requirement. A portion of spinach provides 26 µg, cabbage 177 µg and stem vegetables 170 µg of folic acid. A portion of rocket provides the body with 19 µg of folic acid. Green leafy vegetables also contain plenty of zinc, iron, calcium, potassium and all vitamins. Combine it with avocados or soybeans for an extra folic acid kick.
Brussels sprouts contain a wealth of nutrients, such as vitamins C, K and A as well as potassium, iron and manganese. Brussels sprouts are also a good source of folate. One portion covers 25 percent of your daily requirement. The vegetable promotes digestion. It removes harmful residues from the digestive tract and ensures a smooth bowel movement.
Cauliflower is one of the most important sources of vitamin C and contains plenty of folic acid. One portion of the cruciferous vegetable provides around 55 µg of folate or 14 percent of your daily requirement. Combine cauliflower with other foods from this list and enjoy a healthy meal.
Beetroot is one of the best foods when it comes to cleansing the liver. They detoxify the body and strengthen the immune system. They also contain plenty of folate. One portion of cooked beetroot provides 13 µg of folate.
The nutritional benefits of pumpkin simply cannot be denied. It contains plenty of essential minerals and vitamins. Both summer and winter squashes are excellent sources of folic acid. A portion of winter squ ash contains around 57 µg, a portion of summer squash 36 µg.
A folic acid test can be used to determine the level of folic acid in the blood. Folic acid (vitamin B9) is essential for the formation of healthy red blood cells. These blood cells transport oxygen to all areas of the body and make a decisive contribution to general health. Folic acid also supports cell and tissue growth and the formation of DNA, which contains our genetic material.
Before carrying out the test, please inform your doctor of all medications and supplements you are taking. Some preparations can falsify the test results. You will probably have to fast for six to eight hours before the test. It is therefore advisable to test early in the morning on an empty stomach.
A small blood sample is required to determine the folic acid level. Normally, blood is taken from a vein in your elbow. After the blood has been taken, the sample is analyzed in the laboratory for its red blood cell content.
There are no significant risks when carrying out a folic acid test. Sometimes a bruise occurs at the injection site. You can reduce the risk of this by pressing the swab on the puncture site for a few minutes after taking the blood sample. In rare cases, the vein may swell. This can be alleviated with a warm compress. People who suffer from bleeding disorders may experience persistent bleeding. It is therefore essential that you inform your doctor in advance if you suffer from a bleeding disorder or are taking blood thinners.
Many of us - especially women of childbearing age - are not able to metabolize folic acid very well, so high amounts of unmetabolized folic acid remain in the bloodstream.
This leads to the occurrence of various side effects, for example
These side effects are particularly unfavorable in view of the fact that folic acid is still included on the list of food additives with which foods must be fortified. This list was first published by the FDA (US Food and Drug Administration) in 1998. According to the US Department of Health and Human Services, the FDA has required food manufacturers to fortify cereal products with folic acid since 1998. This applies to breads, cereals, flour, cornmeal, pasta, rice and other packaged goods. Canada, Costa Rica, Chile, South Africa and other countries have also taken mandatory measures and have foods fortified with folic acid. The FDA's measures were actually intended to increase the population's folic acid intake by an average of around 100 µg per day. In fact, the daily intake has almost doubled to around 190 µg per day.
The US Department of Health and Human Services claims that folic acid has a higher bioavailability than folate, which is naturally present in food. It assumes that at least 85 percent of folic acid is bioavailable when consumed with food. The bioavailability of natural folate, on the other hand, is said to be only 50 percent. There are good arguments for and against this view and the resulting measures. The bottom line is that folate levels can be permanently elevated, but certain deficiency symptoms can be prevented.
If you are currently being treated with one of the following medications, you should not take folic acid supplements without first consulting your doctor.
Sources (in English):
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Coppen, A. & Bailey, J. (2000, November). Enhancement of the antidepressant action of fluoxetine by folic acid: a randomised, placebo controlled trial. Journal of Affective Disorders, 60(2):121-30
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Marcus, D. L. & Freedman, M. L. (1985, August). Folic acid deficiency in the elderly. Journal of the American Geriatrics Society, 33(8):552-8
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Winkels, R. M., Brouwer, I. A., Siebelink, E., Katan, M. B. & Verhoef, P. (2007, February). Bioavailability of food folates is 80% of that of folic acid. The American Journal of Clinical Nutrition, 85(2):465-73, doi: 10.1093/ajcn/85.2.465
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