Folic Acid vs. Folate Explained and Simplified

Dr. Eric Berg 04/30/2024

Folic acid and folate - they're both vitamin B9, right? Well, yes and no. While these two terms are often used interchangeably, there's a bit more to the story.

As someone who's always been curious about nutrition and how it affects our bodies, I decided to dig deeper into the folic acid vs folate debate. And let me tell you, what I found out might surprise you.

You see, although folic acid and folate are both forms of vitamin B9, they're not exactly the same thing. One's a synthetic version, while the other is naturally found in foods.

And depending on your unique genetic makeup, one might be better for you than the other. Crazy, right?

Understanding Folic Acid and Folate

Folate and folic acid are both forms of vitamin B9, but they have some key differences. Folate is the natural form found in foods like leafy green vegetables, citrus fruits, and beans. Your body can easily absorb and use this type of B9.

On the flip side, folic acid is a synthetic version used in supplements and added to fortified foods like cereals, breads, and pasta. While it can still help prevent serious birth defects, your body has to do some extra work to convert it into a usable form.

Synthetic vs. Natural Forms

The main difference between folic acid and folate boils down to their chemical structure. Folic acid is a stable, oxidized form that doesn't occur naturally.

It needs to be broken down by your body into the active form called 5-methyltetrahydrofolate (5-MTHF) before it can do its job.

Folate, in its natural form, is already in that 5-MTHF state and ready to be used by your cells right away. This means it has higher bioavailability—basically, your body can absorb it more easily and efficiently compared to synthetic folic acid.

Keto almond bread

Sources of Folic Acid and Folate

You can find folate in various whole foods and incredibly dark leafy greens like spinach, kale, and Swiss chard. Other good sources include citrus fruits, beans, peas, and lentils. Liver and other organ meats are also high in folate.

Folic acid, on the other hand, is added to enriched grain products like bread, pasta, rice, and breakfast cereals. Many dietary supplements also contain folic acid.

Most prenatal vitamins have around 400-800 micrograms of folic acid to help prevent neural tube defects in developing babies.

The Role of Genetics in Folate Metabolism

While folic acid can be a helpful supplement, especially during pregnancy, not everyone processes it the same way. Certain genetic variations can impact how your body converts folic acid into the active 5-MTHF form. The most well-known is a mutation in the MTHFR gene.

Impact of MTHFR Gene Mutation

The MTHFR gene provides instructions for making an enzyme that plays a key role in processing folate and folic acid. A common variation in this gene, called MTHFR C677T, can reduce the activity of this enzyme by up to 70%.

For people with this mutation, converting folic acid into 5-MTHF is less efficient. This means unmetabolized folic acid can build up in the bloodstream. Some research suggests this buildup may actually interfere with the body's ability to use natural folate from food sources.

Health Implications of Folic Acid Intake

Getting enough B9, whether from folate or folic acid, is crucial for many aspects of health. It supports DNA synthesis, red blood cell production, and fetal development.

But when it comes to folic acid specifically, there are some potential risks to consider, especially for certain populations.

Cancer Prevention and Risks

Folate plays a complex role in cancer development. On one hand, it helps maintain healthy DNA and prevent mutations that could lead to cancer. But on the other hand, once pre-cancerous or cancerous cells develop, folate can actually fuel their growth.

Some studies suggest that high intakes of folic acid from supplements or fortified foods may increase the risk of certain cancers, particularly colorectal cancer, in people with pre-existing tumors or lesions. However, the evidence is mixed and more research is needed.

Autism Risk and Genetic Factors

There's also some concern that high doses of folic acid during pregnancy could increase the risk of autism in children, particularly for mothers with the MTHFR gene mutation.

One study found that women with this genetic variation who took high doses of folic acid had a slightly higher risk of having a child with autism.

However, it's important to note that this is a complex issue with many factors at play. Folic acid supplementation during pregnancy is still recommended to prevent neural tube defects. The key may be finding the right balance and considering individual genetic factors.

Fortified Foods and Supplement Use

Folic acid is added to so many foods, so it's easy to consume more than you realize. Many breakfast cereals, breads, pastas, and rice are fortified with folic acid. Even some non-grain products like energy bars and drinks may have it added.

Identifying Fortified Foods

To know if a food has added folic acid, you'll need to check the ingredients list and nutrition facts label. Look for the words "folic acid" or "folate" in the ingredients, and check the % Daily Value (%DV) for folate on the nutrition label.

Keep in mind that the %DV is based on a general recommended intake of 400 micrograms of folate per day. If you're pregnant or have higher needs, your target intake may be different. Talk to your healthcare provider about what's right for you.

Green leafy vegetables

Natural Dietary Sources of Folate

While supplements can be helpful in some cases, it's always best to get nutrients from whole food sources when possible. Luckily, there are plenty of delicious foods that are naturally high in folate.

Dark leafy greens like spinach, kale, collard greens, and Swiss chard are some of the best sources. Just one cup of cooked spinach provides almost 66% of the daily recommended intake of folate.

Other good options include asparagus, Brussels sprouts, avocado, and citrus fruits.

The Importance of Balanced B Vitamin Intake

While folate and folic acid get a lot of attention, it's important to remember that B vitamins work best as a team. They all play unique roles but also interact with and support each other. That's why a balanced intake of all the B vitamins is key.

One important interaction to be aware of is between folate and vitamin B12. These two work closely together, and a deficiency in one can mask or exacerbate a deficiency in the other.

High intakes of folic acid can even hide the symptoms of a B12 deficiency, which if left untreated, can cause serious neurological issues.

Recommendations for Pregnant Women

Pregnant women have increased folate needs to support the rapid growth and development of the fetus. The RDA for folate during pregnancy is 600 micrograms DFE (Dietary Folate Equivalent) per day.

This can be a combination of natural food folate and folic acid from fortified foods or supplements.

Most prenatal vitamins contain at least 400 micrograms of folic acid, which is the minimum amount shown to help prevent neural tube defects. Some women, such as those with a history of neural tube defects or certain genetic variations, may need higher doses.

Always follow your healthcare provider's recommendations. In addition to supplements, focusing on folate-rich foods like leafy greens, beans, and citrus fruits can help ensure a well-rounded intake.

Variety is key, as different foods provide different types of folate and other beneficial nutrients.

Conclusion

So, there you have it - the lowdown on folic acid vs folate. We've learned that while they're both forms of vitamin B9, folic acid is synthetic and folate is the natural version found in foods.

Your body processes them differently, and your genes play a role in how well you can utilize folic acid.

The key takeaway? Eating a diet rich in natural folate from leafy greens, legumes, and other whole foods is the best way to get your B9. If you do take a supplement, consider one with the active form of folate, especially if you have the MTHFR gene variation.

Armed with this knowledge, you can make informed choices about your diet and supplements to support your unique health needs. Because when it comes to nutrition, one size definitely doesn't fit all.