Folic acid the same as folate
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Understanding the Difference Between Folic Acid and Folate
Introduction to Folic Acid and Folate
Folic acid and folate are terms often used interchangeably, but they refer to different forms of vitamin B9. Folate is a naturally occurring B-vitamin found in various foods, while folic acid is a synthetic form used in dietary supplements and food fortification1 4. Both forms are essential for DNA synthesis, methylation, and cellular division, playing a crucial role in preventing neural tube defects and other health conditions1 4.
Biological Functions and Importance
Folate in Natural Foods
Folate is present in many foods, including leafy greens, legumes, and citrus fruits. It is vital for the development of the central nervous system and the production of red blood cells5. Folate deficiency can lead to megaloblastic anemia and has been linked to higher levels of homocysteine, which is associated with cardiovascular diseases and cognitive decline3 5.
Folic Acid in Supplements and Fortified Foods
Folic acid, the synthetic form of folate, is commonly added to dietary supplements and fortified foods like wheat and maize flour. This fortification has been implemented in over 80 countries to prevent neural tube defects and improve overall folate status in populations1 2. Studies have shown that folic acid fortification can significantly increase erythrocyte and plasma folate concentrations, thereby reducing the risk of neural tube defects1 2.
Health Implications of Folic Acid and Folate
Neural Tube Defects and Pregnancy
Folic acid supplementation is particularly important during pregnancy to prevent neural tube defects. Research indicates that pregnant women who consume folic acid-fortified foods have higher folate concentrations, which is crucial for fetal development1 7. However, the effectiveness of folic acid in preventing other conditions like anemia and cognitive decline remains inconclusive1 3.
Cognitive Function and Dementia
There is ongoing research into the role of folic acid and folate in cognitive function and dementia. Some studies suggest that folic acid supplementation, especially when combined with vitamin B12, can lower homocysteine levels, which may be beneficial for cognitive health. However, the evidence does not conclusively show improvements in cognitive function or mood in elderly or demented individuals3.
Potential Risks of Excess Folic Acid
While maintaining adequate folate levels is essential, there are concerns about the potential adverse effects of excessive folic acid intake. High levels of unmetabolized folic acid (UMFA) in the blood have been linked to various health risks, including cancer and impaired brain development in embryos4 6. More research is needed to fully understand these risks and to establish safe upper limits for folic acid intake4.
Conclusion
Folic acid and folate are crucial forms of vitamin B9 with significant health benefits, particularly in preventing neural tube defects and supporting cellular functions. While folate is naturally found in foods, folic acid is a synthetic form used in supplements and fortified foods. Both forms are essential, but it is important to monitor intake levels to avoid potential adverse effects. Further research is needed to clarify the long-term health implications of high folic acid consumption.
Sources and full results
Most relevant research papers on this topic
Fortification of wheat and maize flour with folic acid for population health outcomes.
Folic acid fortification of wheat and maize flour, alone or in combination with other micronutrients, may improve folate status and overall health outcomes in the general population.
Meta-Analysis
Very Rigorous JournalFortification of wheat and maize flour with folic acid for population health outcomes
Folic acid fortification of wheat and maize flour, alone or with other micronutrients, may improve folate status and overall health outcomes in the general population.
Meta-AnalysisFolic acid with or without vitamin B12 for cognition and dementia.
Folic acid supplementation, with or without vitamin B12, may improve cognitive function in elderly individuals at risk of cognitive decline or dementia.
Systematic Review
Highly CitedKnowledge gaps in understanding the metabolic and clinical effects of excess folates/folic acid: a summary, and perspectives, from an NIH workshop.
Excess folic acid intake and elevated folate status may have adverse effects on health, but current evidence is inconclusive and more research is needed to clarify these issues and bridge knowledge gaps.
Very Rigorous JournalHighly CitedFolic acid deficiency and vision: a review
Folic acid (FA), also termed folate, is an essential vitamin for health at all ages since it participates in the biosynthesis of nucleotides, amino acids, neurotransmitters, and certain vitamins. It is therefore crucial for rapidly growing tissues such as those of the fetus. It is becoming clear that FA deficiency and impaired folate pathways are implicated in many diseases of both early life and old age. FA can be transported into the cell by the folate receptor, the reduced folate transporter, and proton-coupled folate transporter. Folate transport proteins are present in certain eye tissues, which explains why FA plays an important role in eye development. The purpose of this literature review is to investigate the evidence relating FA deficiency to eye diseases.
Literature Review
Rigorous JournalThe Concept of Folic Acid in Health and Disease
Folic acid, a B vitamin, plays a crucial role in maintaining health and preventing neural tube defects, ischemic events, and cancer.
Highly CitedImpact of high-dose folic acid supplementation in pregnancy on biomarkers of folate status and 1-carbon metabolism: An ancillary study of the Folic Acid Clinical Trial (FACT).
High-dose folic acid supplementation in early pregnancy increases maternal serum folate but not RBC folate concentrations, suggesting tissue-specific effects.
RCTVery Rigorous JournalFolic acid and diseases - supplement it or not?
Folic acid supplementation is well-established for preventing neural tube defects, but its medicinal effects in treating other diseases require further detailed investigations.
Systematic ReviewRecent Developments in Folate Nutrition.
Folate fortification has reduced neural tube defects, but concerns about excess synthetic folic acid intake may mask vitamin B12 deficiency and promote folate-sensitive cancers.
Highly CitedFolic acid: nutritional biochemistry, molecular biology, and role in disease processes.
Folic acid prevents neural tube defects and lowers homocysteine levels, potentially influencing various diseases and promoting good health.
Highly Cited