Is folate folic acid the same
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Understanding the Differences Between Folate and Folic Acid
Introduction to Folate and Folic Acid
Folate and folic acid are terms often used interchangeably, but they are not the same. Folate is a naturally occurring B-vitamin found in various foods, while folic acid is a synthetic form used in supplements and food fortification1 4. Both forms are essential for numerous bodily functions, including DNA synthesis, repair, and methylation, as well as amino acid metabolism1 7.
Differences in Absorption and Bioavailability
Natural Folate vs. Synthetic Folic Acid
Natural folate, such as 5-methyltetrahydrofolate (5-MTHF), is readily absorbed and utilized by the body, even in individuals with certain genetic polymorphisms that affect folate metabolism1. In contrast, folic acid requires conversion to its active form through a series of enzymatic reactions, which can be less efficient in some people due to genetic variations1 3.
Bioavailability and Metabolic Pathways
5-MTHF has been shown to have higher bioavailability compared to folic acid, meaning it is more efficiently absorbed and utilized by the body1 3. This is particularly important for individuals with methylenetetrahydrofolate reductase (MTHFR) polymorphisms, which can impair the conversion of folic acid to its active form1. Studies have demonstrated that supplementation with 5-MTHF results in higher blood folate concentrations compared to folic acid supplementation3.
Health Implications of Folate and Folic Acid
Preventing Neural Tube Defects
Both folate and folic acid are crucial in preventing neural tube defects (NTDs) during pregnancy. However, the effectiveness of folic acid in reducing NTDs is well-documented, with studies suggesting that increased intake of folic acid significantly lowers the risk of these defects8. Despite this, the potential for unmetabolized folic acid to accumulate in the bloodstream raises concerns about its long-term safety4 6.
Cognitive Function and Cardiovascular Health
Folate deficiency has been linked to cognitive decline and cardiovascular diseases due to its role in homocysteine metabolism2. While folic acid supplementation can lower homocysteine levels, it may not provide the same cognitive benefits as natural folate, especially in individuals with vitamin B12 deficiency2. High levels of unmetabolized folic acid can mask vitamin B12 deficiency, potentially leading to neurological damage2 4.
Potential Risks of Excess Folic Acid
Cancer and Other Health Risks
Excessive intake of folic acid has been associated with potential adverse effects, including an increased risk of certain cancers and negative birth outcomes4 6. The presence of unmetabolized folic acid in the bloodstream has been linked to decreased natural killer cell activity and reduced efficacy of antifolate drugs used in cancer treatment6. These findings highlight the need for cautious use of folic acid supplements and fortified foods4 6.
Conclusion
In summary, while folate and folic acid serve similar functions in the body, they are not the same. Natural folate, particularly 5-MTHF, offers advantages in terms of absorption and bioavailability, especially for individuals with genetic variations affecting folate metabolism. Both forms are essential for preventing neural tube defects and supporting overall health, but the potential risks associated with excessive folic acid intake warrant careful consideration. Further research is needed to fully understand the long-term health implications of high folic acid consumption.
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Most relevant research papers on this topic
Folate, folic acid and 5-methyltetrahydrofolate are not the same thing
5-MTHF supplementation offers advantages over synthetic folic acid, allowing for better absorption, reduced drug interactions, and better prevention of folate deficiency.
Literature Review
Highly CitedFolic 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 ReviewHighly Citedl-5-Methyltetrahydrofolate Supplementation Increases Blood Folate Concentrations to a Greater Extent than Folic Acid Supplementation in Malaysian Women.
L-5-methyltetrahydrofolate supplementation increases blood folate concentrations more effectively than folic acid supplementation in Malaysian women, potentially benefiting their overall health.
RCT
Very Rigorous JournalKnowledge 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 JournalIs folic acid good for everyone?
High folic acid intake may be harmful for some people, and nations considering fortification should carefully research its effects before implementing it.
Very Rigorous JournalHighly 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 CitedQuantifying the effect of folic acid
Increased folic acid intake reduces neural-tube defect risk by about 20%, with greater preventive effect in women with low serum folate levels.
Meta-AnalysisHighly CitedFolic Acid Production by Engineered Ashbya gossypii.
Engineered Ashbya gossypii strains produce 146-fold more folic acid than wild-type strains, offering a potential sustainable alternative to chemical synthesis for folic acid.
Folate and human reproduction.
Folate supplementation is essential for human reproduction, preventing megaloblastic anemia in pregnancy and neural tube defects, and is linked to homocysteine metabolism and gene polymorphisms.
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