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Finding Folate

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folate in fortified cereal The B vitamin folate, also called folic acid, is a water-soluble vitamin. Water-soluble vitamins are stored in the body in very limited amounts and are excreted through the urine. Therefore, it is a good idea to have them in your daily diet. Folate is considered a crucial vitamin before and during pregnancy. Research has shown that folate deficiencies during pregnancy can lead to neural tube birth defects in babies.

Functions

Folate's functions include:
  • Helping amino acid metabolism and conversion
  • Aiding in the conversion of homocysteine to methionine
  • Producing and maintaining new cells
  • Making DNA and RNA, the building blocks of cells
  • Preventing changes to DNA that may lead to cancer
  • Making red blood cells and preventing anemia
  • Assisting in the creation of neurotransmitters (chemicals that regulate sleep, pain, and mood)

Recommended Intake:

Age Group (in Years) Recommended Dietary Allowance
Females Males
1 - 3 150 mcg 150 mcg
4 - 8 200 mcg 200 mcg
9 - 13 300 mcg 300 mcg
14 - 18 400 mcg 400 mcg
Pregnancy, 14 - 18 600 mcg n/a
Lactation, 14 - 18 500 mcg n/a
19+ 400 mcg 400 mcg
Pregnancy, 19+ 600 mcg n/a
Lactation, 19+ 500 mcg n/a
mcg=microgram

Folate Deficiency

Folate deficiency is a common vitamin deficiency. It can occur for a variety of reasons, including:
  • Need is increased, as with pregnancy
  • Dietary intake is lacking
  • Body is excreting more than usual
  • Medications interfering with the body's ability to use folate include:
    • Anti-convulsant medicines
    • Metformin
    • Sulfasalazine
    • Triamterene
    • Methotrexate
    • Barbituates
Signs or symptoms of folate deficiency include:
  • Megaloblastic anemia (shown by blood tests)
  • Irritability, hostility
  • Weakness
  • Weight loss
  • Apathy, forgetfulness
  • Anorexia, loss of appetite
  • Sore tongue, glossitis (inflammation of tongue)
  • Headache
  • Heart palpitations
  • Paranoid behavior
  • Diarrhea

Too Much Folate

Large doses of folate can cause symptoms of vitamin B12 deficiency to appear. Vitamin B12 deficiency is common in older adults. Although folate supplementation will alleviate the anemia caused by the B12 deficiency, the nervous system damage caused by the B12 deficiency will continue. This is why it is important that you talk to your doctor before you take a folate supplement. It may be necessary for you to take vitamin B12 supplements along with the folate.
There is no upper limit for ingesting folate found naturally in foods. However, there are tolerable upper intake levels for folate consumed from fortified foods and supplements:
Age Micrograms (mcg) per day
1-3 years 300 mcg
4-8 years 400 mcg
9-13 years 600 mcg
14-18 years 800 mcg
Pregnant or nursing women up to 18 years 800 mcg
19 years and older 1,000 mcg
Pregnant or nursing women 19 years and older 1,000 mcg

Major Food Sources

There is a variety of foods that contain folate. Some foods, like cereal, rice, and flour, are fortified with folate. Here is a list of major food sources and their folate content.
Food Serving Size Folate Content
(mcg)
Chicken liver, simmered 3.5 ounces 770
Fortified breakfast cereal 3/4 cup 100-400
(check Nutrition Facts label)
Soy flour 1 cup 260
Beef liver, braised 3.5 ounces 217
Chickpeas, canned 1 cup 160
Pinto beans, canned 1 cup 144
Spinach, boiled 1/2 cup 131
Lima beans, canned 1 cup 121
Papaya 1 medium 116
Avocado 1 medium 113
Wheat germ, toasted 1/4 cup 102
Asparagus, boiled 4 spears 85
Orange juice, fresh 8 fluid ounces 75
Spinach, raw 1/2 cup 54
Whole wheat flour 1 cup 53
Green peas, boiled 1/2 cup 50
White rice, long-grain 1/2 cup 45
Orange, navel 1 medium 44
Peanuts, dry roasted 1 oz 41
Wheat flour 1 cup 40
Broccoli, boiled 1/2 cup 39
Tomatoes, sun-dried 1 cup 37
Tomato juice, canned 6 oz 35
Peanut butter, crunchy 2 tablespoons 29
Cashews, dry roasted 1 ounce 20
Banana 1 medium 20
Bread, whole wheat 1 slice 15

Health Implications

Populations at Risk of Folate Deficiency

The following populations may be at risk of folate deficiency and may require a supplement:
  • Pregnant women—Folate is critical for the production and maintenance of new cells. This is especially important during pregnancy—a period of rapid cell division.
  • People who consume excessive amounts of alcohol—Folate deficiency has been observed in alcoholics. Alcohol interferes with the absorption of folate and increases excretion by the kidneys. In addition, many alcoholics tend to have diets low in essential nutrients, like folate.
  • People on certain medicines—Certain medicines can interfere with the body's ability to use folate. Check with your doctor about supplementation if you are on medicine that may affect your folate levels.
  • People with inflammatory bowel diseases—Malabsorption of folate can occur with inflammatory bowel diseases.
  • The elderly—Many elderly have low blood levels of folate, which can occur from low intake of the vitamin or problems with absorption.

Birth Defects

In 1991, a landmark study found a relationship between folate and birth defects. Subsequent research has supported the finding that adequate folate intake during the period before and just after conception protects against a number of neural tube defects, including spina bifida and anencephaly.
The crucial period is before and very early after conception—a time when most women do not know they are pregnant. Therefore, the recommendation is that all women of childbearing age make sure they have a folate intake of at least 400 mcg.

Tips for Increasing Your Folate Intake:

To help increase your intake of folate:
  • Spread a little avocado on your sandwich in place of mayonnaise.
  • Drink a glass of orange juice or tomato juice in the morning.
  • Add spinach to your scrambled eggs.
  • Slice a banana on top of your breakfast cereal.
  • Sprinkle some toasted wheat germ on top of pasta or a stir-fry.
  • Throw some chickpeas or kidney beans into a salad.
  • If you take a vitamin supplement, make sure it contains folate.

RESOURCES

Academy of Nutrition and Dietetics http://www.eatright.org/

US Department of Agriculture http://www.usda.gov/

CANADIAN RESOURCES

Dietitians of Canada http://www.dietitians.ca/

Health Canada http://www.hc-sc.gc.ca

References

Duyff RL. The American Dietetic Association's Complete Food & Nutrition Guide. 3rd ed. Hoboken, NJ: John Wiley and Sons, Inc.; 2006.

Folate. Office of Dietary Supplements, National Institutes of Health website. Available at: http://ods.od.nih.gov/factsheets/Folate-HealthProfessional/. Accessed June 28, 2012.

Folate deficiency. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated December 15, 2010. Accessed June 28, 2012.

Folic acid. EBSCO DynaMed website. Available at: http://ebscohost.com/dynamed. Updated October 14, 2011. Accessed June 28, 2012.

Garrison R, Somer E. The Nutrition Desk Reference. New Canaan, CT: Keats Publishing; 1995.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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