Folic acid – why it is worth supplementing it not only for pregnancy (and not only for women)!

Folic acid, most often taken during the peri-pregnancy period, is wrongly omitted at other stages of women's lives . It is also rarely talked about how important it is for the health of men and children . Even though folic acid is not synthesized by the human body, it participates in a huge number of reactions in our body. Can you get enough of this nutrient from food? Is it worth supplementing it and, if so, to whom? You will find out in this article.

Folic acid and folates – are they the same?

Before we move on to the role folic acid plays in the human body, it is worth distinguishing several concepts. Well, folic acid is a synthetic version of vitamin B9, which can only be found in the form of tablets, capsules or processed food additives. As for products in which vitamin B9 is naturally contained, we find folates , not folic acid. ¹ . And although the terms "folic acid" and "folate" are sometimes used interchangeably, they mean different forms of vitamin B9 .

Why is it worth paying attention to? Different forms have different chemical structures and, therefore, different effects on the body, different bioavailability and bioavailability . Ordinary folic acid may not be absorbed by up to 60% of people due to genetic mutations ² . In this case, unabsorbed folic acid accumulates in the blood and in large amounts it can be toxic to the body and contribute to the development of insulin resistance. ³ , increased development of cancer cells ^4,5 , and also disturb brain functions in older people ^6.7 (read more about how ordinary folic acid can be harmful to health in a separate article ).

Folates are a more bioavailable form of vitamin B9. In this form, they are stored in the human body - in the liver and tissues ⁸ . One type of such vitamin B9 is active (6s)-5-methyltetrahydrofolate , which you will find in nikalab products . At this point, it is the most absorbable form of folate on the dietary supplement market ⁹ . It is also called active folic acid because the body can use it immediately (unlike regular folic acid, which must first be activated). ¹⁰ ).

What role do folates play in the body? 

You can read about the special role of folates in preparation for and during pregnancy in a separate article . Here we will present the role of folates in a broader context - in people of both sexes and of different ages. Every human body needs folates, among others. to create new and repair damaged DNA structures , multiply cells in the body and maintain their proper functions , as well as support the maturation of blood cells - erythrocytes . These basic functions translate into the health of entire organs and systems in the body.

Folates for blood production.

Approximately 1% of red blood cells are renewed in the human body every day . “Old” erythrocytes are broken down and removed, and new ones take their place. Folate is essential in the maturation of new red blood cells . In the event of folate deficiency, this process cannot proceed properly ¹³ . This means that red blood cells will not be able to transport adequate amounts of oxygen to various organs and tissues. This is associated with health damage at any age. However, it is of particular importance in children (and women planning pregnancy, to whom we devoted a separate article in the context of folates). The amount of blood in a growing body is constantly increasing . About 270 ml of blood circulates in the body of a newborn, about 2,650 ml of blood in a school-age child, and over 5,000 ml in an adult. ¹⁴ . When there is a lack of folate, the child cannot develop and grow properly , and his brain does not receive enough nutrients.

Folate for heart health.

The correct level of folate in the body is necessary to maintain optimal homocysteine ​​levels ¹⁵ . When this amino acid is elevated, the risk of cardiovascular disease increases . Folate supplementation helps reduce the risk of heart attack by 10% and the overall risk of heart disease by 4%. ¹⁶ . It is also an effective tool in supporting the treatment of hypertension ¹⁷ .

Folate for brain health.

Vitamin B9 is necessary for the proper functioning of the nervous system and the transmission of signals between neurons in the brain. Folates support our cognitive functions, including: memory ¹⁸ . Reduced folate levels are associated with depression ¹⁹ , schizophrenia and bipolar disorder ²⁰ . It is also one of the prerequisites for the development of neurodegenerative diseases ²¹ . Maintaining optimal levels of folate in the body helps reduce the risk of these diseases, e.g. Alzheimer's disease ²² , and also improve the condition and functioning of people already suffering from dementia ²³ .

Folate for immunity.

The immune system is another area that cannot function properly in the presence of folate deficiency. These compounds are important for both cellular and humoral immunity (related to the production of antibodies) ²⁴ . Folates also help fight inflammation in the body, which is the basis for the development of many serious diseases, including cancer ²⁵ . Efficiently functioning immunity is important for all of us, but more attention should be paid to the defense forces of children whose immune system is still developing, as well as in older people whose immunity begins to weaken with age. Folate can be a good support in the fight against infections and inflammation in the body.

Can you get enough folate from your diet?

Due to the fact that the human body does not produce folates on its own, it must obtain them from outside . Folate can be found in foods such as green leafy vegetables (spinach, kale), broccoli, avocado, citrus fruits, eggs, and beef liver. At the same time, scientists have been observing a decline in the natural content of folates in food for several decades. One study showed that modern broccoli contains more than twice less folate than 40 years ago ²⁶ . This means that the amounts of vitamin B9 given in book tables in one or another product may not actually be found on our plate.

Another problem - folates from food products also have to undergo necessary transformations in the body to be absorbed. And although this pathway is shorter than in the case of ordinary, synthetic folic acid, it is not always successful ²⁷ . It is believed that on average the body can only absorb 50% of the folates contained in food ²⁸ .

Folate deficiencies are such a serious problem around the world that over 60 countries have been implementing programs fortifying flour with folic acid for several decades, including the United States and Canada ²⁹ . It is estimated that these actions have significantly reduced the incidence of folate deficiency. However, such a solution also has its drawbacks. Synthetic folic acid is used to fortify the flour , which we have already mentioned above in the context of poorer absorption (60% of people may have genetic mutations that make it difficult to absorb such acid). Fortifying commonly available foods (such as bread or breakfast cereals) with synthetic folic acid also does not allow us to control the dose we consume. And this may lead to overdose in some cases, e.g. in children. In Poland, fortifying flour with folic acid is not obligatory , but producers may use this solution voluntarily ^thirty .

Why is it worth supplementing active folic acid from nikalab?

The most effective way to supplement the appropriate amount of folates that the body can use immediately is to provide them with their most active form , which will not require additional transformations. In all nikalab products you will find the latest fourth generation folate - Quatrefolic . It is absorbed well by everyone, regardless of genetic mutations. The body can use this folate without the need to transform it into other compounds. It is highly stable and, unlike ordinary folic acid, which can be found in many popular dietary supplements (including premium ones), it does not mask vitamin B12 deficiency. ³¹ .

We have enclosed active folic acid in a capsule using the innovative DRcaps technology , thanks to which the active ingredients bypass stomach acids and are released only in the small intestine. Folates are absorbed in the intestines ³² . By choosing nikalab Everyday Bases, you know that the active ingredients will reach where there are optimal conditions for their absorption.

Folate supplementation in Baz na nikalab helps reduce the feeling of constant fatigue ³³ , supports memory and brain performance ³⁴ , supports immunity ³⁵ , supports hematopoietic processes, helps reduce the risk of coronary heart disease, thrombosis, atherosclerosis, heart attack and stroke ³⁶ . Moreover, in pregnant women it reduces the risk of fetal neural tube defects and the resulting complications and miscarriages by as much as 70%. ³⁷ .

Bibliography:

1. Folate, Fact Sheet for Health Professionals, National Institutes of Health, Office of Dietary Supplements, November 1, 2022.
2. Long S. Goldblatt J., “MTHFR genetic testing: Controversy and clinical implications.” Journal of The Royal Australian College of General Practitioners, April 2016.
3. Krishnaveni GV, Veena SR, Karat SC, Yajnik CS, Fall CH. Association between maternal folate concentrations during pregnancy and insulin resistance in Indian children. Diabetology. 2014 Jan;57(1):110-21.
4. Kim YI. Folate and cancer: a tale of Dr. Jekyll and Mr. Hyde? Am J Clin Nutr. 2018 Feb 1;107(2):139-142.
5. Patel KR, Sobczyńska-Malefora A. The adverse effects of an excessive folic acid intake. Eur J Clin Nutr. 2017 Feb;71(2):159-163.
6. Bailey RL, Jun S, Murphy L, Green R, Gahche JJ, Dwyer JT, Potischman N, McCabe GP, Miller JW. High folic acid or folate combined with low vitamin B-12 status: potential but inconsistent association with cognitive function in a nationally representative cross-sectional sample of US older adults participating in the NHANES. Am J Clin Nutr. 2020 Dec 10;112(6):1547-1557.
7. Moore EM, Ames D, Mander AG, Carne RP, Brodaty H, Woodward MC, Boundy K, Ellis KA, Bush AI, Faux NG, Martins RN, Masters CL, Rowe CC, Szoeke C, Watters DA. Among vitamin B12 deficient older people, high folate levels are associated with worse cognitive function: combined data from three cohorts. J Alzheimers Dis. 2014;39(3):661-8.
8. Folate, Fact Sheet for Health Professionals, National Institutes of Health, Office of Dietary Supplements, November 1, 2022.
9. Gnosis by Lesaffre, Quatrefolic, 2021.
10. Ferrazzi E, Tiso G, Di Martino D. Folic acid versus 5-methyl tetrahydrofolate supplementation in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2020 Oct;253:312-319. doi: 10.1016/j.ejogrb.2020.06.012. Epub 2020 Jun 13. PMID: 32868164.
11. Crider KS, Yang TP, Berry RJ, Bailey LB. Folate and DNA methylation: a review of molecular mechanisms and the evidence for folate's role. Adv Nutr. 2012 Jan;3(1):21-38.
12. Folate (folic acid), Mayo Clinic, mayoclinic.org, accessed November 18, 2022.
13. Koury MJ, Ponka P. New insights into erythropoiesis: the roles of folate, vitamin B12, and iron. Annu Rev Nutr. 2004;24:105-31. doi: 10.1146/annurev.nutr.24.012003.132306. PMID: 15189115.
14. Whole Blood and What It Contains, American Red Cross Blood Service, redcrossblood.org, accessed November 21, 2022.
15. Collaboration HLT. Lowering blood homocysteine ​​with folic acid based supplements: meta-analysis of randomized trials. Homocysteine ​​Lowering Trialists' Collaboration. BMJ. 1998 Mar 21;316(7135):894-8. PMID: 9569395; PMCID: PMC28491.
16. Yanping Li at al, Folic Acid Supplementation and the Risk of Cardiovascular Diseases: A Meta-Analysis of Randomized Controlled Trials, Originally published15 Aug 2016 https://doi.org/10.1161/JAHA.116.003768 Journal of the American Heart Association. 2016;5:e003768.
17. Wang WW, Wang XS, Zhang ZR, He JC, Xie CL. A Meta-Analysis of Folic Acid in Combination with Anti-Hypertension Drugs in Patients with Hypertension and Hyperhomocysteinemia. Front Pharmacol. 2017 Aug 31;8:585. doi: 10.3389/fphar.2017.00585. PMID: 28912716; PMCID: PMC5584015.
18. E. H. Reynolds. BMJ. 2002 Jun 22; 324(7352): 1512–1515. doi: 10.1136/bmj.324.7352.1512. Folic acid, aging, depression, and dementia.
19. Bender A, Hagan KE, Kingston N. The association of folate and depression: A meta-analysis. J Psychiatr Res. 2017 Dec;95:9-18.
20. Nelson Siu Kei Lam, Xin Xin Long, Xuegang Li, Mirette Saad, Florence Lim, James CG Doery, Robert C. Griffin, Cherrie Galletly, The potential use of folate and its derivatives in treating psychiatric disorders: A systematic review, Biomedicine & Pharmacotherapy , Volume 146, 2022.
21. EH Reynolds, op.cit.
22. Jang S, et al. Normal-But-Low Serum Folate Levels and the Risks for Cognitive Impairment. Psychiatry Investig. 2019 Jul;16(7):532-538.
23. Chen H, Liu S, Ji L, Wu T, Ji Y, Zhou Y, Zheng M, Zhang M, Xu W, Huang G. Folic Acid Supplementation Mitigates Alzheimer's Disease by Reducing Inflammation: A Randomized Controlled Trial. Mediators Inflamm. 2016;2016:5912146.
24. Dhur A, Galan P, Hercberg S. Folate status and the immune system. Prog Food Nutr Sci. 1991;15(1-2):43-60. PMID: 1887065.
25. A Dhur, P Galan, S Hercberg. Prog Food Nutr Sci. 1991;15(1-2):43-60. Folate status and the immune system.
26. Erisman, Jan Willem. (2021). Nature-based agriculture for an adequate human microbiome. Organic Agriculture. 11. 10.1007/s13165-020-00304-4.
27. Caudill M.A. Folate bioavailability: implications for establishing dietary recommendations and optimizing status. Am J Clin Nutr. 2010;91(5):1455S-1460S.
28. Folate. Fact Sheet for Health Professionals. National Institutes of Health, Office of Dietary Supplements, ods.od.nih.gov, March 29, 2021.
29. Amy Norton, Do kids, men need folic acid from a pill?, Reuters Health, reuters.com, September 9, 2010
30. Polish flour enriched with folic acid? The Ministry responds..., September 24, 2019, mgr.farm
31. Mills JL, Molloy AM, Reynolds E H. Do the benefits of folic acid fortification outweigh the risk of masking vitamin B12 deficiency? BMJ 2018; 360 :k724 doi:10.1136/bmj.k724
32. Visentin M, Diop-Bove N, Zhao R, Goldman ID. The intestinal absorption of folates. Annu Rev Physiol. 2014;76:251-74. doi: 10.1146/annurev-physiol-020911-153251. PMID: 24512081; PMCID: PMC3982215.
33. In Jacobson et al. Neurology. 1993 Dec;43(12):2645-7. Serum folate and chronic fatigue syndrome.
34. EH Reynolds, op.cit.
35. A Dhur, P Galan, S Hercberg. Prog Food Nutr Sci. 1991;15(1-2):43-60. Folate status and the immune system.
36. Charalambos Antoniades et al. Circulation. 2006 Sep 12;114(11):1193-201. 5-methyltetrahydrofolate rapidly improves endothelial function and decreases superoxide production in human vessels: effects on vascular tetrahydrobiopterin availability and endothelial nitric oxide synthase coupling.
37. LE Martínez-Garza. Editorial. October - December 2016. Twenty-five years of knowledge of the prevention of neural tube defects with folic acid.