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Folate

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Folate is a vital family of nutrients that plays a critical role in human biology. It is also known as vitamin B9 or folacin. This nutrient belongs to the B vitamin group and is considered essential because the human body cannot produce it on its own. We must obtain folate through our diet or via supplements.

Folate family
Folate family

In the field of nutrition, folates refer to the natural nutrients found in food. In chemistry, the term refers to the conjugate base of folic acid. Folic acid is the manufactured, stable form used in dietary supplements and food fortification. This stability makes it easier to use during food processing and storage.

At a molecular level, folate is essential for the fundamental processes of life. It is required for the body to synthesize DNA and RNA. DNA is the genetic blueprint for cells, while RNA helps translate that code into proteins. Folate also helps the body metabolize amino acids, which are the building blocks for proteins. This process is necessary for cell division and the maturation of blood cells.

Folic Acid Biotransformations
Folic Acid Biotransformations

Because folate is needed for these processes, it is especially important during periods of rapid growth. This includes infancy and pregnancy, when cells are dividing very quickly.

Folate deficiency occurs when the body does not have enough of this nutrient. This lack of folate can hinder DNA synthesis and cell division. This affects hematopoietic cells, which are the cells that create blood, more than other cells. A common result is a type of anemia where red blood cells become abnormally large. People with this deficiency may experience fatigue, heart palpitations, or shortness of breath. They might also notice changes in their skin or hair color. In children, these symptoms can develop within just one month of poor dietary intake.

One of the most significant uses of folate is in preventing birth defects. Low folate levels in early pregnancy are believed to cause more than half of all neural tube defects (NTDs). These defects, such as spina bifida and anencephaly, occur very early in development. To prevent this, the CDC recommends that women consume 400 micrograms of folic acid daily.

GrainProducts
GrainProducts

Many of the more than 80 countries using food fortification have seen great success. For example, mandatory fortification programs have been linked to a 30% reduction in live births with spina bifida. Some countries have even reported reductions greater than 50%.

History shows how much we have learned about this molecule. Scientists discovered folate between 1931 and 1943. The name "folic" comes from the Latin word for leaf, because it was first found in dark-green leafy vegetables. Today, folate is so important that the World Health Organization includes it on its List of Essential Medicines. In the United States, it was the 94th most commonly prescribed medication in 2023. More than 7 million prescriptions were written that year alone.

Folate also plays a complex role in managing other health conditions. It is involved in the methionine cycle, which helps manage levels of homocysteine in the blood.

Folate methionine cycle
Folate methionine cycle

High levels of homocysteine are linked to cognitive impairment and dementia. Additionally, folate is used in the field of oncology, or cancer treatment. Some chemotherapy drugs, like methotrexate, work by blocking folate metabolism to stop cancer cells from dividing. Doctors sometimes use folinic acid to "rescue" healthy cells from the toxic effects of these drugs.

While folate is mostly beneficial, researchers study its effects on various risks. Long-term supplementation with large amounts of folic acid may reduce the risk of stroke. However, studies have shown conflicting results regarding cancer. While high dietary folate might reduce colorectal cancer risk, some reviews suggest that high-dose folic acid supplements might increase the risk of prostate cancer. This highlights how important it is to understand the different ways our bodies use various forms of this essential nutrient.

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File:Folate family.svg
Folate family.svg
File:Folic Acid Biotransformations.svg
Folic Acid Biotransformations.svg
File:Folate methionine cycle.svg
Folate methionine cycle.svg
File:GrainProducts.jpg
GrainProducts.jpg
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