Folate vs. Folic Acid: Benefits and risks.

Appropriately, the first week and month of the New Year begins with Folic Acid and birth defect awareness. Folic Acid being the most famous anti-birth defect vitamin in the B family.  However, there is confusion and misunderstanding about this vitamin, its benefits and risks.

This awareness week should be renamed FOLATE WEEK.

Folic Acid is a synthetically made vitamin. Folate, or B9, is the natural form of this B vitamin. It is found in green leafy vegetables, whole grains like brewer’s yeast, legumes like lentils and liver. Unfortunately, most people are still lacking in this B vitamin and many are not aware of how important Folate supplementation is in birth defect prevention.                                                                                               Issues that may arise in a child, from a Folate deficient mother are neural tube birth defects (spina bifida and anencephaly),  mentally retarded children, cleft palate, brain damage, preeclampsia, premature birth, after birth hemorrhaging, anemia in both mom and child, breathing issues, learning or developmental disabilities, premature delivery, and less likely to survive than those born closer to 40 weeks’ gestation.                                                                                                                                                .                                                                                                                                             Spina bifida birth-defects occur within the first 22 to 28 days of pregnancy, when many mothers-to-be may not be aware they are even pregnant. Since half of all pregnancies are unplanned, and half of all unplanned pregnancies occur to women using birth control, it’s important to recommend Folic Acid supplements to ALL women of childbearing age. Studies show that Folic Acid supplements can also help reduce the chance of a premature birth by 70%.

Folic Acid food fortification has reduced birth-defects (spina bifida and anencephaly) by approximately 30%. There has however, been shown this fortification of processed grain foods in 1998 in the Canada and the US, with the synthetic Folic Acid is now causing problems.  An increase in breast and prostate cancer risk by 20-30%, as well as asthma and respiratory tract infections in children by 25%. This has caused Ireland, the UK, Sweden, Italy and the Netherland to rethink plans of fortifications.

Unlike the more easily absorbed natural Folate, Folic Acid is not bioactive as it is proclaimed to be, and must be converted by the intestines and liver before it can be used for critical Folate dependent actions. Many people (< 25%) do not have the ability to convert Folic Acid. These people are particularly vulnerable to Folate deficiency, which is linked to an increased risk of birth defects and cancer. Un-metabolized Folic Acid may store in tissues and possibly increase genetic mutations. Insufficient Folate may lead to blood vessel damage,  abnormal blood clotting, oxidize LDL cholesterol, promote inflammation adversely affecting cardiovascular, neurological, skeletal, endocrine, and digestive health.

Food fortification of processed foods with a single or few synthetic nutrients after they have milled out all of its natural nutrients is problematic. Supplementing with a single nutrient is like trying to bake a cake with just flour….it doesn’t work. Nutrition is like a cake recipe, all nutrients (about 31 including omega fatty acids), work together, and if all nutrients are not present we will not get the same cake or in pregnancy, the healthiest possible baby. An imbalance may cause toxic levels of some nutrients and deficiencies of others. Synthetically produced supplements just do not work the same way as those nutrients found naturally in food.

It would be ideal if all women would eat natural whole grain foods (no need for fortification), fresh vegetables and beans, which have not had their natural Folate and other nutrients milled out of them, as well as take their prenatal supplements.

However, many pregnant women neglect taking vitamins, especially those in low social status, and eat processed foods, never quite achieving full nutrition.

Unfortunately most prenatal supplements contain Folic Acid rather than Folate, as it is much cheaper and neither do they contain the full range of all nutrients.

The general population would also benefit tremendously by avoiding Folic Acid fortified processed foods such as white bread, cookies etc.., that are otherwise nutrient void (useless foodstuff, in my not so humble opinion).  I would venture to bet, that if all men and women consumed sufficient natural Folate and all other nutrients, by eating healthier foods, without synthetic Folic Acid, that these birth defects could be 80-90% prevented. In addition, our overall cancer and heart disease rate would severely decline.

Birgitta Lauren


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