PUBLISHED IN ISSUE 2 | FALL 2022
Vitam B-9
Makayla Hallacy
Emporia State University
INTRODUCTION
Vitamin B-9 is commonly referred to as folate or folic acid. Folate is a water-soluble vitamin so most of it is used or excreted through urine, with little storage in the body (Davidson, 2020). This makes it important to consume a healthy amount of folate in natural foods, which is typically not challenging. Folic acid supplements are also a common way to reach the recommended folate levels, especially during pregnancy. Folic acid is a synthetic form of folate that is easier for the body to convert into a useful format, which is why folate and folic acid are used interchangeably in literature. This vitamin is one of the eight B-complex vitamins and works closely with vitamins B-6 and B-12 (Davidson, 2020). Folate is heavily dependent on interacting with other vitamins to fulfill its functions. Together, they build and protect the body’s most basic mechanisms.
IMPORTANCE TO THE BODY
Folate helps the body to produce red blood cells and protect against damage to genetic materials (Tish, 2013). When proper levels of folate are not met, red blood cells can grow too large, causing malfunctions in their productivity. Folate also works with vitamins B-6 and B-12 to regulate homocysteine, an amino acid created from breaking down proteins (Tish, 2013). Cell growth also relies on folate, as the vitamin works to protect the DNA involved in cell reproduction (Mayo Foundation for Medical Education and Research, 2021). The most important role that folate plays in health is during the development of the neural tube in the fetus. “The neural tube develops into the brain and spinal cord. It closes between the third and fourth week after conception” (Tish, 2013). These functions make folate essential to bodily formation and function by developing the fetus and producing red blood cells. The nonessential function of folate is to protect genetic materials, which is useful in cell division.
INTAKE REQUIREMENTS AND SOURCES
The amount of folate required for excellent health varies based on age and gender. “The recommended daily amount of folate for adults is 400 micrograms (mcg). Adult women who are planning a pregnancy or could become pregnant should be advised to get 400 to 1,000 mcg of folic acid a day” (Mayo Foundation for Medical Education and Research, 2021). Some people who may struggle with getting enough folate are women aged between fourteen and thirty, non- Hispanic black women, individuals with alcohol use disorder, and individuals with disorders that lower nutrient absorption- such as celiac or an intestinal disease (U.S. Department of Health and Human Services, 2021). “Vegetables, fruits, nuts, beans, peas, seafood, eggs, dairy products, meat, liver, poultry, and grains are rich in folate. Folate is also synthesized by the gut microbiome” (Elizabeth, 2021, p. 347). Originally there was an issue of folate deficiency in the United States, and many Americans did not get enough folate in their diet, so the government stepped in. “Starting in 1998, the U.S. Food and Drug Administration (FDA) required that certain foods, such as flour, corn meal, bread, cereal, rice, and pasta, to be fortified with a folic acid” (Davidson, 2020). This made it possible for most Americans to reach a healthy intake of folate every day. The only complication is if folate is taken in excess, exceeding 1,000 mcg a day, then it can lead to irritability or restlessness in average individuals or seizures in people who take antiseizure medications (Tish, 2013).
RELATIONSHIP TO DISEASE
“Prevention of neural tube defects (NTDs), congenital heart diseases (CHDs), facial clefts, and other birth defects by folic acid supplementation is an important milestone in the history of nutrition” (Elizabeth, 2021, p. 347). Folate is essential to the proper formation of the neural tube, which later will develop into the spinal cord and brain- impacting the overall
VITAMIN B-9 5 development of the fetus. The formation of the neural tube happens early in fetal development, making it important that women who may become pregnant or are trying to become pregnant take a folate supplement. Folate is mostly known for its function as disease prevention during pregnancy, however, there are some instances where folate plays a role in disease outside of pregnancy. There can also be various neurological effects that are caused by folate’s high interactions with other vitamins. “A high folate intake can mask vitamin B-12 deficiency until its neurological effects become irreversible” (Mayo Foundation for Medical Education and Research, 2021). As mentioned, there is a possibility of being folate deficient however this is extremely uncommon since the FDA began requiring that certain foods be fortified with folic acid.
RELATIONSHIP TO TOP 10 CAUSES OF DEATH
One of the functions of folate is to interact with other B-complex vitamins and regulate homocysteine. “Folic acid works with vitamins B-6 and B-12 to control high levels of homocysteine in the blood” (Mayo Foundation for Medical Education and Research, 2021). This has important implications regarding heart diseases. “Moderate to high levels of homocysteine in the blood are potentially linked to an increased risk of cardiovascular disease” (Tish, 2013). This connection means that consuming healthy levels of folate may decrease the risk of developing cardiovascular disease, which is included in the top ten causes of death.
Cancer is another top ten cause of death that folate has connections to. The implications regarding cancer and folate’s interaction are complicated because folate is present in foods that reduce the risk of cancer, but folic acid supplements do not serve the body the same way. For the average person, folate and folic acid can be used interchangeably in the body. “People who take recommended amounts of folic acid before cancer develops might decrease cancer risk, but taking high doses after cancer (especially colorectal cancer) begins might speed up its progression” (U.S. Department of Health and Human Services, 2021). Research is still being done in this field of study to find conclusions about how folate interacts with cancer. The recommendation is that individuals should be careful about reaching higher levels of folate consumption.
RESEARCH RELATED TO NUTRIENT
Since folate’s function is so heavily dependent on interacting with other vitamins, modern research is focusing more on folate’s independent effects. There is currently research studying the connection between folate levels and the likelihood of having depression. It is possible that people with low levels of folate do not respond as well to antidepressants as individuals with normal folate levels (U.S. Department of Health and Human Services, 2021). There are also clinical trials studying the connections between folate and various diseases: cancer, cardiovascular disease, and forms of dementia. “Research is also underway on the effect of folate on schizophrenia and the feasibility of including folate in birth control pills” (Davidson, 2020). The idea behind including folate in birth control pills is that women would still be consuming some folate supplementation in case of accidental pregnancy. Overall, folate research is popular in a variety of fields because its independent effects are not well known.
CONCLUSION
Folate is essential to the functioning of the human body. It is crucial for red blood cell formation and fetal development, while also playing a role in protecting genetic materials. Most natural foods contain folate, but so do processed items such as bread, pasta, and cereals due to FDA requirements. The average recommended intake is 400 mcg a day, which few people have issues meeting, and the upper-level intake is 1,000 mcg which can cause health issues in some people, but especially those on antiseizure medication. Neural tube defects and other fetal development issues are prevented by consuming folic acid before and during pregnancy. There is also a possibility that folate helps to prevent cardiovascular disease by lowering homocysteine levels in the blood. Research is being done on the implications between folate’s independent functions and various diseases, ranging from schizophrenia to cancer.
REFERENCES
Davidson, T. (2020). Folate. In J. L. Longe (Ed.), Gale virtual reference library: The Gale encyclopedia of medicine
(6th ed.). Gale [electronic version].
Elizabeth, K. E. (2021). Folate: Its biological interactions and strategies to achieve sufficiency without causing excess. American Journal of Public Health, 111(3), 347–349. https://doi.org/10.2105/AJPH.2020.306067.
Mayo Foundation for Medical Education and Research. (2021, February 23). Folate (folic acid). Retrieved September 23, 2021, from https://www.mayoclinic.org/drugs-supplements- folate/art-20364625.
Tish, D. A. (2013). Folate. In K. Key (Ed.), The Gale encyclopedia of diets: A guide to health and nutrition (2nd ed.). Gale [electronic version].
U.S. Department of Health and Human Services. (2021, March 22). Folate. Retrieved September 23, 2021, from https://ods.od.nih.gov/factsheets/Folate-Consumer/.
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