Folate is the generic term for a group of chemically related B vitamins. Also known as vitamin B9, folate is an essential nutrient (not synthesized by the body) that is required for cell function and tissue growth.
We need to get adequate folate from our diet for optimal health. Dietary sources include leafy green vegetables, legumes, grains, dairy products, meat, poultry, and seafood.
Folate is similar but different to folic acid. Folic acid is the synthetic version of folate. The vast majority of supplements contain synthetic folic acid rather than folate.
Chemically, folate is a mixture of reduced polyglutamates (having multiple glutamic tails attached), while folic acid exists as an oxidised monoglutamate form (conjugated to one glutamate residue).
Folate metabolism is intimately linked to that of the amino acid methionine. A low folate level leads to the conversion of methionine to homocysteine, which is in turn linked to increased cardiovascular disease risk and dementia. Taking a folate supplement together with vitamins B6 and B12 can significantly slow the rate of brain shrinkage (atrophy) that occurs in older age. This is due to the homocysteine-lowering effects of folate.
Through the methionine cycle, folate also serves as the primary carbon donor for DNA methylation, one of the fundamental epigenetic mechanisms that modulate gene expression independent of the DNA sequence. Having just the right amount of folate is therefore essential to keeping your cells' DNA in good shape!
Folate also has a role in cell growth and replication. Folate deficiency has an adverse impact on tissues with high cell turnover, such as the bone marrow and the gastrointestinal tract. Low folate levels are also a risk factor for developing high blood pressure.
Folate is best known for its role in foetal development and folate deficiency in pregnancy is linked to foetal abnormalities. However, it is clear that having an optimal folate confers benefits through the life course; it has been linked to protection against diseases in ageing such as strokes, cardiovascular diseases, osteoporosis, and age related cognitive decline.
The most well-known use of folate is to support healthy pregnancy and breastfeeding.
Folate is also recommended when someone is deficient in folate. In severe cases, a condition known as megalobastic anaemia develops.
Supplementation with folate/folic acid/other folate ingredients is recommended for those suffering mild-to-moderate low moods and folate is often recommended as part of a supplement regime to support healthy brain aging.
The most common signs of a folic acid deficiency include physical weakness, heart palpitations, headaches, shortness of breath and a sore tongue. Psychological signs that you may need folic acid supplements include behavioral disorders and irritability. Adults with an advanced folic acid deficiency may suffer from megaloblastic and macrocytic anemia.
Folate is particularly important in women of childbearing age. A folate deficiency during pregnancy can lead to birth defects.
The Health Benefits and Risks of Folic Acid Fortification of Food. A report by the Office of the Prime Minister’s Chief Science Advisor and the Royal Society Te Apārangi. June 2018. ISBN 978-0-473-44637-6.
Firth, J et al. The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta-review of meta-analyses of randomized controlled trials. World Psychiatry 2019;18:308–324.
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