Many people (even health professionals!) tend to use "folate" and "folic acid" as interchangeable terms. However, they're two different types of nutrients altogether. And consuming too much of the fortified kind could have unintended and potentially harmful side effects.
Folate and folic acid are two different forms of vitamin B9. Folate is the naturally occurring form of the vitamin found in many foods. Folic acid is a form of folate that's used in fortified foods and dietary supplements.
Ready to set the record straight? Let's break it down even more.
What Is Folate?
Folate is the naturally occurring form of vitamin B9.
Folate is found in many whole foods, including vegetables such as asparagus, avocados, brussels sprouts, spinach and lettuce; citrus fruits; eggs; and beans.
Our bodies require this B vitamin in order to perform many essential functions, such as dividing cells and creating DNA and other genetic material, according to the National Institutes of Health.
Folate may also help prevent neural tube birth defects in babies. If you're pregnant or trying to become pregnant, you've probably heard you should increase your intake of folate. That's because research has found that folate may help prevent neural tube defects in babies, such as anencephaly or spina bifida.
For women who are expecting, 800mcg per day is the recommended amount; 500mcg per day is recommended for breastfeeding women. For all other adults, the recommended daily amount is 400mcg.
While folate deficiencies are rare in the U.S., there are some potentially serious consequences if you don't get enough. Low levels of folate have been associated with a number of health conditions and diseases, such as anemia, depression, cognitive diseases such as dementia and Alzheimer's, an increased cancer risk, and an increased risk of heart disease and stroke.
What is Folic Acid?
In the U.S., many foods such as flour and breakfast are required to be fortified with folic acid — the supplement form of folate, also known as pteroylmonoglutamic acid.
While getting your folate via supplementation may sound like a simple solution to avoid folate deficiencies, it's not that straightforward.
Experts used to think that folic acid was thought to be much better absorbed than naturally-occurring folate, as Healthline's Atli Arnarson, Ph.D., reports. But it turns out that's not necessarily true.
Folate actually refers to a group of related compounds with similar nutritional properties. The active form of vitamin B9 is a folate known as 5-MTHF. In the digestive system, the majority of dietary folate (the kind derived from whole foods) is converted into 5-MTHF before entering the bloodstream.
But research has found that unlike naturally occurring folate, the majority of folic acid is not converted to the active form of vitamin B9 (5-MTHF) in the digestive system. Instead, it needs to be converted in the liver or other tissues — which is a slow and inefficient process. After taking a folic acid supplement, it takes time for the body to convert all of it to 5-MTHF.
Not only are you not reaping the benefits of the nutrient, but the un-metabolized folic acid that remains in your bloodstreams might also be harmful to your health. Studies have indicated that long-term high levels of un-metabolized folic acid could be associated with increased cancer risk, and may hide vitamin B12 deficiency among elderly people. One 2005 study even found that older adults taking more than the daily recommended value of 400 mcg of folic acid experienced faster cognitive decline than adults who didn’t supplement.
Your Game Plan
While the exact health risks of un-metabolized folic acid are still unclear and require more research, the bottom line is that (as with most vitamins) it's best to obtain your folate from whole food sources — especially those healthy veggies like avocado, brussels sprouts, spinach, and lettuce.
However, if you're pregnant or trying to become pregnant, it's still a smart idea to supplement with vitamin B9. Instead of folic acid choose supplements that contain the active form of folate (5-MTHF), which is considered a healthier and more effective alternative to folic acid, according to Healthline. This is usually listed as methyl folate or levomefolate calcium on ingredient lists.
And guess what? We've already done the legwork for you. Our prenatal vitamins only include methylated folate — the most active form of folate that's critical to preventing neural tube defects. Simply order your prenatal vitamins from Binto, and you'll rest assured you're equipped with the most highly digestible and effective form of folate you can buy.