Folate, also known as folic acid and vitamin B9, is one of eight essential B vitamins. Due to its role in red blood cell formation and healthy cell function and growth, folate is key for overall health and wellbeing.
With that said, we’ll be taking a look at exactly what folate is, its health benefits, and how to make sure you’re getting enough.
What is folate (vitamin B9)?
Folate is the natural form of vitamin B9. Our bodies can’t make folate, so we have to get it from our diet.
It’s found naturally in a number of foods, like spinach and broccoli, and is added to others, including breakfast cereals. Folate is also sold as a supplement in the form of folic acid. Folic acid is the manmade form of folate and is actually better absorbed by the body than the folate that occurs naturally in foods – around 85% compared to 50%, respectively.
Folate plays a key role in a number of bodily processes, including the formation of DNA, protein metabolism, and the break down of homocysteine – an amino acid that can be harmful in high amounts. Folate is also needed to produce healthy red blood cells and is particularly key during periods of rapid growth – for example, during pregnancy.
What are the health benefits of folate (vitamin B9)?
Due to its role in cell growth, development, and healthy red blood cell function, getting enough folate has a number of health benefits.
We’ll cover some of these below…
Folate may reduce the risk of heart disease
Research suggests that folate-based supplements, including folic acid, may boost heart health and reduce the risk of heart disease.
Having high levels of the amino acid, homocysteine, has been linked with an increased risk of heart disease. And because folate plays a role in breaking down homocysteine, not getting enough can lead to higher levels. Therefore, increased folate intake has been shown to lower homocysteine levels and potentially reduce the risk of heart disease.
In this scientific review, which included more than 80,000 participants, those we took folic acid supplements were 4% less likely to develop heart disease and 10% less likely to have a stroke. One possible reason given for this is that folic acid supplements may improve blood vessel function in people with heart disease.
Further research suggests that taking folic acid supplements alongside blood pressure medications may lead to greater reductions in high blood pressure than taking medications alone.
Folate is important for brain health and may reduce the risk of dementia
Low levels of folate in the blood have been linked with decreased mental function and an increased risk of dementia.
Meanwhile, getting enough folate may help to protect against Alzheimer’s disease.
In this study of adults with mild cognitive impairment, when participants took 400mcg of folic acid supplements every day for two years, brain function improved and protein levels linked with Alzheimer’s reduced.
Another study looked at whether treatment for Alzheimer’s (the medication, donepezil) was more effective when taken with 1,250mcg of folic acid daily. After six months, those who took 1,250mcg of folic acid alongside donepezil had improved thinking ability and lower levels of inflammation than those who took donepezil alone.
Folate can be beneficial for mental health
Folate is needed for the production of neurotransmitters. These are brain chemicals which carry chemical signals to target cells. As a result, research has linked a lack of folate with an increased risk of depression and other mental health conditions like schizophrenia.
For example, studies have suggested that people with depression may have lower levels of folate in their blood than those without depression.
Another scientific review also found that taking folate and folic acid supplements may help to reduce symptoms associated with mental health, including bipolar disorder and postpartum depression.
Folate may reduce the risk of certain cancers
Research into the link between folate and cancer has been mixed – but there are a number of studies that are worth noting.
The results of this study suggest that folate may offer protection against esophageal cancer. And other research linked low folate levels with an increased risk of cancers including lung, ovarian, breast, and stomach.
While researchers haven’t yet established why this is, one theory is that folate may influence cancer development through its role in DNA formation and cell division.
However, other studies have found no such link between folate and cancer.
There’s also evidence that taking too much folic acid may accelerate the progression of cells in preneoplastic lesions, which can increase the risk of certain cancers. Preneoplastic lesions are made up of altered cells that are more likely to become cancerous than regular cells. For this reason, it’s important not to take too much folic acid, and to always speak to your GP before adding any new supplements to your diet.
Folate may be beneficial for people with kidney disease
Our kidneys filter waste from our blood. So, when they’re damaged or not functioning properly, levels of the amino acid, homocysteine, can quickly build up.
It’s estimated that around 85% of people with chronic kidney disease have too much homocysteine in their blood, which can increase the risk of conditions like dementia, stroke, and heart disease.
As discussed above, there’s evidence that folic acid supplements may help to lower homocysteine levels in people with kidney disease and reduce their risk of heart disease.
Folate may be beneficial for managing diabetes
There’s research to suggest that folate supplements may help to improve blood sugar regulation and insulin resistance in people with diabetes.
Metformin, the most common treatment for type 2 diabetes, can lower folate levels, which is why supplementation is sometimes required for those on this medication.
Folate may help to prevent pregnancy complications and reduce the risk of birth defects
Folate is involved in cell division and tissue growth and plays an essential role in a baby’s development. In particular, this includes the development of the baby’s brain and spine – an area known as the neural tube.
As a result, research suggests that taking folic acid supplements before and during pregnancy can help to prevent neural tube irregularities, such as spina bifida and anencephaly. Eating foods fortified with folic acid, such as flour, has also been found to have a similar effect.
Folate is also important for the mother’s health and research suggests it may reduce the risk of pregnancy-related complications, including pre-eclampsia.
Note: Taking too much folic acid may have a negative impact on brain development, with some studies indicating that it could increase the risk of autism. For this reason, it’s important to always seek the advice of your GP when considering taking supplements.
What are the best sources of folate, and how much do I need?
According to the NHS, adults need a minimum of 200mcg (micrograms) of folate per day. Because the body cannot store folate long-term, it’s important to eat folate-rich foods frequently. The majority of people are able to get enough folate by eating a healthy and varied diet.
Folate is found naturally in a number of foods. Some of the best sources include…
- Spinach (165mcg per 100g)
- Cabbage (66mcg per 100g)
- Kale (84mcg per 100g)
- Citrus fruits (approximately 34mcg per 100g orange)
- Avocado (35mcg per 100g)
- Cauliflower (17mcg per 100g)
- Eggs (47mcg per 100g)
Beef liver (290mcg per 100g) – however, the NHS advises to avoid this during pregnancy.
Folic acid (the manmade form of folate) is also added to foods like flour, breads, and breakfast cereals. If you’d like to add more folate to your diet, why not try some of these 40 healthy recipes that are rich in folate from Delicious? There’s everything from bruschetta to refreshing salads and roasted vegetables.
For people who are pregnant or may become pregnant, the NHS advises taking a 400mcg folic acid supplement until the pregnancy reaches 12 weeks. As discussed above, this can help to prevent neural tube defects and support healthy growth and development. However, as always, it’s important to speak to your GP before adding any supplements to your diet as they aren’t suitable for everyone.
What are the symptoms of folate deficiency and toxicity, and who’s at risk?
Folate deficiency can lead to a number of health issues. Some of the most common problems include anemia, mental impairment, and an increased risk of certain cancers and heart disease – as well as developmental issues in children if pregnant women don’t get enough folate.
There are various reasons why folate deficiency may occur, but some of the most common include…
- Having a lack of folate in your diet
- Having low stomach acid (hypochlorhydria), or no stomach acid (achlorhydria)
- Excessive alcohol consumption
- Diseases or surgeries that affect how the body absorbs folate. Examples include celiac disease, short bowel syndrome, and gastric bypass surgery
- Dialysis
However, while not getting enough folate can cause complications, the good news is that increasing your dietary intake or taking supplements can help to increase your levels.
In contrast, it’s equally important not to consume too much folate. Although it’s extremely rare to reach folate toxicity through food sources alone, it’s possible to take too many folic acid supplements.
According to the NHS, folic acid toxicity can cause a number of health issues. For example, it may mask the symptoms of vitamin B12 deficiency, which can cause damage to the nervous system if left untreated. This can be of particular concern for older adults, because, with age, it becomes more difficult for the body to absorb vitamin B12.
As a result, experts advise taking no more than 1mg of folic acid supplements each day.
Final thoughts…
Folate is one of eight essential B vitamins. Among other things, it’s important for cell growth, development, and red blood cell function. When we supply our bodies with enough folate, it can have powerful health benefits.
For further reading, head over to the diet and nutrition section of our website. Here, you’ll find further essential vitamin and mineral guides, as well as tips on everything from healthy diet swaps to ways to cut down on added sugar.
What do you do to make sure you’re getting enough essential vitamins and minerals? Do you have any tips that you’d like to share? We’d love to hear from you in the comments below.