Folate

Folate is a water-soluble vitamin, also known as vitamin B9. It plays a key role in the synthesis and modification of nucleic acids(one of a large family of molecules including DNA and RNA) and amino acids.

Our body doesn’t produce or store folate; therefore it is important for us to consume folate every day to have enough of it in our system.

Folate is found naturally in food, while folic acid is actually the synthetic form that is used as a supplement and/or food additive. As required by federal law, folic acid has been added to flour, cold cereals, breads, bakery items, cookies, crackers, and pasta since 1998. 

Musculoskeletal Benefits of Folate

Folate is required for the conversion of homocysteine to methionine. High levels of homocysteine have been associated with:

  • Oxidative stress
  • Chronic inflammation
  • Increased fracture risk
  • Decreased bone mineral density
  • Collagen dysfunction

Oxidative stress, chronic inflammation, and collagen dysfunction are associated with chronic musculoskeletal diseases such as osteoporosis, sarcopenia(muscle loss and weakness), osteoarthritis, and tendonitis. 

Folate helps convert harmful levels of homocysteine to healthful levels of methionine, an essential amino acid. Also, methionine is required fro S-adenosylmethionine (SAM) a universal methyl donor that is involved in the synthesis of over 100 substances including DNA, RNA, hormones, proteins, and good fats.

Muscle and bone are metabolically hyper active; constantly building and breaking down. Any disruption in the building process causes a shift to an overall state of breakdown or “catabolism”. Many musculoskeletal diseases such as osteoporosis, osteoarthritis, and sarcopenia can be conceptualized as a situation in which the cellular machinery that destroys overwhelms the cellular machinery that builds. Insufficient folate can magnify and accelerate this catabolic process.

Selected Evidence

 

1. Folate Boosts Bone Health

Investigators at Purdue University explored the association between folate and the risk for osteoporosis. The researchers concluded that decreased folate levels were significantly correlated with increased risk of low back osteoporosis. (Baily et al. B-vitamin status and bone mineral density and risk of lumbar osteoporosis in older females in the United States. Am J Clin Nutr. 2015 Sep;102(3):687-94.)

2. Folate Supports Muscle Health

Researchers from Singapore examined the association between folate, muscle strength, gait and fall history in patients >65 years old. The author found that folate levels were significantly correlated with grip and leg strength. And that leg strength was positively correlated with gait measures and negatively correlated with a history of falls. (Wee Ak. Serum folate predicts muscle strength: a pilot cross-sectional study of the association between serum vitamin levels and muscle strength and gait measures in patients >65 years old with diabetes mellitus in a primary care setting. Nutr J. 2016 Oct 18;15(1):89.)

Homocysteine Metabolism

Other Health Benefits

There are other conditions that folate may assist, although more research is needed and for some conditions results to date have been mixed. Those include:

  • Production of healthy red blood cells
  • Prevention of neural tube defects
  • Improving brain health
  • Improving age-related hearing loss
  • Protecting heart health

Best natural sources of folate

Best natural sources of folic acid are dark green vegetables and legumes. When cooking, make sure you don’t overcook, as it may cause the folic acid content to drop considerably.

 

Recommended Dietary Allowance (RDA)

The Food and Nutrition Board has developed a table of recommended dietary allowances (RDAs) of folate, based on age and gender. The values are:

Category RDA
0-6months 65 micrograms (mcg) per day
Alequate Intake(AI)
7-12 months> 80 mcg per day
Adequate Intake (AI)
1-3 years 150 mcg per day
4-8 years 200 mcg per day
9-13 years 300 mcg per day
14 years and up 400 mcg per day
Pregnant women 600 micrograms/day
Breastfeeding women 500 mcg per day

Precautions

Folate from natural foods is generally well tolerated. RDA amounts can be obtained from a balanced, healthful diet. 

The FNB has published an upper limit value of 1000 mcg /day. 

Excessive intake of supplemental folic acid may be associated with certain forms of cancer. Any consideration a supplementation should be discussed with a qualified health professional familiar with your unique medical history.

References

Salari P, Abdollahi M: Association of hyperhomocysteinemia with osteoporosis: a systematic review. Therapy 2008, 5(2):215–222.

Salari P, Abdollahi M: The role of platelets in bone remodeling. Inflamm Allergy Drug Target 2010, 9:393–399.

 

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