Folinic Acid is not folic acid

Folinic acid (an active form of folate) has many important roles in human health including:

- making DNA

- forming red blood cells

- growth and repair of cells and tissues. (1)

Folate Deficiency

Isolated folate deficiency is rare, usually presenting alongside other nutrient deficiencies due to malnutrition, alcoholism, or a malabsorption issue. (2) A deficiency in folate can interfere with the synthesis of nucleic acids and the metabolism of amino acids, and may lead to megaloblastic anemia. (2)

Symptoms of megaloblastic anemia include:

路聽聽聽聽聽 Weakness

路聽聽聽聽聽 Fatigue

路聽聽聽聽聽 Difficulty concentrating

路聽聽聽聽聽 Irritability

路聽聽聽聽聽 Headache

路聽聽聽聽聽 Heart palpitations

路聽聽聽聽聽 Shortness of breath (2)

Folate deficiency may also cause:

路聽聽聽聽聽 Sore, shallow ulcerations on the tongue and oral mucosa

路聽聽聽聽聽 Changes in skin, hair, or fingernail pigmentations

路聽聽聽聽聽 Gastrointestinal symptoms

路聽聽聽聽聽 Elevated blood concentrations of homocysteine

路聽聽聽聽聽 Neural tube defects in the children of folate deficient women. (2)

Foods Naturally Containing Folate

Folate is naturally present in many foods including vegetables (especially leafy greens), meat, poultry, seafood, fruits, nuts, beans, peas, eggs, and grains. Foods with the highest amount of folate are spinach, liver, asparagus, and brussels sprouts. (2) Considering that only approximately 7% of adults and 5% of children eat enough vegetables, it is reasonable to be concerned about inadequate folate intake from unfortified foods. (3)

Folate and Fortification

In Australia, it is mandatory for folate to be added to all flour used to make bread. One exemption from this rule is for organic flours and breads, which do not require fortification. (1) Eating only organic bread may increase the risk for folate deficiency and increase associated health risks. (4)

Gluten Free Diet and Folate Deficiency

Eliminating foods containing gluten also increases the risk of folate deficiency due a reduction in folate-fortified flour. (4) The popularity of gluten-free diets is growing in Australia, and it is estimated that between 10-20% of Australians eat gluten-free foods. (4) There is currently insufficient evidence to recommend gluten-free diets for reducing behavioural issues in children, however, the rising prevalence of unqualified nutrition advisers on social media tend towards these types of elimination diets to treat behavioural disorders. This may lead many children diagnosed with behavioural problems to be put on a gluten-free diet at some point in time, increasing the risk of folate deficiency. 聽

Folate Supplementation

Folate supplementation is recommended to all women trying to conceive due to its importance in the prevention of neural tube defects in the baby. (2) There is also some evidence to suggest that folate supplementation may be beneficial for improving symptoms of depression and autism spectrum disorder. (2)

References

1. Department of Health. Folate. Department of Health [Internet]. 2010 [cited February 24 2020]. Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-folate-index.htm

2. National Institutes of Health. Folate Fact Sheet for Health Professionals [Internet]. 2020 [cited July 7 2020]. Available from: https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/

3. Australian Institute of Health and Welfare. Australia鈥檚 health 2018 [Internet]. 2018 [cited July 7 2020]. Available from: https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/indicators-of-australias-health/fruit-and-vegetable-intake

4. Cruchet S, Lucero Y, Cornejo V. Truths, Myths and Needs of Special Diets: Attention-Deficit/Hyperactivity Disorder, Autism, Non-Celiac Gluten Sensitivity, and Vegetarianism. Annals of nutrition & metabolism. 2016;68 Suppl 1:43-50.

Written By聽Brittany Darling

NUTRITIONIST (BHSC), WESTERN HERBAL MEDICINE (ADV DIP),

CERT. PAEDIATRIC NUTRITION

Brittany Darling
Tags: Folate