What is the role of Vitamin B9 or Folate in Systemic health?
The role of folate or vitamin B9 is of utmost importance in the field of nutrition as well as in reproductive biology as it has many beneficial effects in the dynamic phases of pregnancy and in the postpartum period as well. Folate is the natural form of vitamin B9, water-soluble, and naturally found in many foods. The upper limit for adults for folic acid either from fortified food or from supplements (not including the dietary folate from food) should not exceed 1000 mcg per day.
The term folate is rather a generic name that refers to the group of chemically related compounds based on the structure of the element folic acid. Folate, or vitamin B9, is recognized by nutrition experts as one of the 13 essential vitamins that cannot be synthesized by the body, and must either be obtained from dietary sources or through folate supplementation.
Folate helps in our bodily metabolism in the formation of both DNA (Deoxy ribo nucleic acid) and RNA (Ribonucleic acid) apart from being involved in protein metabolism pathways. It plays a key role in the breakdown of amino acid homocysteine which can otherwise be capable of exerting harmful effects in the body if circulated in high amounts. Folate is also needed in the production of healthy erythrocytes or red blood cells.
Folate, especially in children and young adults, benefits systemic health. However, the effects of folate are researched more in pregnancy owing to its potential for aiding healthy fetal development during pregnancy. Common folate-rich foods in the diet include legumes, beans, broccoli, shellfish, peanuts, spinach, asparagus, fortified foods, folic acid supplements, sunflower seeds, fresh fruits, fruit juices, whole grains, and eggs.
How Is the Active Form of Folic Acid Synthesized in the Body?
It is essential to know that neither folate nor folic acid is actually metabolically active. L-methyl folate is known as the predominant micronutrient of folate, one can obtain through diet or through supplements that circulate in plasma and which get involved in all biological processes of the body. To firstly be metabolically active, folic acid is primarily converted after consumption to dihydrofolate (DHF) and then tetrahydrofolate (THF) through a process known as enzymatic reduction. Eventually, this process is further catalyzed by the enzyme DHF reductase (DHFR). THF is thus converted to the biologically active form of folate or folic acid.
What Are the Dietary Recommendations?
The supplementation with folic acid either for pregnant individuals or for individuals planning to be pregnant is linked with the reduced risk of infants or offspring developing NTD (neural tube defects). Additional measures have also been adopted in many countries with the United States making fortified grain products (with folate) mandatory since January, 1998.
In many countries, multivitamin supplementation with folate and general fortification of grain-based products with folate (flour, cereal, and pasta) has been done over the last two decades to increase the red blood cell concentration or erythrocyte concentration in women (on a community level ) of child bearing age.
Prior to conception and during the phase of pregnancy as well, as per recommendation by the US National Institutes of Health (NIH) and Institute of Medicine (IOM), 600 micrograms of folic acid is ideal for consumption daily by pregnant women to reduce the risk of fetal NTDs. This supplementation can be reduced to 500 micrograms during the phase of breastfeeding or lactation.
What Is the Current Research on Folate Requirement During Pregnancy?
Folate ( vitamin B9) cannot usually be synthesized by the body and hence one should be dependent on dietary sources or dietary supplements for folate supply. It is indeed common for pregnant women to regularly consume folic acid supplements on a daily basis as recommended by their healthcare provider gynecologist or physician. This is because the recommended daily intake of folic acid or folate increases during pregnancy which is a dynamic phase that requires more nutrition to meet the growing metabolic demands of the body. As it is difficult to get the right amounts of daily folate from a diet like the regular consumption of green leafy veggies, it is essential to take folic acid supplement to meet the nutritional needs. Nutritionists, physicians, obstetricians, or gynecologists also recommend higher doses of folic acid supplementation in pregnancies that have an increased risk of developing congenital heart diseases, neural tube defects, birth defects, and even the possibility of preterm birth. Increased folate levels in the mother's bloodstream are directly associated with a nearly 28% decrease in the risk of preterm birth. Blood folate levels, as well as plasma or red blood cell (RBC) folate levels, are reliable indicators of folate status during pregnancy. Monitoring these levels is beneficial for ensuring the birth of a healthy child during this phase.
It is generally recommended that women of age past 19 years, men and older people should ideally aim for a 400 to 500 micrograms daily intake of folate. As folate absorption is impaired in alcoholics, they should consume even more amounts of folate up to 600 mcg per day.
Conclusion
Folate is an essential vitamin needed to ensure healthy fetal growth and infant birth. Due to the higher risk in the last few decades associated with an increase in preterm birth, in infants developing birth defects or fetal neural tube defects, folate is generally recommended by gynecologists as well as nutritionists across the globe, both prior to conception, during pregnancy and also in the postpartum phase of the woman. One can consult or talk with a registered healthcare provider to know the specific requirement of folate.
