Folate vs. Folic Acid for Pregnancy: What you need to know

“Make sure you have enough folic acid for pregnancy.” This is pretty standard advice these days with doctors recommending all women of child bearing age to get enough folic acid in their diet since it’s important even before conception. For any woman trying to get pregnant, the thought of neural tube defects (NTD) is enough motivation to be super diligent about taking prenatal supplements with plenty of folic acid.

But do you know the difference between folate and folic acid? The words ‘folate’ and ‘folic acid’ are often used interchangeably but there are important differences between them.

Folate vs. Folic Acid

Folate is the naturally-occurring form of the vitamin. It’s found in foods like liver, spinach, lentils, and garbanzo beans.

Folic acid is the synthetic form of the vitamin that is used in most supplements and in fortified foods. (Think “enriched.”)

Here’s the technical nitty gritty: Folate is a general term for a group of water soluble b-vitamins, and is also known as B9. Folic acid refers to the oxidized synthetic compound used in dietary supplements and food fortification, whereas folate refers to the various tetrahydrofolate derivatives naturally found in food.

Now, if you’re familiar with my ideas on health you can probably guess where this is headed, right? My journey toward real health has been about getting back to basics… back to nature. It’s about living a more real life and a less synthetic one. That’s not to say that I don’t think there are instances where our modern world (including the technology, practices, or synthetic approaches to health) aren’t necessary, but I prefer to use them as a last resort.

That’s why I think folate is more important than folic acid for pregnancy.

Folate Vs. Folic Acid for Pregnancy: Which is better?

Many processed foods like cereals are fortified with folic acid. This mandatory food fortification came about in 1998 with the overwhelming evidence that folic acid before conception and during early pregnancy helped protect newborns for neural tube defects.

But here’s the thing: Several studies have reported the presence of unmetabolized folic acid in the blood following the consumption of folic acid supplements or fortified foods. In fact, human exposure to folic acid was non-existent until it was chemically synthesized in the 1940’s. (source)

So why the unnatural levels of unmetabolized folic acid? According to Chris Kresser:

The form of folate that can enter the main folate metabolic cycle is tetrahydrofolate (THF). Unlike natural folates, which are metabolized to THF in the mucosa of the small intestine, folic acid undergoes initial reduction and methylation in the liver, where conversion to the THF form requires dihydrofolate reductase. The low activity of this enzyme in the human liver, combined with a high intake of folic acid, may result in unnatural levels of unmetabolized folic acid entering the systemic circulation.

So what does this excessive folic acid lead to?

While there is still plenty of research to be done on the subject, researchers have hypothesized that this excessive amount of folic acid may be directly related to the increase in cancer rates (source).  There is especially concern for men and older women who may have excessive amounts of folic acid.

That’s not to say that we should ignore the doctor’s recommendations for folic acid for pregnancy… or should I say folate for pregnancy. Despite the risks associated with high levels of folic acid intake, having adequate folate in your diet is essential. That’s why it is important to know the difference between folate and it’s synthetic counterpart.

Folate is important to your health because it:

• Aids the complete development of red blood cells
• Supports the nervous system
• Prevents neural tube defects in newborns

So instead of folic acid for pregnancy, look for folate… the honest-to-goodness natural vitamins found in real food. Once again, nature trumps man. Way to go nature!

Best food sources for folate

Not sure where to get folate? The best way is to eat a variety of foods… real food. Here are 10 good sources of natural folate:

1. 1/4 cup peanuts: 207 mcg
2. 3 oz. beef liver: 185 mcg
3. 1/2 cup garbanzo beans: 134 mcg
4. 1 cup navy beans: 129 mcg
5. 1/2 cup pinto beans: 117 mcg
6. 1/2 cup lentils, split peas, black beans, or kidney beans: 114 mcg
7. 1/2 cup black-eyed peas: 105 mcg
8. 1/2 cup cooked spinach: 100 mcg
9. 1/2 cup corn: 88 mcg
10. 4 spears of asparagus: 85 mcg

But keep in mind:

Even though folate is the natural form of the vitamin, folic acid is actually better absorbed by the body. This is why it’s important to ensure you’re eating the right foods, and plenty of them. This is especially true if you are planning to get (or already are) pregnant.

And while there are mixed opinions on the use of supplements, I personally think it’s a good idea to have quality supplements on hand. Just keep in mind that they should be supplemental... not substitutes for a real foods diet.

What to look for in a supplement

Avoid products that say “folic acid” on the label. Most health food stores will have quality brands of prenatal and multi-vitamins that have folate instead of folic acid. If choosing to supplement look for organic to avoid GMOs. If you take a multi-vitamin make sure to check the label because most multi-viatmins contain folic acid and not folate.

How much folate should I take?

Women planning on becoming pregnant should consume between 800 and 1200 mcg of folate per day for several months before the start of pregnancy. Unless you’re consuming chicken or beef liver and substantial amounts of leafy greens on a regular basis, it’s difficult to obtain this amount from diet alone (just another reason to start eating your liver!).

If you’re pregnant or trying to get pregnant, you may want to supplement with 600-800 mcg of folate per day, depending on your dietary intake. Keep in mind that the recommendations for folate is more than folic acid since it’s not as easily absorbed.

All other people, such as men and older women, should be able to get plenty of folate in a diet with adequate vegetable consumption, and do not need to supplement.

So… folic acid for pregnancy? Or Folate? What do you think?

Additional Sources:
http://www.webmd.com/baby/folic-acid-and-pregnancy
http://nutritionovereasy.com/2011/01/folate-vs-folic-acid-whats-the-difference/
http://chriskresser.com/folate-vs-folic-acid
http://www.fitsugar.com/10-Sources-Folate-2944377
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=1343280

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