Folate is a B-vitamin that enables the body to make genetic material and divide cells. Folate occurs naturally in many foods such as beef liver; vegetables such as asparagus, Brussels sprouts, and dark leafy greens; fruit such as oranges; nuts; and legumes. The synthetic form of folate, called folic acid, is added to fortify foods such as enriched grains like flour, corn meal, pasta, cereals, and rice. Folic acid is also found in most dietary supplements such as multivitamins and prenatal vitamins.
The quantity of folate needed depends on an individual’s age. Recommended amounts are listed in micrograms (mcg) or dietary folate equivalents (DFEs). DFEs are used because most individuals absorb more folic acid from fortified foods and supplements than the folate that occurs naturally in foods. As a result, people need less folic acid than folate to reach the recommended amounts. 400mcg of folate and 240mcg of folic acid are both equivalent to 400 mcg DFE.
In supplements, folate can be found in two forms: folic acid and methylfolate (5-methyl-THF). Due to absorption issues, methylfolate is recommended over folic acid for people with celiac disease, inflammatory bowel disease, and the methylenetetrahydrofolate reductase (MTHFR) gene mutation.
Folate is critical in the prevention of neural tube defects, congenital heart defects, premature birth, and low birth weight. All females of childbearing age should consume 400mcg of folate daily, either through diet or fortified foods and supplements, as an estimated half of all pregnancies are unplanned. Consuming 400mcg of folate daily for three months prior to conception shows a 70% to 80% reduction in risk for open neural tube defects.
For women who have had a prior pregnancy affected by neural tube defects, a higher daily dose of 4 milligrams (mg) of folic acid is recommended starting at least four weeks prior to the conception of a subsequent pregnancy. [27]