Folate is a water soluble B vitamin (B9) that is naturally found in food.

Folic acid is the synthetic form of folate found in supplements and fortified foods.

Folate plays a vital role in good health.

• It helps make normal red blood cells and aids in preventing anemia in both adults as well as children.
  
• Is vital for production and maintenance of new cells and necessary to make DNA and RNA.
  
• Is essential for the metabolism of homocysteine and maintaining normal levels of amino acids in the body.

Because this nutrient is so important, in 1996 the FDA regulated the addition of folic acid to enriched breads, cereals, flour, corn meals, pastas, rice and other grain products. Because cereals and grains are widely consumed in the U.S., they are leading contributors of folic acid to the American diet.

The RDA for folate is expressed as Dietary Folate Equivalent or DFE. The DFE takes into account the differences in absorption of the naturally occurring dietary folate and the more bioavailable synthetic folic acid. The RDA is expressed as micrograms (ug) of DFE and 1 DFE = 1 ug food folate = 0.6 ug folic acid from supplements and fortified foods. The RDA for folate for adults is 400 ug/day for both males and females with an increase for woman who are of child bearing age to a minimum of 600 ug/day.

Why the education on folate?

Folic acid fortification has been a great public health success along with heightened education campaigns. Since cereal and grain fortification began over a decade ago, neural tube defect (NTD) birth defects, most commonly spina bifida and anencephaly, have seen a dramatic decrease. Likewise, a recent study from Quebec indicates a 6 percent decrease in heart defects since fortification started in Canada. However, for all the good the increase in folic acid fortification has done to improve the rate of birth defects when adequately received in woman of child bearing age, new studies are suggesting that too much folic acid for other demographics might actually be fueling certain types of cancer.

Health experts agree that too little folate or folic acid for certain populations is not good. Likewise, too much folate or folic acid for other populations may not be either. But knowing how much is enough for a diverse population is tough to answer. With folic acid readily available in cereals, breads, snack bars, and multivitamins, the risk of getting too much folic acid is high. There is little risk of getting too much folate from foods such as leafy greens, orange juice, legumes and lentils, but there is a more significant risk of getting too much folic acid from fortified sources and supplements. Studies show that not only can too much folic acid delay the detection of vitamin B12 deficiency, it can also fuel certain types of cancer especially in men related to colorectal and prostate cancer.

So how much is enough with out being too much? The Institute of Medicine's Food and Nutrition Board recommends an upper limit of 1 milligram/1,000 micrograms per day for folic acid and folate combined. Since enzymes in the intestine convert folic acid to usable folate, the body is limited by how much synthetic folic acid the body can process, so excess gets dumped into the blood stream. Because it takes more for the body to absorb folate compared to folic acid, you absorb higher amounts of folic acid from fortified foods and supplements than you would from whole food sources with equivalent folate.

The bottom line - Eating a balanced diet rich in natural sources of folate such as beans, lentils, orange juice and leafy greens is recommended. Being aware of the folic acid content of vitamins and supplements and your overall folic acid intake from those and other fortified and enriched foods is a good idea. If you are of child bearing age, it is important to have at least 600 ug/day so you are in good nutritional health related folic acid should you become pregnant. Care should be taken from everyone to ensure an intake of less than 1 milligram/1,000 micrograms each day unless otherwise prescribed by your medical provider.

Have you ever thought about getting too much folic acid? Will you do a folic acid check up for your supplements and vitamins ?