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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Folic acid in diet

Folic acid; Polyglutamyl folacin; Pteroylmonoglutamate; Folate

Last reviewed: February 18, 2013.

Folic acid is a type of B vitamin. It is the man-made (synthetic) form of folate that is found in supplements and added to fortified foods.

Folate is a generic term for both naturally occurring folate found in foods and folic acid.

Folic acid is water-soluble. Water-soluble vitamins dissolve in water. Leftover amounts of the vitamin leave the body through the urine. That means your body does not store folic acid and you need a continuous supply of the vitamin in the foods you eat.

Function

Folate helps tissues grow and cells work. Taking the right amount of folic acid before and during pregnancy helps prevent certain birth defects, including spina bifida. Folate also helps prevent anemia.

 Folate deficiency may cause:

It may also lead to certain types of anemias.

Folate works along with vitamin B12 and vitamin C to help the body break down, use, and create new proteins. The vitamin helps form red blood cells and produce DNA, the building block of the human body, which carries genetic information.

Folic acid supplements may also be used to treat folic acid deficiency, certain menstrual problems, and leg ulcers.

Food Sources

Folate occurs naturally in the following foods:

  • Dark green leafy vegetables
  • Dried beans and peas (legumes)
  • Citrus fruits and juices

Fortified means that vitamins have been added to the food. Many foods are now fortified with folic acid, including enriched breads, cereals, flours, cornmeals, pastas, rice, and other grain products.

Side Effects

Too much folic acid usually doesn't cause harm, because the vitamin is regularly removed from the body through urine.

Recommendations

The best way to get the daily requirement of essential vitamins is to eat a wide variety of foods. Most people in the United States get enough folic acid in their diet because it is plentiful in the food supply.

There is good evidence that folic acid can help reduce the risk of certain birth defects (spina bifida and anencephaly). Women who are pregnant or planning to become pregnant should take at least 400 micrograms (mcg) of a folic acid supplement every day. Pregnant women need even higher levels of folic acid. Ask your health care provider which amount is best for you.

The Recommended Dietary Allowance (RDA) for vitamins reflects how much of each vitamin most people should get each day.

  • The RDA for vitamins may be used as goals for each person.
  • How much of each vitamin you need depends on your age and gender. Other factors, such as pregnancy and illnesses, are also important.

The Food and Nutrition Board of the Institute of Medicine Recommended Intakes for Individuals - Daily Reference Intakes (DRIs) for folate:

Infants

  • 0 - 6 months: 65 mcg/day*
  • 7 - 12 months: 80 mcg/day*

*For infants from birth to 12 months, the Food and Nutrition Board established an Acceptable Intake (AI) for folate that is equivalent to the mean intake of folate in healthy, breastfed infants in the United States.

Children

  • 1 - 3 years: 150 mcg/day
  • 4 - 8 years: 200 mcg/day
  • 9 - 13 years: 300 mcg/day

Adolescents and Adults

  • Males age 14 and older: 400 mcg/day
  • Females age 14 and older: 400 mcg/day 
  • Pregnant teens 14-18 years: 600 mcg/day
  • Pregnant females 19 and older: 500 mcg/day
  • Breastfeeding females 14-18 years: 600 mcg/day
  • Breastfeeding females 19 and older: 500 mcg/day

References

  1. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, PantothenicAcid, Biotin, and Choline. National Academy Press, Washington, DC, 1998. [PubMed: 23193625]
  2. Escott-Stump S, ed. Nutrition and Diagnosis-Related Care. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2008.
  3. Sarubin Fragaakis A, Thomson C. The Health Professional's Guide to Popular Dietary Supplements. 3rd ed. Chicago, IL: American Dietetic Association; 2007.
  4. Suren P, et al. Association Between Maternal Use of Folic Acid Supplements and Risk of Autism Spectrum Disorders in Children. JAMA. 2013: Vol. 309; pp 570-577. [PMC free article: PMC3908544] [PubMed: 23403681]

Review Date: 2/18/2013.

Reviewed by: Alison Evert, MS, RD, CDE, Nutritionist, University of Washington Medical Center Diabetes Care Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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  • Folic acid supplementation in pregnancy
    Folate is a naturally occurring vitamin while folic aid is the synthetic replacement of folate used in most supplements and in fortified foods. Folate is essential as its deficiency can be caused by poor dietary intake, genetic factors or the interaction between genetic factors and the environment. Women with sickle cell disease and those women in areas where malaria is endemic have a greater need for folate and in these areas anaemia can be a major health problem during pregnancy. Women need more folate in pregnancy to meet their need for extra blood and to meet the growing baby's need for blood. Without adequate folate intake in a mother's diet, she can become anaemic and this can contribute to her baby being small, anaemic and born too early (preterm birth). Folic acid supplementation taken before conception can reduce the chance of the baby having neural tube defects. This review looked to see if taking folic acid supplements during pregnancy could reduce the chance of the baby being born too early and of low birthweight and to see its impact on the mother’s blood (hematological values), folate levels and on pregnancy complications.
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