Introduction
Folate is a naturally occurring vitamin that is part of the B complex group of vitamins. Folate, a water-soluble vitamin is converted to various active forms in the body. Folate is a general name used to refer to folic acid or folacin. Folate is a core vitamin that is required in synthesis of DNA and RNA, which are essential components for every living cell. For this reason, folate is paramount to normal cellular processes. Folate acts by donating a methyl group in various cellular reactions (Meshkin and Kenneth 56).
Importance of Folate
Extensive research has clearly demonstrated the importance of folate in many body processes. Folate plays a role in metabolism of several amino acids. Pregnant mothers due to increased demand require folate in amounts larger than normally needed. The demand is high because of rapidly developing fetal cells that require folate for the synthesis of nucleic acids such as DNA and RNA. The demand is so high that the pregnant mother’s body cannot keep up with it and as such prenatal or even preconception folate supplementation is needed for proper development of all fetal organs. Deficiency of folate especially in expectant mothers results in disabling neural tube defects.
Several studies have been carried out to asses the link between folate and prevention of some heart related conditions such as coronary heart disease. Folate is known to reduce blood levels of the amino acid homocysteine. Evidence from research has shown that elevated homocysteine is a core risk factor for cardiac disease. It is clear that high levels of homocysteine result in direct damage to coronary blood vessels, a risk factor for coronary cardiac disease.
For this reason, some researchers have advocated for the use of folate supplementation in those patients at risk since folate reduces levels of homocysteine. Despite this, there is little current evidence to show that use of folate in such cases is of any value. Because of this, the use of folate in prevention of coronary heart diseases is still controversial (Webb, Ellie, Frances, and Eleanor 34).
The role of folate in cancer prevention is a controversial one. Some studies show that folate supplementation result in decreased incidences of some specific forms of cancer such as breast and colorectal cancers. This is linked to the role of folate in synthesis of DNA precursor molecules namely purines. These nucleotides are essential in DNA repair and synthesis, two processes that may result in cancer. Furthermore, folate decreases levels of the compound S-Adenosyl Methionine (SAM), a methyl donor in cellular processes such as nucleic acid synthesis.
Its been demonstrated that increased DNA methylation results in some forms of cancer and as such inhibition of this process through folate suppression of SAM production may be of value in prevention of cancer. On the contrary, it has been demonstrated that high amounts of folate may be a risk factor in itself in promotion of cancer. As such, the role of folate in cancer is a series of complex mechanism that need further research before any concrete recommendations can be made.
The importance of folate has been demonstrated in many situations. Studies show that folate may play a role in prevention of obesity and type 2 diabetes mellitus. This is linked to the ability of folate to initiate lipolysis and increased conversion of excess cholesterol into bile acids for excretion. Other studies have elicited the role of folate in prevention of a myriad of medical conditions such as depression, nephritis and some infectious disease such as malaria (Webb, Ellie, Frances, and Eleanor 38).
Folate deficiency
Since folate is a water-soluble vitamin, its storage in the body is impossible. For this reason, the body needs to acquire folate from external sources and failure of this result in deficiency. Deficiency of folate may be because of drugs collectively known as antifolates. Such drugs include methotrexate and phenytoin. Deficiency may be because of disease conditions especially gastrointestinal ailments that result in decrease absorption of folate. Furthermore, poor diet, excessive alcohol consumption, and increased demand especially in expectant mothers are major causes of folate deficiency. Birth defects especially neural tube defects (NTD) are the most common consequences of folate deficiency. Extensive research has clearly linked the deficiency of folate to NTDs such as spina bifida and ancephal (Meshkin and Kenneth 59).
Because of this, it is a requirement in many countries for expectant mothers to be put on a daily folate supplementation program of 5mg of folate daily. Other conditions linked to folate deficiency include, diarrhea, depression and anemia. Diarrhea is a result of failure of regeneration of the rapidly dividing cells that line the gastrointestinal tract resulting in malfunctioning of these cells. On the other hand anemia is as a result of failure of the red blood cells to fully develop due to decreased levels of nucleic acids. This type of anemia has been termed folate deficiency anemia and is characterized by enlarged red blood cells (Meshkin and Kenneth 60).
Food sources of folate
Green vegetables have been shown to be rich in folate. These include spinach, cabbage, and tomatoes. Other sources include whole grain, some fruits, and liver. Amount of folate is measured in special modified units that incorporate both food and microorganism derived folate. This unit is called the Dietary Folate Equivalent (DFE). DFE units are expressed in µg/100g.
Importance of folic acid supplementation
Folic acid supplementation is essential since folate is a water-soluble vitamin that cannot be stored by the body. Therefore, in cases where demand overrides dietary supply, supplementation is needed. Such scenarios include increased demand in expectant mothers, in patients on anti-folates and in some disease conditions such as liver disease and crohn’s disease.
Realization of importance of folate has led to many countries fortifying foods considered to be consumed by most of the population with folic acid to ensure no one is at risk of folate deficiency. In the United States, fortification of flour is a common practice that is required by law. Other fortified foods include dairy products, sweets, baked foods such as biscuits, salt and non-alcoholic beverages such as soft drinks and cocoa.
Difference between folate and folic acid
Folic acid is the natural form that is present in foods while folate is the synthetic form that is found in most fortified foods. The two have different bioavailabilities with folic acid being more available and better tolerated by the body as compared to folate.
Daily requirements
The body requires about of folate 400-µg everyday with expectant mothers requiring more folate than other members of the population do. Increased demand that necessitates increased supplementation occurs in patients on antifolates or those at risk of infection.
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Works Cited
Meshkin, Brian, and Kenneth, Blum. Folate nutrigenetics: A convergence of dietary folate metabolism, folic acid supplementation, and folate antagonist pharmacogenetics. Drug Metabolism Letters, 1(2007): 55-60.
Webb, Frances V., Ellie, Whitney Y., Frances, Sizer, and Eleanor, Whitney. Nutrition concepts & Controversies, 12th ed. Stamford, CT: Cengage Learning, 2008.