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Folates are an important part of our daily dietary requirements and its deficiency can be easily overlooked. To avoid this health issue and its consequences, take a look at the importance of this nutrient and how to make sure you are getting enough of it.

In order to keep our body in perfect conditions so that it endures everyday stress, we need to provide it with substances that are mainly obtained from the diet and that are key factors in several vital functions. Some of these substances are even a fundamental part of human development, participating in the formation of a human being, from the womb to adulthood. This is the case of folates, also referred to as folic acid.

Get some spinach, liver and folates!

Folates, a group of water-soluble B vitamins, are present mainly in legumes, leafy green vegetables, some fruits like oranges and liver. Yes, even when you didn't like it, your mom had a very good reason to give you liver for dinner, since it is a great source of not only folates but also iron.

If eating liver is really not your thing, you can also get the amount of folates that you need from avocado, spinach, kale, asparagus, Brussel sprouts, beans and peas, seafood, and some grains.

Why is it so important to include good sources of folate in your diet? Folate, and other vitamins can´t be synthesized by our cells, which is the reason why they need to get them from an external dietary source.

When we ingest foods rich in folates, these vitamins are absorbed in the small intestine and then, they are chemically modified by enzymes in order for our cells to be able to use them for certain functions.

Without these chemical modifications, even if we stuffed ourselves with spinach and Brussel sprouts, our cells would not be capable of using the folates present in the food we ate.

The function of folates in our cells

The main cell function in which folates participate is the synthesis of nucleotides. Nucleotides are like the building blocks that construct our DNA, which basically constitutes the only form in which our genetic information is stored and guarded. Folates also have an important role in the modification of DNA and the genetic expression. 

In other words, folates are needed to control which genes are expressed under a certain situation and which genes are switched off.

Nucleotide synthesis is necessary especially during cell replication and when the DNA needs to be repaired and nucleotides have to be replaced because of an unwanted chemical modification caused by, for example, UV rays.

Cell replication occurs in almost all our cells, but it varies depending on the tissue and in the developmental stage in which we are. 
For example, skin cells have to be replaced constantly, because they are exposed all the time to the environment, whereas bone cells proliferation rate is really high during childhood, while we grow and develop, but it slows down and eventually stops when we reach adulthood. This tells us then that our requirements of folic acid vary a lot, which is why in certain conditions, such as pregnancy, it is such an important dietary constituent and special care has to be taken to make sure that the person is getting the proper amount of folic acid. 

Folic Acid Deficiency And Its Consequences

During the embryonic and fetal development DNA synthesis is extremely important. A baby originates from the combination of two cells: the egg and the sperm. From this point on, cells start to proliferate and to form the baby´s organs and body. During this amazing process, DNA replicates at a very fast rate and so nucleotide synthesis has to be just as fast and also well controlled in order to avoid mistakes that could lead to malformations.

Folate requirements are then very high too, compared to the requirements of an adult, for example. A pregnant woman needs around 75% more folate than a woman that is not pregnant, which is why pregnant women are advised to consume folic acid supplements in order to make sure that they have the proper amount of folates that the baby needs.

Neural tube malformations

The most common problem that arises from folic acid deficiency during embryonic development is related to the formation of the neural tube. The neural tube in a normal baby gives rise to the brain and the spinal cord.

If the baby doesn't have the proper supply of folates and can't synthesize enough DNA, the neural tube development gets disrupted, causing what is known as a neural tube defect.

Years ago, this was a very common health problem, because women didn't have the proper folate intake during pregnancy. But current folic acid supplementation campaigns have managed to reduce the incidence of this disease. For example, fortification of flour with folic acid in the UK as well as a folic acid supplementation campaign introduced since 1995 in this country, has helped in the prevention of neural tube defects in babies.

It appears that folates have a very important role specifically in the development and maintenance of the nervous system.

Not only the neural tube defects have been related to folic acid deficiency, but also other neurological problems, such as depression and cognitive impairment in the elderly.

These health issues can be derived either from dietary folic acid deficiency or from an alteration on its metabolism as a result of a genetic mutation.

Other health issues related to folic acid

Our red blood cells are one of those types of cells that have to be replaced constantly. They are produced in the bone marrow and just as any other cells, they need folic acid in order to synthesize DNA and proliferate.

Folates deficiency can lead then to disruptions in the production of red blood cells and end up in anemia.

This health problem is characterized by the production of abnormally big red blood cells, known as megalocytes or megaloblasts, which can be detected in a blood sample. People with megaloblastic anemia, as it is known, are usually undernourished and not only lack of the proper folate intake but of all dietary nutrients in general.

Alcoholics, pregnant women and the elderly are the most vulnerable to folate deficiency.

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  • CZEIZEL, A. E., DUDAS, I., VERECZKEY, A. & BANHIDY, F. 2013. Folate deficiency and folic acid supplementation: the prevention of neural-tube defects and congenital heart defects. Nutrients, 5, 4760-75
  • MANTOVANI, E., FILIPPINI, F., BORTOLUS, R. & FRANCHI, M. 2014. Folic acid supplementation and preterm birth: results from observational studies. Biomed Res Int, 2014, 481914
  • NAZKI, F. H., SAMEER, A. S. & GANAIE, B. A. 2014. Folate: metabolism, genes, polymorphisms and the associated diseases. Gene, 533, 11-20
  • REYNOLDS, E. H. 2002. Benefits and risks of folic acid to the nervous system. J Neurol Neurosurg Psychiatry, 72, 567-71.Photo courtesy of Woodleywonderworks by Flickr: www.flickr.com/photos/wwworks/4633459332
  • Photo courtesy of FixersUK by Flickr: www.flickr.com/photos/fixersuk/10709402033

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