Folate (vitamin B9) is an essential nutrient for the functioning of our body, however, it is not synthesized by the human body and therefore must be obtained through diet and/or supplementation. The term folic acid (FA) is used to refer to the synthetic form produced in laboratories, found in vitamin supplements and fortified foods. When this form is ingested, it is metabolized and activated by the body, and this form is called methylfolate. Every woman who wants to have a child needs to pay extra attention to her diet and lifestyle. An adequate intake of folic acid during pregnancy is essential for the proper development of the fetus and can determine how the child’s metabolism and hormonal profile will function in the future. During pregnancy, the body requires a high concentration of this nutrient to generate the fetus, and as a result, the mother’s blood concentration of this vitamin decreases.
It is estimated that more than a third of women worldwide are deficient in folic acid, and this nutritional imbalance, especially during critical periods such as pregnancy, can predispose to diseases in adulthood.
Prenatal care should begin as soon as you want to become pregnant, and using a supplement of folic acid or methylfolate is one of them. This supplementation is recommended by medical societies around the world, as even with a balanced diet, the amount of folic acid is not enough to meet the increasing demands of pregnant women. Thus, having a good prenatal preparation with appropriate planning during pregnancy lowers the chances of a congenital anomaly in the baby.
- What is folate
- Methylfolate and folic acid: what are the differences
- Functions of methylfolate and folic acid
- Problems caused by insufficient intake
- Problems caused by excessive supplementation
What is folate
Folate is a very important nutrient for the development of the baby’s central nervous system, especially the brain and spinal cord. The lack of this nutrient can cause anemia in the mother, influence placental rupture, poor intrauterine growth, and premature birth. 
Methylfolate and folic acid: what are the differences
Both folic acid and methylfolate are derived from the same nutrient found in nature: folate, also known as vitamin B9. The term folate includes all forms of this vitamin. Folic acid is produced in laboratories, and when ingested it is converted by our body’s enzymes to its active form, called methylfolate, which performs essential functions in our body such as DNA formation and cell multiplication. So to summarize, folic acid is the synthetic form and methylfolate is the natural form, which is better absorbed because it is already in its active state.
Functions of methylfolate and folic acid
Although folic acid is widely distributed in foods, dietary intake of this nutrient is, in most cases, insufficient, especially in pregnancy, when nutritional needs increase. In general, this vitamin influences the growth of the uterus, the growth of the placenta and fetus, as well as the prevention of respiratory diseases in childhood and Down syndrome. It is also a vitamin vital for cell division and protein synthesis, playing a fundamental role in the baby’s growth process, especially in the central nervous system. Methylfolate is also an essential cofactor for the production of neurotransmitters such as: serotonin, dopamine, and norepinephrine. These neurotransmitters are responsible for regulating mood and, when at low levels, can contribute to depression in adults.
This nutrient is the main source of folate in the umbilical cord, indicating that when there is proper supplementation, it is immediately transported to the fetus.
Foods that contain folate
- Dark green vegetables, such as kale, spinach, broccoli, and asparagus.
- Animal organ meats.
- Citrus fruits.
- Grains and seeds.
- Avocado.
- Nuts and chestnuts.
- Legumes (chickpeas, peanuts, lentils, peas).
- Corn.
- Orange.
- Closure of the child’s neural tube;
- Better future learning;
- Protection against harmful effects triggered by other nutritional disorders, such as malnutrition;
- Reduces the risk of genetic changes in the fetus’s liver;
- Improved immune system.
Which is more efficient: folic acid or methylfolate? When ingested in its active form, methylfolate has a 26% higher absorption rate compared to folic acid; moreover, this form reduces the likelihood of interactions with medications that would decrease the absorption of the nutrient. In order to reduce problems caused by folic acid deficiency in pregnant women, the National Health Surveillance Agency (ANVISA) has made it mandatory in Brazil to fortify wheat and corn flours with iron and folic acid, which are about 35% to 100% more likely to be absorbed.
Problems caused by insufficient intake
Methylfolate deficiency is associated with the following conditions:
- Hypertensive disorders of pregnancy,
- recurrent spontaneous miscarriages,
- premature births,
- low birth weight,
- chronic cardiovascular and cerebrovascular diseases,
- dementia,
- and depression.
Congenital conditions can also occur as a result of improper or incomplete closure of the neural tube between the third and fourth week of embryonic development, such as anencephaly, encephalocele, and spina bifida. Concerning folic acid, other factors such as genetic disorders, smoking, chronic use of oral hormonal contraceptives, diabetes, and use of anticonvulsant medications may also be strongly associated with a decreased blood concentration of this nutrient. Studies have found that lack of knowledge about supplementation at the right time during pregnancy can also be significant.
Problems caused by excessive supplementation
Consuming a diet high in folic acid at other periods in life, besides pregnancy, can alter fat metabolism and end up causing liver damage. Furthermore, excess folic acid disrupts the relationship with vitamin B12 and stimulates a high incidence of colon and rectal cancer in those women. It has also been associated with a slight increase in the risk of early respiratory infections in newborns, especially in the first trimester. To conclude, if you are trying to conceive or are already pregnant, make sure you contact your doctor, who will assess your needs and indicate the most appropriate supplementation.
