All about folic acid...

If you are an adult woman, you are probably aware that folic acid is a critical nutrient for you to consume at all times in your diets. This is because folic acid prevents neural tube (brain and spinal) defects in babies but needs to be consumed before as well as in early pregnancy, often before a woman knows that she is even pregnant (see the HERE). But there is a lot more that this B vitamin does in your body and it is critical for the diets of both men and women. Today I am writing about the many hats of folic acid.

Reduction in Neural Tube Defects

This is probably the most familiar reason to increase your intake of folic acid because of the various ad campaigns which have surrounded it. Neural tube defects include defects in the formation of the brain and spine which are formed early in pregnancy, the bulk of the work happening before a woman may be aware that she is is building a little one. The most common neural tube defects include spina bifida, hydrocephalus and anecephaly.

• Spina  bifida is a condition where the spinal column (the neural tube) does not close properly in the first month of pregnancy and results in paralysis and at times excessive fluid on the brain, see HERE. Once the damaged has occurred it must be addressed with physical therapy, leg braces and at times surgery, depending on the severity.
• Hydrocephalus is a condition where there is too much fluid on the brain which causes pressure on the brain. This pressure can then cause brain damage and death if it is not treated, see HERE.
• Anecephaly is a condition which occurs when the upper portion of the neural tube, which becomes the brain, does not develop properly, see HERE. This can result in in an absence of the skull or of large portions of the brain as well as facial abnormalities. Since there is no therapy or treatment, so sadly this condition results in death.

We all love our children and want what is best for them so it is important to remember that not all neural tube defects are caused by folic acid deficiency. Genetics and toxic load also play an important part. Maintaining a consistent and appropriate level of folic acid in the diet is critical for all women during their child bearing years, even if they are not planning a pregnancy. Being mindful of the risks of certain anti-seizure medications (see HERE) as well as exposure to toxins are steps you can take to protect unborn children. Check out the Healthy Child, Healthy World campaign for more information, advice and tips on reducing exposure in your and your children, see HERE.

Reducing the Risk of Stroke and Cardiovascular Disease

Most people are not aware of the role of folic acid in maintaining cardiovascular health but it is the mechanism for lowering homocysteine levels in the blood. Homocysteine is an amino acid that is present in your blood and high levels are associated with an increased risk of heart disease, stroke, blood clots and Alzheimer's Disease. The body has a complicated process to moderate the amounts of homocysteine and methionine in the blood in order to avoid toxic levels and this process depends on an adequate availability of folic acid. There are some people who have a genetic condition which increases their need for folate because of they have trouble absorbing folic acid. This is causes by  a  genetic condition known by the abbreviation MTHFR. MTHFR stands for methylenetetrahydrofolate reductase, and   there are more than a few different mutations which result in different risks and complications, see HERE. Not all people with a mutation have a problematic one and those who have only a single copy of the gene have a much reduced risk of problems. Usually there is no need to be tested for MTHFR if you have no family history of premature cardiovascular problems (like in the twenties) or of stroke and blood clots.

When one of my children had a stroke at twelve months, we all were tested and all the children born since. It turns out my father and I each have one copy of a specific MTHFR mutation and two of my children have two copies. My father and I are fortunate that for the most part we can ameliorate our risks with increased intake of folate or folic acid.

Preventing Folate Deficiency Anemia

There are some types of anemia (insufficient red blood cells) which are actually caused by a deficiency in this B vitamin, see HERE. You may also see the term "folic acid deficiency anemia" because folic acid is the man made form of folate and a deficiency in either form can result in this time of anemia. Folic acid  is  part of the complicated process of producing red and white blood cells in your bone marrow and a lack of this vitamin can interrupt this process leaving you with too few red blood cells which makes you anemic, see HERE. There are a couple of causes of deficiency. One of the most common is during pregnancy, the need for folic acid increases and can leave women with too little for their own needs if they are not eating enough foods rich in natural folate and do not compensate with a supplement. Some people are chronically low in their intake no matter what their needs are and this can contribute to anemia, see the section on cardiovascular health above.

Folate, the Natural Source of Folic Acid

As is the case with many vitamins, there is a natural source and one which is man made. Folate is the natural source of this B vitamin and there are many foods which are good sources of it. Federal law mandates that flour sold in stores is supplemented with it as are many baked goods and cereals and while you often see these foods listed as being good sources of folate, it is really that they are good sources of folic acid because of supplementation. Foods rich in natural folate include the following (source):

• organ meats, like chicken and beef livers (see HERE ideas for incorporating more liver in your diet)
• dark leafy greens, but remember to cook them to reduce goitrogens (see HERE)
• sunflower seeds
• beans including garbanzos, limas and kidneys (remember to soak to reduce phytic acid, see HERE)
• asparagus

How B Vitamins Work Synergistically

Folate, B6 and B12 work together in the body and to some degree can stand in for each other in metabolic processes. This is how vegans can limp along with very low levels of B12 for a long time so long as they get sufficient amounts of folate or folic acid in their diets (learn more about B12 ). The elderly are known for hidden deficiencies in B12, see HERE, but this same risk can apply to anyone who eats a diet high in processed grain foods and low in vegetables and organ meats. If you are unfamiliar with the role of B12 in the body, and that real B12 is only found in animal foods, read my post HERE. So while you are in the process of increasing your folate intake, you should probably increase your intake of B12 foods (see that post for lists of good sources) as well as B6 foods. The following are good sources of B6 (source:

• tuna
• turkey
• venison
• potatoes
• cod, halibut
• spinach (remember to cook it, as mentioned above)
• bananas

While I am mentioning all the important sources of these B vitamins, Kimi at The Nourishing Gourmet has a fantastic printout listing all of these as well as good sources for other important nutrients. It is available free on her site so grab the free PDF HERE.