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Folate or Folic acid?

This nutrient is one of my favourites to delve into, it’s a huuuuge topic but I wanted to get clear on the difference between folate and folic acid (particularly for those of you experiencing fertility concerns, are planning pregnancies, or are early on in your first trimester).

This nutrient is critical for fertility and a healthy pregnancy. Folate (vitamin B9) is naturally occurring, and found in dark leafy greens, eggs, legumes and liver to name a few. It is not the same as folic acid which is synthetic i.e. it is not naturally occurring. Foods ‘fortified’ or ‘enriched’ with folic acid (e.g. bread and grains) are synthetic.

Folate is particularly important during the very early weeks of pregnancy for organ development. That is why it is recommended to start taking a prenatal supplement at least 3 months prior to conception to normalise folate blood levels.

You may have heard of MTHFR gene variations which are prevalent in up to 40-60% of the population - if this is you, you have a reduced ability to process folate, and even more so, folic acid.

The issue is that if you….

❌ have an impaired ability to use folate (MTHFR mutation)

❌ are consuming a lot of bread/products fortified with folic acid

❌ are on a prenatal formula that is high dose folic acid (e.g the doctor’s favourite - Elevit!)

❌ consume a low amount of folate (leafy greens, liver, eggs, nuts/seeds and legumes)

…. excessive folic acid builds up which is linked to adverse health outcomes and you cannot use it in a bioavailable form anyway! You may absorb it but you cannot utilise it and they are two different matters.

So, this basically means people with an MTHFR gene variation (I have both!) need active forms of folate. They need to consume a high amount of dietary folate and if supplementing for pregnancy, use the active forms; folinic acid (not folic) and/or methylfolate (5-MTHF). But even if you are not an MTHFR carrier our bodies much prefer natural forms of folate rather than synthetic.

Without delving into the science too deeply, there is also a link between high folic acid intake and high homocysteine which is an inflammatory marker. Homocysteine is a risk factor for miscarriage - you can ask for this blood test as part of a preconception check up, and especially if you are experiencing recurrent miscarriage.

So my take home message here really is:

✅ Check your prenatal (does it have an active form of folate?)

✅ Eat loads of legumes! (folate + protein + iron + fibre powerhouses!)

✅ Choose organic breads and grains (they are not required to fortify with folic acid)

✅ Consider getting an MTHFR mutation test

So how much folate should I take?

Look for a supplement with around 600mcg/day of folinic acid and/or methylfolate (5-MTHF).

What foods could I eat to boost my folate intake?

The highest sources are eggs, legumes like chickpeas, liver seeds and leafy green veg. You could make homemade hummus (and blend in spinach it barely alters the taste) or have boiled eggs with avocado on toast, grate liver into a spaghetti bolognese pasta or make my lentil + veggie balls.

Lastly, and not at all least - men should also be aware of folate intake as it impacts upon sperm health, and they are half the DNA of your little one!

If you are interested in more on this, get in touch with me to book a preconception or pregnancy consultation. I can assess your diet, help make little tweaks so you are boosting the nutrition of each meal, recommend recipes and discuss what nutrients are needed during the differing prenatal stages. This will prepare you (and your partner!) to create and welcome your best possible baby.

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