Have a Digestive Disease? You Might Be at Higher Risk for Folate Deficiency.
Anything that interferes with your body’s ability to absorb folate can lead to a deficiency. Chronic digestive diseases like Crohn’s disease and celiac disease cause inflammation or swelling in the small intestines. These conditions can seriously impair appetite and may require dietary changes, medication, or surgery to treat. Both the symptoms and the treatments of digestive disease can make it harder for nutrients to be absorbed by the small intestine. For example, surgeries to remove part of the small intestines may reduce some Crohn’s disease symptoms but can also impair folate absorption. Several studies have found that folate deficiency is much more common in adults with inflammatory bowel diseases.
Diseases aren’t the only thing that affects your body’s ability to absorb and process folate. Certain drugs can interfere with folate absorption and cause deficiency. Methotrexate is a drug that suppresses the immune system to treat inflammatory disorders like Crohn’s disease and rheumatoid arthritis. The drug keeps the body from using folate, so it is released as waste. Some seizure medications may prevent your body from absorbing folate from food, while the antibiotic trimethoprim blocks an enzyme that activates folate. People taking these drugs may be advised to take folic acid or active forms of folate to avoid deficiency.
Your Vulnerability to Folate Deficiency May Be in Your DNA.
While many people are able to absorb folate normally, people with specific genetic mutations cannot process the nutrient. MTHFR is an enzyme that converts the folate and folic acid absorbed from food and supplements into an active form. Unactivated folate can’t function in the body in the same way as activated folate. Mutations in the gene that produces MTHFR prevent it from properly activating folate. This means that the body lacks active folate, resulting in a folate deficiency. These mutations are also linked to a toxic build-up of the amino acid homocysteine, which is normally broken down by folate. People with MTHFR mutations cannot simply increase folate in their diet or take folic acid supplements because their bodies will be unable to process the nutrient in those forms. Instead, they take an already active form of folate.
Make Sure You’re Getting Enough Folate for Your Age.
Everyone needs folate, but the amount you need varies based on age, gender, and individual health. Recommended doses may also vary between countries. Pregnant women need the highest folate dose, between 400 and 800 micrograms (mcg) per day. The next highest dose is recommended for women who are breastfeeding, who may also need between 260 and 800 mcg daily. Most adults and older teens of any gender will only need between 150 and 400 mcg of folate per day, although some doctors recommend that all women of childbearing years get at least 400 mcg. Health conditions that affect your ability to process folate may require you to take a higher dose than those recommended.
Folate is found naturally in foods like leafy greens and oranges, but you can get the same benefits from folic acid, a synthetic form of folate that is found in some food and supplements. Unlike folate, folic acid is very stable at high temperatures and under pressure. Folic acid is also more easily absorbed than its natural counterpart. The body can absorb about 85 percent of folic acid compared to around 50 percent of folate. This can make folic acid a better option for restoring low folate levels and preventing folate deficiency in people who are at risk for the condition. While folate is absorbed and activated in the intestines, folic acid is converted to its active form outside of the digestive system, usually in the liver. That means it takes slightly longer for your body to metabolize folic acid, which can build up in the body, potentially causing health problems. Drinking orange juice and taking other B vitamin or vitamin C supplements in combination with folic acid can help your body process folic acid faster.
In the 1990s, the U.S. became the first country to fortify foods with folic acid to ensure that the population, especially women of childbearing age, were consuming enough of the nutrient. In the decades since dozens of countries implemented similar folic acid fortification initiatives. The initiatives, which included all cereal grain products, substantially increased folate intake across all age groups. Some of the foods that are typically fortified with folic acid include flour, bread, pasta, rice, and breakfast cereals. Folate deficiency used to be far more common worldwide and still is in some countries. However, improved diets and the introduction of fortified foods have dramatically reduced folate deficiency and related health issues. A study conducted two years after U.S. folate fortification began found that reports of low folate had decreased by almost 97 percent.
Leafy Greens, Fruits, Nuts, and Legumes Are Excellent Natural Sources of Folate.
So, what should you be adding to your diet to up your folate intake? Fortunately, there are many delicious foods that arenaturally rich in folate. Dried legumes, such as lentils, beans, and chickpeas, pack the biggest folate punch per serving. One serving of these foods contains up to 90 percent of the daily recommended intake for most adults and 60 percent for pregnant women. But remember that these values only apply to legumes that are cooked from dried. Canned legumes have less than half the folate of dried legumes. Green leafy vegetables like Brussels sprouts, asparagus, spinach, broccoli, and kale are another excellent source of folateâas long as they’re not overcooked. One serving of beef liver will provide you with around half of your daily recommended folate, while beets provide about 37 percent. Some fruits that are high in folate include avocado, pomegranates, citrus, and papayas.
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