Philip J. Goscienski, M.D.
August 2005
If you're a woman of childbearing age you may not be getting enough folate to protect your baby if you become pregnant. If you're a senior you may not have enough on board for good heart health. Folate, also known as folic acid or vitamin B9, was never in short supply in the Stone Age but the U.S. government ordered food manufacturers to add this nutrient to their products in 1998 because so many of us, especially young women, don't get enough in our diet.
In the not too distant past we got most of our folic acid from green leafy vegetables, which probably explains why we need a little nudge from the government now. Barely 20 percent of children eat the recommended number of fruit and vegetable servings every day even when French fries are classified as a vegetable, and adults don't do much better. Cooking is hard on folic acid; heating inactivates as much as 90 percent of it.
As a group the B vitamins are extremely important in many body processes, especially those involved with energy production and growth. A deficiency of folic acid during pregnancy greatly increases the risk that a baby will be born with a defect of the brain and spinal cord or of the upper lip and palate. After food manufacturers began the mandated addition of folate to grain-based products such as flour, bread, pasta and cereals, the incidence of spina bifida and related defects fell by as much as 70 to 90 percent among women of normal weight. The decrease was less dramatic in obese women.
Preeclampsia, known also as toxemia of pregnancy, is a dangerous condition in which a pregnant woman suffers high blood pressure and accumulation of fluid throughout the body. It can lead to convulsions and to loss of the infant. Physicians have discovered that women with preeclampsia have low levels of folic acid.
There are many reasons why nutritionists promote a high intake of fruits and vegetables so vigorously for persons of all ages. Maintaining heart health is one of them, and folate plays a prominent role. Homocysteine reaches abnormally high levels in persons that are deficient in folate and other B vitamins. High blood pressure, heart attacks and diseases of the blood vessels of the legs are associated with high homocysteine levels and low levels of folic acid. That's probably not a coincidental link. Giving folate to persons at risk of heart disease improves the ability of blood vessels to dilate so that blood flow increases. Folic acid also lowers the risk of heart attack in other ways, namely by raising levels of HDL (good) cholesterol and bringing down levels of LDL (bad) cholesterol.
The depression that is common in our elderly population may have as much to do with nutrition as with aging. Depressed patients often have low folate levels, and antidepressant medications work better when folate is added to the diet.
Every one of us should take in at least 400 micrograms of folic acid every day. The best sources are green, leafy vegetables and legumes. Multivitamin preparations usually contain 400 micrograms and there is no problem with taking higher amounts.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.