Discover how folate could help you feel energised, protect your heart and make you happier

By Helen Foster

When you think of folate or folic acid, you might think it’s only something you need when you’re pregnant – or planning to be – but emerging evidence suggests this nutrient is vital at every age.

Folate – or folic acid, which is the synthetic version added to breakfast cereals and lots of supplements – is a form of vitamin B9. It’s one of the eight B vitamins you need each day to produce energy. ‘But on top of that, B9 has a number of specific roles in the body,’ explains Dr Emma Derbyshire, public health nutritionist and advisor to the Health and Food Supplements Information Service. ‘It plays a role in the synthesis and repair of DNA, it helps cell division and growth and it’s involved in a process called methylation.’

Liver is one of the richest food sources of folate

Methylation is the reason why B9 is shaping up to be an essential health supplement for everyone, not just those planning a baby. Put very simply, methylation is a process of adding atoms to molecules, which triggers those molecules to do their job. The process takes place throughout your body, for example:

Your heart: ‘Methylation helps your body convert a potentially harmful substance called homocysteine into a harmless one called cysteine,’ says David Croft, nutritional scientist at Nature’s Bounty. ‘If this doesn’t happen, homocysteine can build up in your body, and this is a known risk factor for heart disease and stroke.’

Your mood: ‘Methylation helps support the production of neurotransmitters including mood-boosting serotonin, and dopamine, the chemical that makes you feel motivated and driven,’ says David. Supplementing with specific forms of folic acid has been shown to improve symptoms of depression and enhance the effects of antidepressant drugs in some studies.

Your brain: ‘While it’s not yet conclusively proven, there’s a strong belief that the build of homocysteine is also linked to the development of dementia in old age,’ explains David. One study found that supplementing with a combination of 400mcg of folic acid and 100mcg of vitamin B12 for two years improved memory in a group of 60-74 year olds.

Your sex organs:Folic acid’s role in DNA repair means there’s also some belief that it may play a role in reducing your risk of some cancers, including cervical, ovarian and also breast, but the jury is still out on this one.

Edamame beans contain lots of folate

With all these potential benefits, you can see why getting enough B9 is a positive thing… but there’s a good chance you’re not. The latest figures in the National Diet and Nutrition Survey in the UK highlighted a worrying fall in folate measures over the past nine years. In women aged 16-49, levels have fallen a whopping 34 percent and 90 percent of women in this age range now have worryingly low levels.

  • You need 200mcg of B9 daily, which is found in three large handfuls of spinach.
  • Signs of B9 deficiency include mouth ulcers, sore tongue, headaches, tiredness and heart palpitations.
  • 73%… That’s how much the risk of stroke fell for people taking 800mcg of folic acid daily alongside blood pressure medication, compared to those taking medication alone.

The reason most people are low in folate is simple: not eating enough of the foods that contain it. ‘Vegetables are a major source of folate and we tend not to eat enough of these – even when we get our five a day it tends to come from fruit, which is not such a great source,’ says Dr Derbyshire. ‘Some food trends are also playing a role. Breakfast cereal is often fortified with folic acid, but trends for skipping breakfast and a move away from carbohydrates can mean you’re not consuming this as regularly.’

The genetic reason for low levels of folate

For some people, there’s a genetic reason for having low levels of folic acid, but before delving into that, let’s explore the different forms of vitamin B9 and how they can help you…

When folate (the natural form) or folic acid (the synthetic version) enter your body, they are both converted to a third form of B9 called 5-methyltetrahydrofolate (often shortened to methylfolate or 5-MTHF). This is the form your body can actually use, and you can get supplements that contain it, meaning your body doesn’t have to do the conversion work.

So far so good, however, around 40 per cent of the population carries a variant in the MTHFR gene, and this affects the folate conversion process. ‘If you inherit a variation in the MTHFR gene, it will affect how well you convert folate or folic acid to 5-MTHF, reducing it by up to 30 per cent,’ says David Croft. ‘But if you inherited the gene variant from both parents,your ability to convert B9 could be reduced by up to 70 percent.’ About 12 percent of the UK population has this double variant.

While screening for MTHFR is not usually suggested by GPs, you can be tested privately to see whether you carry the altered version of the gene. A naturopath or nutritionist can order this test for you if you’re keen to find out.

Eat folate-rich foods to boost your level of folic acid

Clearly it’s important to consume much higher levels of folate-rich foods if you have the MTHFR genetic variant, but even if you don’t – and that’s 60 per cent of us – boosting your intake could still help you stay energised and help ward off age-related brain conditions as well as protecting your ticker. And it’s quite easy to achieve:

Broccoli asparagus avocados and spinach contain good amounts of folic acid

  • You only need 200mcg of B9 daily and you’ll get that in about three large handfuls of spinach. The more greens you pop on your plate, the better though.
  • Don’t overcook your vegetables– folate is a water-soluble nutrient, meaning it can easily leach into cooking water. Stick with stir-frying, stewing, sauteeing or other cooking techniques where water is absorbed back into your dish.
  • Alcohol reduces your ability to absorb folate and also breaks down what you do take in, so you store less in your body. This is why it’s sensible to only drink in moderation.

If you do carry the MTHFR gene, simply eating more folate may not be enough to raise your levels effectively and you’ll probably want to supplement but it’s crucial to pick the right one – after all, the issue with the MTHFR gene variation is you can’t convert folic acid to the 5-MTHF your body needs, and most multivitamins and other supplements contain folic acid. However, you can now find some supplements that contain 5-MTHF. It’s not always called this on the label though, so look out for l-methyl-folate, too. ‘This really is becoming the gold standard when it comes to folic acid supplementation,’ says Dr Derbyshire. ‘Not only is it more bioavailable, it can cross the blood-brain barrier, which means it may be more effective for improving cognitive health. It also doesn’t mask B12 deficiency, which normal folic acid can do. This is important as you get older, when B12 deficiency can become more common.’

So, it’s clear that not only pregnant women need folate (but if you are pregnant, or know anyone who is, perhaps mention to them about 5-MTHF?) – we could all do with a boost to stay energised, motivated and sharp of mind. Anyone for a green juice?

Top 10 food sources of folate

  1. Marmite – 1250mcg per 100g
  2. Edamame – 311mcg per 100g
  3. Liver – 280mcg per 100g
  4. Lentils – 181mcg per 100g
  5. Bran flakes – 166mcg per 100g
  6. Asparagus – 149mcg per 100g
  7. Spinach – 146mcg per 100g
  8. Broccoli – 108mcg per 100g
  9. Avocados – 81mcg per 100g
  10. Mangos – 43ug per 100g

How to test your levels of folate

The NHS will only test your folate level if you’re suspected of having anaemia associated with low folate or low B12 levels. If you want to know your folate levels otherwise, you’ll need to pay for a private test. Smart Nutrition offers a single folate test for £66. They also offer a methylation panel test (by blood or saliva) to check how well your body methylates in general, for £280. You can add on specific genetic testing for the MTHFR gene variant (by saliva) for £160.

Rather than testing folate levels though, you might be better off testing your levels of homocysteine, as it’s high levels of this that you really need to be wary of. Your homocysteine score predicts your risk of more than 100 diseases and medical conditions and it is a very strong predictor of your risk of cardiovascular disease. A nutritionist or nutritional therapist can order this test for you and work with you to interpret the results. Or, you can buy tests online. Try The Smart Nutrition Homocysteine Test UK & Europe (£77).

Sources for further info:

British Dietetic Association Food Factsheet

Cognitive decline and Cancer

Depression and folate link

National Diet and Nutrition

Folic Acid Supplements and stroke patients

Top 10 Foods Highest in Vitamin B9

Check out Helen’s blog and follow her on Twitter  @HelenF_NYNHB and @bemoreunicorn