What is the role and importance of folate in the human body?

From the Guidelines

Folate is a crucial B vitamin that plays a vital role in cell division, DNA synthesis, and the prevention of neural tube defects, particularly during pregnancy and infancy. The importance of folate in the human body can be understood by its functions, which include participation in one-carbon transfers, methylation reactions, and purine and pyrimidine synthesis, as noted in studies such as 1 and 1.

Key Functions of Folate:

• Cell division and DNA synthesis
• Production of red blood cells
• Prevention of neural tube defects during pregnancy
• Proper brain function Some key points to consider about folate include:
• Adults generally need 400 micrograms of folate daily
• Pregnant women require 600 micrograms to support fetal development
• Folate deficiency can lead to anemia, weakness, fatigue, and serious birth defects like spina bifida
• Folate occurs naturally in foods like leafy greens, legumes, and liver, while folic acid is the synthetic form found in supplements and fortified foods As highlighted in 1 and 1, the body cannot store large amounts of folate, making regular dietary intake or supplementation necessary for maintaining optimal levels.

Recommendations for Folate Intake:

• The USPSTF recommends daily folic acid supplementation at a dose of 400–800 μg (0.4–0.8 mg) daily in all reproductive-age women, as stated in 1
• Higher doses of folate supplementation (>400 μg or >0.4 mg) may be recommended for women with a personal history of neural tube defects or other birth defects, as suggested in 1

From the FDA Drug Label

Folic acid acts on megaloblastic bone marrow to produce a normoblastic marrow. In man, an exogenous source of folate is required for nucleoprotein synthesis and the maintenance of normal erythropoiesis Folic acid is a precursor of tetrahydrofolic acid, which is involved as a cofactor for transformylation reactions in the biosynthesis of purines and thymidylates of nucleic acids Impairment of thymidylate synthesis in patients with folic acid deficiency is thought to account for the defective deoxyribonucleic acid (DNA) synthesis that leads to megaloblast formation and megaloblastic and macrocytic anemias.

Folate's role in the human body is to:

• Act on megaloblastic bone marrow to produce a normoblastic marrow
• Support nucleoprotein synthesis
• Maintain normal erythropoiesis
• Serve as a precursor of tetrahydrofolic acid for the biosynthesis of purines and thymidylates of nucleic acids
• Support DNA synthesis to prevent megaloblast formation and megaloblastic and macrocytic anemias 2

From the Research

Role of Folate in the Human Body

• Folate, also known as vitamin B9, plays a crucial role in various bodily functions, including DNA synthesis and repair, cell division, and growth 3.
• It functions as a coenzyme to transfer one-carbon units necessary for deoxythymidylate synthesis, purine synthesis, and various methylation reactions 3.
• Folate is essential for the production of red blood cells and prevents anemia, a condition characterized by a decrease in the number of red blood cells or the amount of hemoglobin in the blood 4, 5.

Importance of Folate in Preventing Diseases

• Folate deficiency has been linked to an increased risk of megaloblastic anemia, a condition characterized by the production of abnormally large red blood cells that are not able to function properly 4, 5.
• A diet rich in folate has been shown to reduce the risk of chronic diseases such as cardiovascular disease, cancer, and cognitive dysfunction 3, 6.
• Folate has also been found to play a critical role in preventing birth defects, particularly neural tube defects (NTDs), and it is recommended that women take folic acid supplements during the periconceptional period to reduce this risk 3.

Mechanisms of Folate Deficiency

• Folate deficiency can lead to impaired DNA synthesis and repair, resulting in the destruction of hematopoietic cells and a decrease in blood cell production 4, 7.
• Apoptosis, or programmed cell death, has been found to mediate the destruction of erythroblasts in folate deficiency anemia, and thymidine has been shown to prevent this apoptosis 7.
• The mechanisms by which folate deficiency leads to disease are complex and involve the perturbation of various cellular processes, including DNA biosynthesis, repair, and methylation 6.