Recommended Daily Folate Intake for Adults
The recommended daily intake of folate from food for adults is 400 μg (0.4 mg) for the general adult population, with 800 μg (0.8 mg) recommended for pregnant and lactating women. 1
General Recommendations by Population
- General adult population: 400 μg (0.4 mg) daily 1, 2
- Pregnant women: 600 μg (0.6 mg) of dietary folate equivalents daily 1
- Lactating women: 800 μg (0.8 mg) daily 1, 2
Special Considerations
High-Risk Populations
- Women with previous neural tube defect-affected pregnancies: 4,000 μg (4 mg) daily under medical supervision 1
- Patients on chronic hemodialysis: May require 1-5 mg daily 1
- Patients taking medications that interfere with folate metabolism (anticonvulsants, sulfasalazine): May require higher doses 1
Medication Interactions
- Methotrexate therapy: Folate supplementation recommended for all patients 1
- High doses of folate (>1 mg/day) may mask vitamin B12 deficiency - always check B12 levels before initiating high-dose therapy 1, 2
Current Intake Status
Despite these recommendations, actual folate intake in many populations falls short of the recommended levels:
- Historical data showed mean daily folate intake in US adults was only 242 μg, with even lower levels in women (207 μg) 3
- More recent data from Slovenia (2021) showed that only about 12% of the population achieved the WHO recommended level of 400 μg/day 4
Clinical Implications
- Inadequate folate during pregnancy significantly increases the risk of neural tube defects 1
- For treatment of folate deficiency, oral folic acid 5 mg daily for a minimum of 4 months is recommended 1
- Daily doses greater than 1 mg do not enhance hematologic effects, and excess is excreted unchanged in urine 2
Common Pitfalls
- Timing of supplementation: Many women start supplementation after conception, missing the critical period for neural tube development (first 28 days after conception) 1
- Vitamin B12 masking: Always check vitamin B12 levels before initiating high-dose folate therapy to avoid masking B12 deficiency 1, 2
- Maintenance therapy: After correcting deficiency, continue with appropriate maintenance dosing to prevent relapse 2
Food Sources
Major food sources of folate include:
- Orange juice
- White breads
- Dried beans
- Green salad
- Ready-to-eat breakfast cereals
- Vegetables and fruits
- Cereal products
These foods contribute approximately 37% of total folate intake on a given day 3.