See also: excess folic acid - folic acid - folic acid quiz - folic acid in pregnancy
Folic acid deficiency - a micronutrient also known as vitamin B9 or folacin - is still a widespread condition, especially in some areas of the globe.
The inability of the organism to synthesize this vitamin justifies the extreme importance of an adequate dietary intake.
The body's reserves of folic acid amount to about 12-15 mg, stored mainly in the liver and sufficient only to compensate for a few weeks of lack of food intake.
Health Risks
Folic acid, as well as vitamin B12, is essential for adequate cell proliferation and maturation; therefore, the deficiency of this nutrient affects in the first instance the tissues with a high degree of proliferation, such as the bone marrow and those of the embryo-fetus. This explains the origin of the two most known and widespread consequences of folic acid deficiency. represented by "macrocytic anemia - megaloblastic and spina bifida in the unborn child.
Folic Acid Deficiency Anemia
In the "macrocytic - megaloblastic anemia, red blood cells become excessively large, assuming an abnormal shape and very short life. As a result, the folic acid deficient subject complains of weakness and easy fatigue, both physical and mental (insomnia, irritability and difficulty concentrating). .
Neurological suffering is also due to the essentiality of folate in the synthesis of some neurotransmitters, such as glutamic acid (an excitatory amino acid released in the central nervous system).
Spina Bifida
If a pregnant woman does not take adequate amounts of folic acid, irreversible damage to the fetus can result, with an increased risk of neural tube defects (embryonic structure from which the central nervous system originates), the most common of which is precisely the spina bifida. The fetus, in turn, removes much of the folic acid from the mother, which justifies the integration from when the pregnancy is still sought until its conclusion. In fact, the first stages of development of the embryo-fetus have the most intense rate of proliferation. In a child with spina bifida, the spinal cord is not well enclosed between the vertebrae and can be damaged to the point of causing paralysis of the legs.
Homocysteine and Cardiovascular Risk
A folic acid deficiency raises the subject's cardiovascular risk by increasing the levels of circulating homocysteine, which in turn increases the chances of suffering cardio-vascular diseases. This condition is common in people who contrast an excessive intake of protein foods (dairy products, meat, legumes, eggs) with a low consumption of fresh vegetables.
Other Possible Disorders
Serious folic acid deficiencies have also been linked with depression, lesions of the skin and mucous membranes, growth and ossification disturbances, increased susceptibility to infections, infertility (both male and female), mental retardation and atrophy of the lymphatic organs.
Folic Acid in the Diet
Recommended daily intake
The recommended daily intake of folate is 200-300 µg in adults, 400 µg in pregnancy and 350 µg in breastfeeding.
It is estimated that a "balanced diet provides 100 to 300 µg of folic acid per day.
Foods rich in folic acid
Vegetables - especially green leafy ones (cabbage, spinach, watercress, etc.) - fruit, whole grains, legumes, liver and brewer's yeast are particularly rich in this vitamin.
Normally about 40-60% of the folic acid of food origin is absorbed, while that taken as a supplement or pharmaceutical product is absorbed for about 80%.
Vitamin B9 is also synthesized by the intestinal bacterial flora.
Losses with Cooking
Losses with cooking vary from 50 to 95% (unfortunately, the most generous food sources, such as cauliflower, Brussels sprouts and spinach, are the ones that are used to cook the longest).
The high temperatures, the prolonged soaking and the annealing / heating of already cooked vegetables almost cancel the folic acid heritage of the fresh food.
Subject to Shortage Risk
In our latitudes, in industrialized countries, the deficiencies of folic acid of food origin are quite rare and mostly affect the elderly who follow monothematic and repetitive diets, particularly poor in fresh fruit and vegetables, for example due to lack of appetite, social problems, difficulties in chewing etc..
The overcooking of food, the intensive use of food warmers (a typical problem of canteen meals) and the intake of folic acid antagonist drugs (in particular some antibiotics and chemotherapy), represent further predisposing factors for folate deficiency. Prolonged exposure to light depletes the folic acid content of food.
Folic acid deficiencies are more common among alcoholics and drug addicts; smoking also has a negative effect. They are also typical of malabsorption syndromes, where the bowel's ability to absorb nutrients is limited by various diseases and conditions, such as celiac disease (celiac disease), intestinal infections, pancreatic diseases, Crohn's disease and surgical resections of the intestine.
The deficiency is also frequent in poor tropical and sub-tropical countries (where it is often associated with other nutritional deficiencies) and in those of the far north, where the supply of fresh vegetables is limited for most of the year.
Supplements: When Are They Necessary?
Folic acid supplements are indicated only in deficient states, as there are no deficiency problems in healthy adults who follow a "balanced diet."
Pregnant and breastfeeding women deserve a separate discussion, in which the supplementation with folic acid is prescribed by the doctor and must take place under his control and according to the indications given.
To learn more, read: folic acid in pregnancy.
Folic acid supplements are justified in low-calorie diets, in elderly alcoholics or malnourished, in alcoholics and in patients with malabsorption. They can also be prescribed in high-level athletes in order to solve anemia problems.
In some supplements or pharmaceutical products, folic acid is combined with iron, as it is not uncommon for the association between the two types of deficiency, possibly ascorbic acid and vitamin B12 (with the aim of providing the body with the micronutrients necessary for the " optimal synthesis of red blood cells).
The normally recommended intake doses for folic acid supplements are 400mcg per day.
