Folate supplement dosage 400 mcg health benefit, Foods high in folate vitamin, sources, deficiency, use for homocysteine lowering
August 17 2016 by
Ray Sahelian, M.D.

Folate is important in maintaining the DNA within cells, and some small studies have suggested that women who get more folate have a lower breast cancer risk although the results have been conflicting. Most women probably know that adequate levels of folate are important to prevent a major pregnancy complication such as neural tube defect, but in recent years folate levels have decreased among non-pregnant US women of childbearing age.

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Food sources of folate, what are dietary sources?
It is found naturally in greens like spinach and broccoli, oranges and orange juice, and dried beans and peas, among other foods. Its synthetic form, folic acid, is added to enriched breads, breakfast cereals and other grains.

Folate fortification
Folate fortification has been required by law for the past decade, as studies have shown that folate before and during pregnancy can prevent neural tube defects -- birth defects of the brain and spine, such as spina bifida.
   Older people who are deficient in vitamin B12  may run the risk of developing anemia and cognitive impairment if they're getting too much folate through a folate supplement or folate fortification of food.

Folate and breast cancer
The B vitamin folate has important health benefits, but a lower risk of breast cancer may not be one of them. In an analysis of 22 past studies, researchers found no evidence that higher folate intake was related to a lower breast cancer risk. Across the studies, women's cancer risk remained virtually unchanged with every 100 microgram (mcg) increase in daily folate, the study authors report in the Journal of the National Cancer Institute.

Folate and colon cancer
Q. A well-respected medical newsletter [Harvard Men's Health Watch] carried an article in 2008 about daily multiple vitamins, concluding that people should no longer take them because recent studies indicate that the folate they contain raises the risk of colo-rectal cancer. They are proposing that the amount of folate in daily multiples and also added to cereals be reduced. Until then, stop taking daily multiples. Do you have any thoughts or opinion on this subject?
   A. In my opinion, more research needs to be published before we determine the role of folate supplements regarding colon cancer.

The influence of folate and multivitamin use on the familial risk of colon cancer in women.
Cancer Epidemiol Biomarkers Prev. 2002.
Low intake of folate and methionine and heavy alcohol consumption have been associated with an increased overall risk of colon cancer, possibly related to their role in methylation pathways. We estimated the relative risk of colon cancer according to a history of colorectal cancer in a first-degree relative and categories of folate, methionine, and alcohol intake in a prospective cohort study of 88,758 women who completed family history and detailed food frequency questionnaires. During 16 years of follow-up, colon cancer was diagnosed in 535 women. The inverse association of folic acid with colon cancer risk was greater in women with a family history. Our results suggest that higher intake and avoidance of moderate to heavy alcohol consumption may diminish the excess risk of colon cancer associated with a family history of the disease.

In a study of 596 colorectal cancer patients and 509 healthy individuals, South Korean researcher Dr. J. Kim of the National Cancer Center in Goyang found that the women who ate the most folate were at about two-thirds lower risk of the disease than women who consumed the smallest amount of the B vitamin. But folate intake didn't significantly affect men's colorectal cancer risk. Deaths from colorectal cancer have jumped more than six-fold among South Koreans since the early 1980s and an increasingly Western-style diet may be a factor in the increase. There is evidence that intake of folate, which is found in green, leafy vegetables and citrus fruits, may reduce colorectal cancer risk. European Journal of Clinical Nutrition, August 2009.

Depression and mood
Drugs Today (Barc). 2013 Dec. Folate augmentation of antidepressant response. The use of two antidepressants from the initiation of treatment in major depressive disorder has been investigated in several recent studies and forms a paradigm shift in the pharmacotherapy of the condition. Several, but not all, trials have claimed improved response and remission rates with the combinations as opposed to monotherapy. The use of folate preparations (folic and folinic acid and l-meth-ylfolate) have shown effective augmentation of antidepressant response in a variety of controlled and open-label settings in patients with normo- and hypofolatemic status. Several recent trials using L-methylfolate, the active and more bioavailable form of folic acid, have shown promising adjunctive use with a well-tolerated adverse event profile.

Folate and hearing loss
Folate supplementation appears to slow the decline in hearing loss that commonly occurs with age, at least in people with high levels of the amino acid homocysteine. Folate is a B vitamin, which the body uses to make new cells. Previous reports have linked low folate levels with poor hearing, but it was unclear if administration of the vitamin could slow age-related hearing loss. To investigate, Dr. Jane Durga, from the Nestle Research Center in Lausanne, Switzerland, and colleagues assessed changes in hearing among 728 subjects, between 50 and 70 years of age, who were randomized to receive folate (800 micrograms) or inactive placebo daily for 3 years. Because there is evidence that folate may improve hearing by lowering plasma homocysteine levels, the researchers excluded subjects who had low homocysteine levels at the start of the study. None of the subjects had any pathologic ear conditions unrelated to aging. At 3 years, the threshold for low frequency hearing increased by 1.0 dB in the folate group, significantly less than the increase noted in the control group. By contrast, high frequency auditory acuity worsened by a similar extent in each group, the researchers found. Whether the current findings are applicable to subjects in the US is unclear since at the time of the study, folate fortification of foods was prohibited in the Netherlands and, as a result, the subjects had baseline folate levels that were about half of those typically seen in the US population. Archives of Internal Medicine, 2007.

Folate and ovarian cancer
Dietary folate consumption and risk of ovarian cancer: a prospective cohort study.
Eur J Cancer Prev. 2006.
Deficient dietary folate intake may be associated with increased cancer risk in humans owing to DNA damage resulting from impaired nucleotide excision repair. In the cohort study reported here, we examined the association between dietary folate intake and ovarian cancer risk, overall and within strata defined by alcohol and methionine intakes. The investigation was conducted in 49 613 Canadian women who were participants in the National Breast Screening Study and who completed self-administered lifestyle and food frequency questionnaires between 1980 and 1985. During a mean 16.4 years of follow-up, we observed 264 incident ovarian cancer cases among 48 766 women for whom data were available. Dietary folate intake was associated with a 25% decrease in risk of ovarian cancer for the highest versus the lowest quartile level of intake. On stratification by alcohol intake, dietary folate was not associated with ovarian cancer risk among women consuming <4 g/day of alcohol, but there was some suggestion of reduced risk at relatively high levels of folate intake among women consuming >/=4 g/day of alcohol/day . The association between folate and ovarian cancer risk did not vary by strata of methionine intake. Relatively high dietary folate intake may be associated with a reduction in ovarian cancer risk among women with relatively high alcohol consumption and among those with relatively high methionine intake.