Folic acid

5 Best Natural Folic Acid Prenatal Supplements with Folate - MTHFR support

Did you know that not all folic acid supplements are safe? Most prenatal vitamins on the market contain a type of Folic acid that is hard to metabolize and can result in a build up of toxic chemicals. Find out how to avoid these and what to look for in your prenatal vitamin for the safest and healthiest pregnancy.


How to find out if you have a MTHFR genetic variant using 23andme

MTHFR genetic variants

MTHFR genetic variants affect up to half of the population and may reduce your ability to process folic acid and turn it into folate. If you can't convert enough folic acid into folate, you may have low folate levels. Low folate levels has been proven to contribute to birth defects and can cause high levels of homocysteine in your body which may lead to cardiovascular problems. If you're a woman of childbearing age, it is especially important to check for the variants and keep track of your folate levels.

Additionally, if your diet is rich in folic acid from supplements and fortified foods and you have the variants that make it difficult for you to metabolize it, folic acid may build up in your body and cause you harm. Some studies have found that too much folic acid contributes to breast, lung, and prostate cancer. Learn more about folic acid and folate in my post here.

The easiest way to find out if you are affected by a variant (no doctor required):

Step 1. Order a 23andme DNA kit to have your DNA sequenced. When the results come back sign into your 23andme account. 23andme does not include MTHFR variants in your summary report because they feel that the health implications are inconclusive at this time (1). To find out if you have the variants, you will need to dig into your raw genomic data on 23andme by  looking up at positions rs1801131 and rs1801133 in your genetic code. Luckily there is an easy way to do this.

Step 2. Check your DNA for MTHFR A1298C variant

To do this, go here: https://www.23andme.com/you/explorer/snp/?snp_name=rs1801131 to look at SNP rs1801131. If you see T/T on the right where is says "Your Genotype", you do not have the variant and this is the best case scenario. If you see G/G you are homozygous for the MTHFR A1298C variant and this results in 40% loss of function in processing folic acid. If you see G/T (as shown below) you are heterozygous for MTHFR A1298C and this results in 20% loss of function in processing folic acid (2). For more information about this piece of DNA visit: https://snpedia.com/index.php/Rs1801131

23andme MTHFR gene

Step 3. Check your DNA for the MTHFR C677T variants

Next click on this link: https://www.23andme.com/you/explorer/snp/?snp_name=rs1801133 to look at SNP rs1801133. If you see G/G on the right where is says "Your Genotype", you do not have the variant for MTHFR A1298C and this is the best case scenario. If you see A/A you are homozygous for the MTHFR A1298C variant and this results in 70% loss of function in processing folic acid. If you see A/G (as shown below) you are heterozygous for MTHFR C677T and it is unknown how much loss of function this causes (3). For more information about this piece of DNA visit: https://snpedia.com/index.php/Rs1801133

23andme MTHFR gene

If you are heterozygous for both A1298C and C677T as shown in the example above, this is called "compound heterozygous" and results in a 50% loss of function in processing folic acid. This happens in about 20% of the population (4).

Step 4. If you have found a variant and have reduced ability to process folic acid, I suggest reading this post I wrote on what to do about it.

You can learn more about the MTHFR gene at the National Institute of Health: https://ghr.nlm.nih.gov/gene/MTHFR

About the author

Jessica Glago is the CoFounder of the Wholesome App. After having two different cancers in  her childhood she developed the app with the help of her husband to get more healthfulness out of her diet. To date, Wholesome for iOS has had over 250,000 downloads and over 1.5 million whole foods tracked. The app has been featured on BuzzFeed, LikeHacker, CultofMac, and The Seattle Times. 

Micronutrient tracking for folate and vitamins using the Wholesome app

Top 25 high folate foods for pregnancy

Folate (usually referred to as 'Folic Acid' or Vitamin B9) is essential for a healthy pregnancy because it protects against neural tube defects. According to the National Institute of Health, if you are pregnant or trying to conceive, your daily folate requirement increases from 400 mcg to 600 mcg (source: NIH).

Few know that it is best to avoid synthetic folic acid supplements and instead eat a diet rich in natural folate instead. Why is that? Folic acid is actually the synthetic, man-made form of folate, which can be found abundantly in whole foods. A subset of the population has trouble metabolizing folic acid. For these people it can stay in the body and even do harm, a process that several studies have linked to cancer. Folate, in contrast and even in excess, is perfectly safe - for more information, read more here

The 25 best folate rich plant-based whole foods:

100% = 600mcg of folate (what you need daily before and during your pregnancy)

High folate folic acid foods app

1. Asparagus 1 cup has 45%

2. Edamame 1/2 cup has 40%

3. Chickpea Flour 1/2 cup has 34% 

4. Lentils 1/2 cup cooked has 30%

5. Black eyed peas 1/2 cup cooked 30% 

6. Turnip Greens 1 cup broiled has 28%

7. Broccoli 1 cup cooked has 28%

8. Avocado 1 whole avocado has 27% 

9. Wheat Germ 1/2 cup has 27%

10. Mung Beans 1/2 cup cooked has 27% 

11. Pinto Beans 1/2 cup cooked has 25%

12. Chickpeas 1/2 cup cooked has 24%

13. Adzuki beans 1/2 cup cooked has 23%

14. Beets 1 cup cooked has 23% 

15. Black beans 1/2 cup cooked has 21%

16. Broccoli rabe 1 cup cooked has 11%

17. Kidney beans 1/2 cup cooked has 19%

18. Green soybeans 1/2 cup cooked has 17%

19. Brussels Sprouts 1 cup cooked has 16%

20. Kale 1 cup raw has 16%

21. Parsnip 1 whole parsnip has 23%

22. Parsley 1 cup raw has 15%

23. Great northern beans 1/2 cup cooked has 15%

24. Fava beans 1/2 cup cooked has 15%

25. Peanuts 1/4 cup raw has 15%

Source: Wholesome sources it's data from the USDA

Wholesome Nutrition tracker micronutrients app

Are you getting enough folate from your diet for a healthy pregnancy?

The Wholesome app can help you get what you need from your diet and visualize your progress tracking toward your 600 mcg goal.  Simply update your profile to 'pregnant' and the app and it will set your goal to 600 mcg per day. You can also customize your goal higher should you desire to do so.

An easy way to calculate the folate in your recipe

Calculate the nutrition and calories of recipe app

Want to know how much folate is in your recipe? You can add the recipe to Wholesome and it will analyze it for 90 nutrients. It also generates a score out of a possible 10 points to give you a sense for how nutritious and healthy the recipe is per the calories.

View and track 90 nutrients in your foods and recipes

Wholesome tracks a variety of vitamins, minerals, antioxidants, omega 3's and 6's:

Macronutrients and the usuals: Protein, Fat, Carbohydrate, Sugars, Fiber, Water, calories

Vitamins: Vitamin A, Vitamin B12, Retinol, Vitamin B6, Folate (Vitamin B9), Vitamin C, Vitamin D, Vitamin E, Vitamin K, Choline, Pantothenic Acid, Thiamin, Riboflavin, Niacin.

Minerals: Calcium, Iron, Iodine, Magnesium, Phosphorus, Potassium, Sodium, Zinc, Copper, Manganese, Selenium.

Omega 3's and 6's: Linoleic Acid, α-Linolenic Acid, EPA, DPA, DHA. 

Sterols: Phytosterol, Stigmasterol, Cholesterol.

Carotenoids (antioxidants): β-Carotene, α-Carotene, β-Cryptoxanthin, Lycopene, Lutein.

Tocopherols (antioxidants): β-Tocopherol, γ-Tocopherol, δ-Tocopherol, α-Tocotrienol, β-Tocotrienol, δ-Tocotrienol, γ-Tocotrienol.

Flavanoids (antioxidants): Cyanidin, Petunidin, Delphinidin, Malvidin, Pelargonidin, Peonidin, Catechin, EGC, Epicatechin, ECG, EGCG, Gallocatechin, Eriodictyol, Hesperitin, Naringenin, Apigenin, Luteolin, Isorhamnetin, Keampferol, Myricetin, Quercetin, Daidzein, Genistein, Glycitein, Isoflavones, Proanthocyanidins, Gingerol, Glucosinolates, Pterostilbene, Diallyl Disulfide, Molybdenum.

Other: Cysteine, Betaine, Curcumin, L-DOPA, Resveratrol.

Wholesome app set nutrition goals

How to set Wholesome app to pregnant setting

Click on the menu icon on the top left, then click on "My Profile". Change the setting to Pregnant as shown on the right. The app will auto-adjust your nutrients goals for the recommend amounts for pregnancy, such as 600 mcg of folate per day and 27 mg of iron per day. To customize your goals further, click on the 'daily goals' tab and click 'edit goals'.

What is the difference between folate and folic acid?

Folic acid is the synthetic form whereas folate is the natural form commonly found in whole foods. After ingesting the synthetic form, it must go through a complex metabolic pathway in order to turn it into the useable form, folate. But not everyone is able to process folic acid properly. Read more in my post about the differences between folate and folic acid. I also recommend that you find out whether you have any genetic variants in your MTHFR gene that would impact your ability to process folic acid - find out an easy way to check for the variant in my post here.

About the author

Jessica Glago is the CoFounder of the Wholesome App. After having two different cancers in  her childhood she developed the app with the help of her husband to get more healthfulness out of her diet. To date, Wholesome for iOS has had over 250,000 downloads and over 1.5 million whole foods tracked. The app has been featured on BuzzFeed, LikeHacker, CultofMac, and The Seattle Times. 


Top 25 folate rich whole foods - nutrition analysis

Folate rich foods Wholesome app

Top plant-based whole foods that are rich in natural folate

DV = Daily value. If you are pregnant you will need to adjust your daily goals higher.

1. Asparagus - 1 cup has 67% DV

2. Edamame - 1/2 cup has 60% DV

3. Chickpea Flour - 1/2 cup has 50% DV 

4. Lentils - 1/2 cup cooked has 45% DV

5. Black eyed peas - 1/2 cup cooked has 45% DV

6. Turnip Greens - 1 cup broiled has 43% DV

7. Broccoli - 1 cup cooked has 42% DV

8. Avocado - 1 whole avocado has 41% DV

9. Wheat Germ - 1/2 cup has 40% DV

10. Mung Beans - 1/2 cup cooked has 40% DV

11. Pinto Beans - 1/2 cup cooked has 37% DV

12. Chickpeas - 1/2 cup cooked has 35% DV

13. Adzuki beans - 1/2 cup cooked has 35% DV

14. Beets - 1 cup cooked has 34% DV 

15. Black beans - 1/2 cup cooked has 32% DV

16. Broccoli rabe - 1 cup cooked has 31% DV

17. Kidney beans - 1/2 cup cooked has 29% DV

18. Green soybeans - 1/2 cup cooked has 25% DV

19. Brussels Sprouts - 1 cup cooked has 24% DV

20. Kale - 1 cup raw has 24% DV

21. Parsnip - 1 whole parsnip has 23% DV

22. Parsley - 1 cup raw has 23% DV

23. Great northern beans - 1/2 cup cooked has 23% DV

24. Fava beans - 1/2 cup cooked has 22% DV

25. Peanuts - 1/4 cup raw has 22% DV

Source: Wholesome sources it's data from the USDA

How much folate do you need each day?

According to the National Institute of Health, 100% DV = 400 mcg per day. If you are pregnant or trying to get pregnant you will need need to increase the amount of folate in your diet from 400 mcg to 600 mcg (source: NIH). In the Wholesome app settings, simply update your profile to 'pregnant' and the app will set your goal to 600 mcg per day instead of 400 mcg.

What is the difference between folate and folic acid?

Both are termed Vitamin B9 but folic acid is the synthetic form whereas folate is the natural form commonly found in whole foods. After ingesting the synthetic form, it must go through a complex metabolic pathway in order to turn it into the useable form, folate. But not everyone is able to process folic acid properly. Read more in my post about the differences between folate and folic acid.

An easy way to calculate the folate in your recipe

Wholesome analyzes 80 nutrients in your recipe and then generates a score out of a possible 10 points for how healthy the recipe is. You can track foods and recipes and monitor your progress against your folate and other nutrient goals.

Recipe nutrition and tracking micronutrients on the Wholesome app

About the author

Jessica Glago is the CoFounder of the Wholesome App. After having two different cancers in  her childhood she developed the app with the help of her husband to get more healthfulness out of her diet. To date, Wholesome for iOS has had over 250,000 downloads and over 1.5 million whole foods tracked. The app has been featured on BuzzFeed, LikeHacker, CultofMac, and The Seattle Times. 

“Let food be thy medicine and medicine be thy food.”
— Hippocrates

Folate vs. Folic Acid: What your doctor isn't telling you

Folate foods vs Folic Acid supplements

If you're a woman of childbearing age you know that every medical appointment includes a recommendation that you take folic acid supplements. The reason for this is simple, too little folic acid has been proven to cause severe neural tube defects in a developing fetus. While all doctors know that too little folic acid is harmful, they generally do not know that too much folic acid may also have toxic effects as well. Luckily, there is a safer alternative: folate.

Folic acid vs. Folate - what's the difference?

Folic acid is a synthetic form of folate that is found in supplements and fortified foods, whereas folate is the natural form commonly found in whole foods. Both folic acid and folate go through their own metabolic pathway to turn them into the bioavailable 'final' form of folate, called methylfolate (5-MTHF). Ultimately, methylfolate (5-MTHF) is what your body needs to be healthy.

The 5-MTHF folate pathway

MTHFR mutations reduce conversion to methylfolate

A large subset of the population with certain variations in the MTHFR gene are unable to fully breakdown both folic acid and folate into its final state, methylfolate (5-MTHF). That means you may not be getting enough methylfolate even when you're taking the recommended amount in your supplement because your body cannot process it properly.

The easiest way to find out if you have a MTHFR mutation is to ask your doctor to run a panel or to do it on your own have your DNA sequenced by 23andme and then follow these instructions. I recently did both and found out that I have a compound heterozygous mutation in this gene which simply means that I have a 50% reduction in my ability to break down folic acid into methylfolate. 

MTHFR mutation in the folate pathway

Here's why folic acid (the synthetic form) is harmful

When you ingest large amounts of synthetic folic acid found in supplements and fortified foods, some of it may not be metabolized into methylfolate and it may run free in your body. The un-metabolized folic acid (called 'UMFAs') may be toxic as some studies have found that theycontribute to the development of several types of cancer. While too much synthetic folic acid results in UMFAs, too much folate from whole foods does not create UMFAs and is not harmful to your health. Thus, folate is the safer alternative.

UMFAs folic acid pathway

The research is ongoing and not fully proven yet but there is compelling evidence building that UMFAs are harmful. In one study, supplementation with folic acid was found to be associated with an increased risk of breast cancer (1). Another study found a higher rate of prostate cancer in those supplementing with folic acid (2). In 2012, a study found a correlation between the childhood eye cancer called Retinoblastoma with folic acid intake of the child's parents. Mothers who took folic acid supplements while pregnant and had the genetic MTHFR mutation in which they could not turn folic acid into folate, were 4 times more likely to have a child with Retinoblastoma than the control. The study found that “both insufficient folate intake and increased folic acid intake have been associated with the development of carcinomas in adults and with the promotion of neoplastic lesions and genetic damage in rodent models" (3).

The metabolic pathway: folic acid vs. dietary folate

In sum, your body's goal is to convert both folic acid and dietary folate into methylfolate (5-MTHF) which is the form that can be used by your cells. Unmetabolized folic acid (UMFAs) is a product of folic acid ingestion through supplementation and food fortification that may result in potential toxic effects. A better alternative is dietary folate (through foods and supplements made from whole foods), which is safe even in excess amounts. Both folic acid and folate are affected by MTHFR mutations and may reduce the conversion to methylfolate (5-MTHF).

folate pathway.jpg

If you have a MTHFR mutation it is best to increase your dietary folate. You may also consider taking a supplement directly in the form of methylfolate. In this article, find out which of the 5 best folate supplements will work best for your situation.

Your doctor is clueless about folic acid vs. folate

Don't be surprised that your doctor does not know about the dangers of folic acid nor that there is a simple and safe alternative: folate. The vast majority of doctors do not receive nutrition education in medical school, so they never learn the difference between folic acid and folate. After explaining to one of my doctors the reasons why I would not take folic acid supplements, he responded saying "I need to learn more about nutrition". 

What your doctor learned in medical school (which is true) is that too little folic acid can cause terrible birth defects and that's why they push the folic acid supplements. They are generally not aware that too much folic acid may have serious consequences, especially for those with a MTHFR mutation. So the next time your doctor recommends taking folic acid, take folate instead. Remember they both are converted into methylfolate (5-MTHF) so it's the same thing, just safer. You can get folate by eating whole foods (the Wholesome app ranks which foods are the most rich in folate) or by taking a whole food supplement. After doing heavy research into supplements, here are the 5 best folate supplements that I recommend.

Folic acid is in fortified foods, not just supplements

Unfortunately saying no to folic acid supplements is not enough to avoid it. If you eat any breads, pastas, rice, cereals, or flours, they are all fortified heavily with folic acid. Since 1998 the FDA has been fortifying with folic acid mandatory with the goal of reducing birth defects. But it is likely that too much folic acid in our diets is causing harm especially if you are eating these things everyday (4). A 2009 study looked at colon cancer in Chile before and after the start of the flour fortification program with folic acid and found that "fortification programs could be associated with an additional risk of colon cancer" (5).

What you can do

So what do you do when too little folate causes birth defects and too much folic acid may increase your risk of cancer? 

Top folate foods in the Wholesome app

1. Avoid folic acid and get as much folate from whole foods as you can. There is no danger in eating too much natural folate like there is with folic acid. Folate helps the development of red blood cells, reduces levels of homocysteine in the blood which supports cardiovascular health, and it supports nervous system function. 

The Wholesome app can help you get know if you're getting enough folate in your diet. It allows you to track toward the USDA's recommended goal based on your age and gender. It also has an easy access list of the foods with the most folate.

If you are pregnant or trying to get pregnant you will need need to increase the amount of folate in your diet from 400mcg to 600mcg (source: NIH). In the Wholesome app settings, simply update your profile to 'pregnant' and the app will set your goal to 600mcg per day. If you have a MTFHR mutation, you should set your goal higher as not all of the folate that you eat will be absorbed. 

2. Have a blood test performed by your doctor to measure your actual level of folate. I had this done recently and found out mine were way above the recommended amount (finally some validation that I don’t need those pills!). Your doctor may also run your homocysteine level which is an amino acid that can be elevated when you are deficient in folate. High homocysteine levels can put you at risk for cardiovascular disease (source).

3. Find a better folate supplement. If your levels of folate are low or you are trying to get pregnant find a supplement that says 'folate', '5-methyltetrahydrofolate', or  '5-MTHF' on the label and avoid anything that says 'folic acid'. After doing my own research, I have found that these are the 5 best folate (prenatal) supplements. Before you buy, read the nutrition label because most multivitamins contain folic acid.

4. Assuming you are getting enough folate, avoid packaged goods with folic acid listed on the label – that probably means less cereal and energy bars. Sometimes the labels are confusing, for example, cliff energy bars list “folate” under vitamins but then in the ingredients it says “folic acid”. Eat whole foods instead. 

5. Find out if you have a MTHFR mutation that can impact your ability to metabolize folic acid and puts you more at risk.

Here is an easy way to find out if you have a MTHFR mutation. 

At a minimum, do your best to get natural folate from whole foods rather than simply relying on folic acid supplementation.

About the author

Jessica Glago is the CoFounder of the Wholesome App. After having two different cancers in  her childhood she developed the app with the help of her husband to get more healthfulness out of her diet. To date, Wholesome for iOS has had over 250,000 downloads and over 1.5 million whole foods tracked. The app has been featured on BuzzFeed, LikeHacker, CultofMac, and The Seattle Times. 

“Let food be thy medicine and medicine be thy food.”
— Hippocrates

 

Image sources: 'Asparagus' by Liz West and ‘Pills’ by Grumpy Puddin