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Vitamin B9 (aka: folate, folicin, folic-acid) is a water-soluble B vitamin with many rich natural sources. Other Beans High in Folate (%DV per cup cooked): Mung Beans (80%), Pinto Beans (74%), Chickpeas (71%), Pink Beans (71%), Lima Beans (68%), Black Beans (64%), Navy Beans (64%), and Kidney Beans (58%). Other Dark Green Leafy Vegetables High in Folate (%DV per cup cooked): Turnip Greens (42%), Pak Choi (Chinese Cabbage)(17%), Savoy Cabbage (17%), and Collard Greens (8%). Other Lettuce High in Folate (%DV per cup shredded): Endive (18%), Butterhead (10%), Salad Cress (10%), Chicory (8%), and Arugula (4%). Other Brassica Vegetables High in Folate (%DV per cup cooked): Chinese Broccoli (22%), Broccoli Raab (15%), and Cauliflower (14%). Other Tropical Fruit High in Folate (%DV per fruit): Pomegranate (27%), Papaya (15%), Guava (7%), Kiwi (7%), and Banana (6%). Other Bread High in Folate (%DV per slice): French Bread (24%), Italian Bread (14%), Wheat Germ Bread (8%). Protect and Repair DNA to Reduce Cancer Risk and Slow Aging - Folate (Vitamin B9) is essential for the maintenance and repair of DNA which helps to prevent cancer. Alcoholics - Alcohol interferes with absorption of folate and increases excretion of folate by the kidneys.
Vitamin B9 supplements and fortified foods, usually in the form of folic acid, cannot be absorbed by some people, and may hinder absorption of natural dietary B9 (folate). Display Of Foods Rich In Folic Acid Cotswolds Uk Stock Photo, Picture And Royalty Free Image. Folic acid is an essential water soluble B vitamin which has been used for decades in the prevention of folate deficiency anemia of pregnancy. Where fortification has been implemented and studied, it has led to dramatic increases in serum folate concentrations, reduction in neural tube defects, folate deficiency anemia, as well as the reduction in homocysteine concentrations and stroke mortality with no known risk. Sixty years after the Wills paper, Sir Nicholas Wald and colleagues at the United Kingdom’s Medical Research Council demonstrated that spina bifida and anencephaly are folate deficiency diseases by reporting a randomized controlled trial proving that folic acid would prevent these important birth defects. Several years later, the Institute of Medicine (IOM) report corrected this mistake by setting the upper tolerable level as 1000 micrograms of synthetic folic acid. The Berry chapter in the Bailey book describes the remarkable increase in serum and red blood cell (RBC) folates that occurred after fortification.5 The shift upwards of the distributions of serum and RBC folates are sufficient to virtually eliminate folate deficiency anemia. The fact that several provinces in Canada still have spina bifida and anencephaly rates of more than 1 per 1,000 live births suggests that prevention could be augmented by increasing the concentration of folic acid fortificant.
Berry and colleagues were curious about those who had blood folates in the upper quintile, because of reports of poor cognitive performance among people with upper folate quintiles and low serum B12 concentrations.25 In contrast, those with normal B12 concentrations and folates in the upper quintile had a 50 percent reduction in cognitive problems.
However, political blocking of mandatory fortification of flour with folic acid continues to occur. Often the policy discussions on folic acid fortification bring up hypotheses of risk based primarily on conjecture or modest data.
Folate security remains a problem in all of Europe and many other countries around the world.
In the late 1990s, the Framingham studies showed that mild B12 deficiency was very prevalent, with or without increased homocysteine or methyl malonic acid concentrations.
Longstanding experience in the United States, Canada and other countries, most recently with folic acid fortification, has shown that flour fortification is a very effective way to get a B vitamin to the whole population in a nearly uniform dose.
Longstanding experience of fortifying flour with iron and several water soluble B group vitamins in the US, Canada and many other countries, has shown success in preventing micronutrient deficiency conditions, most recently in the very cost-effective prevention of spina bifida, anencephaly, and folate deficiency anemia. No European country has as yet implemented mandatory folic acid or B12 fortification, so that Europeans are being exposed to this unnecessary food insecurity. In this review, we have discussed the vital importance of mandatory folic acid and vitamin B12 fortification of flour for public health food security. The UK government will finalize its decision on mandatory folic acid fortification of white flour next year following blood folate tests, says the Department of Health (DoH). Nevertheless, according to the FSA there is strong evidence that increasing folic acid intake before pregnancy and in the first 12 weeks of pregnancy reduces the risk of neural tube defects.
Half of US consumers surveyed say the fiber level of a food product influences their purchase decision. Folic acid improves endothelial function in coronary artery disease via mechanisms largely independent of homocysteine. In 1991, folic acid taken prior to the start of pregnancy was shown unequivocally to prevent spina bifida and anencephaly—two of the most serious and common birth (neural tube) defects.


This opened a new, important chapter in the ability of folic acid to prevent human disease.2 Although flour fortification was implemented in the United States in the early 1940s for thiamine, riboflavin, niacin and iron, the science of folate and B12 deficiency diseases had not advanced far enough for folic acid or vitamin B12 to be included in this original fortification.
He and his colleagues performed metabolic testing and found evidence to suggest that folate metabolism was more common among post-partum women who had babies with birth defects than among those who had normal babies.16 Because of the necessity for folate in cell division, he was curious about whether or not these observations pointed to folate deficiency.
The MRC study was a two-by-two design that permitted one to determine if it was folic acid alone or folic acid with other vitamins that Smithells used that prevented the birth defects. Public Health Service (CDC, FDA, National Institutes of Health, and others) published recommendations indicating that all women who could potentially become pregnant should consume 400 micrograms of folic acid daily to prevent the birth defects.21 Discussions then began on how to maximize the prevention of neural tube defects by greatly increasing the proportion of women who consumed the recommended 400 micrograms of folic acid a day. The FDA finally decided upon a concentration that was projected to increase the consumption of folic acid by women of reproductive age by 100 micrograms, a concentration resulting in the complete prevention of folic acid-preventable spina bifida and safe for population wide use. Doubling the concentration and monitoring the rates could indicate what amount of folic acid is necessary to prevent all folic acid-preventable birth defects.
Berry and colleagues showed that, remarkably, the consumption of synthetic folic acid from mandatory fortification was a near constant 100 micrograms of serum folate across the whole distribution of population.26 They showed that those in the upper quintile with regards to serum folate reach that level by voluntarily consuming vitamin supplements or breakfast cereals fortified with folic acid. Studies also showed that the prevalence, regardless of how the deficiency was defined, was reduced by 70 percent among those who consumed vitamin pills that contained a median of six micrograms of vitamin B12.28 It is usually thought that this B12 insufficiency is due to reduced gastric acid secretion, thereby preventing absorption of food-bound vitamin B12, even in the presence of adequate intrinsic factor. Folic acid fortification has led to reductions in primary stroke possibly due to elevated homocysteine levels. In the best interest of public health, all countries in Europe and around the world should move quickly to require folic acid and B12 flour fortification. We recommend wide public education of the benefits of folic acid along with promotion of regular use of folic acid supplements for women capable of pregnancy, adoption of universal mandatory fortification of flour with folic acid and vitamin B12, and promotion of folate rich foods in regular diets. Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 19992000 (and supplemental tables). Use of folic acid for prevention of spina bifida and other neural tube defects – 1983-1991.
Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects.
Ordering folate assays is no longer justified for investigation of anemias, in folic acid fortified countries.
Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Folic acid source, usual intake, and folate and vitamin B-12 status in US adults: National Health and Nutrition Examination Survey (NHANES) 20032006. Dietary reference intake: thiamin, riboflavin, niacin, vitamin B6, folate, p antothenic acid, biotin, and choline. It says that 50% of pregnancies in the UK are unplanned and approximately 700 to 900 pregnancies are affected by neural tube defects each year in the UK.Voluntary fortification already happeningSome food manufacturers already voluntarily fortify certain cereals and margarines with folic acid.
Soon governments recommended that women of reproductive age consume folic acid daily to prevent these birth defects.
To date, no country in Europe has implemented mandatory folic acid fortification of flour, although it has been recommended by the UK Food Safety Authority. Folic acid was synthesized in the 1940s and has been used by millions of pregnant women to prevent folate deficiency anemia associated with pregnancy. It is surprising that, nearly 20 years after the scientific proof that folic acid prevents neural tube defects and more than 10 years since the countries in North America required folic acid fortification and demonstrated that such action prevents neural tube defects in the population, no country in Europe has required folic acid fortification.
It was assumed at the time that recommendations geared toward all women of reproductive age to consume folic acid daily might have high compliance among the well educated population, but would be ignored by many, even the majority.
Current levels of fortification may not be sufficient to achieve maximum potential preventive effects, and assuring complete prevention probably requires increasing the concentration of folic acid in flour. This observation is very important for those considering mandatory folic acid fortification.
Long delayed in Australia, fortunately, folic acid fortification was implemented on schedule in September of 2009. No risks were evidenced even from these high exposures.12 Moreover, even if these high doses were harmful, the process of folic acid fortification, in itself, would be safe, because it could never lead to such intake levels. Figure 1 shows that more than 50 countries, including most of those in the Americas, have mandated folic acid fortification, but that no country in Europe has yet required it.


More than 50 countries have implemented mandatory folic acid fortification, including the US (1998) and most recently, Australia (September 2009). Because compliance was low and since more than half of pregnancies are unplanned, the United States Food and Drug Administration mandated in 1998 that all enriched flour be fortified with folic acid at a concentration estimated to give the average woman an intake of 100 micrograms of folic acid a day.
This review discusses the vital importance of mandatory flour fortification with folic acid and vitamin B12, for public health food security and as a challenge to the New Public Health in Europe and globally.
Folic acid combined with iron continues to be a program promoted by the World Health Organization (WHO) for women in the latter half of pregnancy in developing countries. Food and Nutrition Board recommended adding folic acid to flour because of concern that older Americans were folate deficient, but the U.S. Not only would such a policy prevent neural tube defects in Europe, but it would also virtually eliminate folate deficiency anemia and lower serum homocysteine concentrations with the likelihood of preventing strokes with no known risks.10 The most puzzling public policy stance in Europe is taken by the Netherlands, which, rather than implement a folic acid fortification program that would prevent spina bifida, has chosen euthanasia for many with spina bifida. It has subsequently been shown that government recommendations alone, including those in Europe, fail to improve consumption.22 Thus if children are to have the full benefit of folic acid in preventing birth defects, there needs to be mandatory folic acid fortification in a commonly consumed food.
This low concentration of folic acid was selected because of an error in the modeling by the FDA. To this day, no validated risk has been found nor has any litigation been initiated, even after hundreds of millions of North Americans have been consuming flour fortified with folic acid for more than a decade. The current evidence suggests that an extra 100 micrograms of folic acid from fortification is safe for the population, so that safety concerns cannot be professionally used as an argument against fortification.
In the UK, the recommendation of the Food Standards Agency (FSA) of 2007 was turned back by the Chief Medical Officer for further review of the evidence, then resubmitted in 2009, and now awaits ministerial decision. No known risks have been associated with folic acid fortification which has been in place for more than a decade, reaching hundreds of millions of North Americans. It is right that the government balance both the risks and the benefits of a policy that would see the mandatory fortification of a staple food.”Mandatory fortification is recommended by the Scientific Advisory Committee on Nutrition (SACN) and the Food Standards Agency (FSA) but with controls on voluntary fortification and advice on supplementation.
There is voluntary fortification to consider as well as assessing current blood folate levels in consumers.
Canada and Chile followed with similar requirements for folic acid fortification of wheat flour. The FDA decided based on a risk hypothesis stating that the fortification concentration should be set so that an 18-year-old male consuming a multivitamin with 400 micrograms of folic acid, and eating food made with fortified flour, would not consume more than 1000 micrograms of total folate daily—the sum of synthetic folic acid and the natural folate in food. THT has taught and published on policy issues in prevention of birth defects and in food fortification. Too much folic acid in the diet can increase the risk of colorectal adenomas or colorectal cancer in the over 50s and can mask the symptoms of vitamin B deficiency, they say.
A strong communication campaign is also needed to target people who do need folic acid supplementation.”When a decision is finally reached it could take a further two years to implement, adds Polson. Health workers used large doses of folic acid to cure folate deficiency anemia around the world.
They were concerned that folic acid could mask the anemia of B12 deficiency, and thereby potentially prevent diagnosis and treatment of this condition. The total global prevention of these birth defects will require mandatory folic acid fortification of flour in Europe. Folate, Vitamin B9, is a water soluble vitamin that is well regulated by the body, thus overdose is rare in natural food sources, and can only occur from supplements.
The role of folate in one-carbon metabolism was worked out and anti-folates became the mainstay of cancer treatment. The biochemistry is such, however, that folate contained in food cannot cure the anemia of B12 deficiency.
Folic acid will neither prevent nor cure these vitamin B12 conditions, but will also not make these worse. Below is a list high folate foods, click here for high vitamin B9 (folate) foods by nutrient density, here for an extended list of folate rich foods, and here for other vitamin B foods.



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