It is well-known that optimal folate consumption has positive effects on a wide range of health conditions including fetal neural tube defects (eg. anencephaly, spina bifida), orofacial deformities such as cleft palate, pre-eclampsia and premature birth, as well as mood stability and longevity. This list is by no means extensive.
Folic acid has been added to non-artisan/non-organic bread in Australia since 2009 for the purpose of protecting babies born with neural tube defects. While folic acid is certainly the cheapest form of the folates, the question remains, "Is it the best form?" Certainly, folic acid is NOT synonymous with folate from food or 5-MTHF supplements and errors or omissions in research papers and dietary guidelines stating "folate" when folic acid is the actual form used, are not correct, nor acceptable.
Moreover, evidence is mounting not only of the penetrance of single nucleotide polymorphisms (SNPs) in general, especially the A677T form, but also how these SNPs affect folate metabolism and worryingly how they affect the metabolism and excretion of cheap folic acid from fortified foods and supplements.
Carolyn Ledowsky has long been a fervent advocate of the 5-methyltetrahydrofolate (5-MTHF) form because of issues with this unmetabolised folic acid taken by some individuals in doses well above the 1000mcg upper tolerable limit set out by medical and food authorities.
Listen in today as Carolyn Ledowsky takes us through the discoveries of her Masters thesis and her plans to shake the halls of orthodoxy with her Ph.D project. The data will tell what they will, but Carolyn says the evidence is mounting against folic acid food fortification and favouring 5-MTHF supplementation in those with single nucleotide polymorphisms, esp homogenous 677C>T SNP.
Research:
Ledowsky C, Mahimbo A, Scarf V, et al. Women Taking a Folic Acid Supplement in Countries with Mandatory Food Fortification Programs May Be Exceeding the Upper Tolerable Limit of Folic Acid: A Systematic Review. Nutrients. 2022 Jun 29;14(13):2715.
https://pubmed.ncbi.nlm.nih.gov/35807899/
Sweeney MR, McPartlin J, Scott J. Folic acid fortification and public health: report on threshold doses above which unmetabolised folic acid appear in serum. BMC Public Health. 2007 Mar 22;7:41.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1839088/
Long S, Goldblatt J. MTHFR genetic testing: Controversy and clinical implications. Aust Fam Phys. 2016 Apr;45(4).
https://www.racgp.org.au/afp/2016/april/mthfr-genetic-testing-controversy-and-clinical-imp#ref-20
Tsang BL, Devine OJ, Cordero AM, et al. Assessing the association between the methylenetetrahydrofolate reductase (MTHFR) 677C>T polymorphism and blood folate concentrations: a systematic review and meta-analysis of trials and observational studies. Am J Clin Nutr 2015;101(6):1286-94.
https://academic.oup.com/ajcn/article/101/6/1286/4564518?login=false
Bailey LB, Stover PJ, McNulty H, et al. Biomarkers of Nutrition for Development-Folate Review. J Nutr 2015;145(7):1636S-80S. doi: 10.3945/jn.114.206599.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478945/
Kelly P, McPartlin J, Goggins M, et al. Unmetabolized folic acid in serum: acute studies in subjects consuming fortified food and supplements. Am J Clin Nutr 1997;65(6)