To supplement or not to supplement, that is the question: preventing folic acid deficiency.
Folic acid, also known as folate, is most famous for its role in preventing birth defects in infants. However, folic acid deficiency has also been associated with age related diseases such as Alzheimer’s and Parkinson’s so it is important for older adults to consume the correct amount of folic acid in their diet.1 This can be tricky and controversial, however. Folic acid appears in dozens of forms in our food and each form is absorbed differently by our bodies. In 1996, the USDA mandated that all flour and uncooked cereal-grain products be fortified with a form of folic acid that is absorbed at about twice the rate of natural forms of folate found naturally in our food. Also, anywhere from 50-90% of folic acid is lost during the preparation of foods. This makes it difficult to determine the amount of folic acid we consume each day.
So why not just take a folic acid supplement that provides 100% of our needs?
While consuming too little folate been proven to be unhealthy, there is concern that overconsumption can be harmful. This is due in part to the close relationship between vitamin B12 and folic acid. Folic acid supplementation can mask the harmful effects of B12 deficiency which older adults are at a higher risk of.2 Recently, there has also been speculation that high folic acid intake may lead to harmful levels in the blood.3 A recent study found that over 84% of older adults taking a supplement with folic acid exceeded the recommended amount in the diet.4
So how should an older adult get the right amount of folic acid in their diet?
The easiest way of obtaining 100% of the recommended amount of folic acid is by taking a multivitamin or by eating a fortified food product such as breakfast cereal every day. There may be some risk of getting too much folic acid however, and older adults consuming these products should be sure to take a vitamin B12 supplement. Folic acid can also be obtained from natural food sources too, which have other health benefits. If you decide not to take a supplement and do not regularly eat fortified products, the best sources of folic acid are liver, kidney beans, lima beans, and fresh dark leafy veggies. Asking your doctor check your B12 and folic acid levels is the most sure-fire way of determining your needs.
Helpful Handout: Folic Acid and the Older Adult_nkelly
Guest Blogger: Nate Kelly
- Irizarry et al. (2005) Association of homocysteine with plasma amyloid beta protein in aging and neurodegenerative disease. Neurology, 2005 Nov 8, 65(9), 1402-8.
- 2. Morris et al. (2007) Folate and vitamin B-12 status in relation to anemia, macrocytosis, and cognitive impairment in older Americans in the age of folic acid fortification. Am J Clin Nutr, 2007, 85, 193-200.
- 3. Morris et al. (2010) Circulating unmetabolized folic acid and 5-methyltetrahydrofolate in relation to anemia, macrocytosis, and cognitive test performance in American seniors. Am J Clin Nutr, 2010 Jun; 91(6):1733-44.
- 4. Weeden, Allisha. Impact of Vitamin and Mineral Supplement Use on Adequacy of Micronutrient Intakes of Older Adult Kansans. Available at: http://www.eatright.org/search.aspx?search=weeden.