Folate: essential for a healthy pregnancy and general wellbeing

Super food: Folate is not just essential for a healthy pregnancy, but low levels may contribute towards a higher risk of stomach cancer and heart disease.

FOLATE is essential for a healthy pregnancy and key to our overall health.

Folate is found in two forms — naturally occurring folate which we get from beans and legumes, dark green leafy vegetables, liver and citrus fruits and juices; and synthetic folic acid which we get from fortified cereals, breads, milks and juices, and from vitamin supplements. Folic acid is used more efficiently by the body. Here’s why folate is crucial.

Neural tube defects (NTDs)

Neural tube defects include birth deformities, such as spina bifida, anencephaly and hydrocephalus. These are caused by a failure of the foetal spinal column (the neural tube) to close early in pregnancy, and can result in severe disability or death.

The link between low maternal folate intake and increased risk of birth defects was proven in the early 1990s, and women are advised to take a daily supplement (tablet) containing 400 micrograms of folic acid.

This pre-emptive strategy is because half of all pregnancies in Ireland are unplanned, and because the neural tube closes at around day 21-23, post-conception, so by the time the woman misses her first period and realises that she’s pregnant, it will be too late for folic-acid supplementation.

Only 1-2% of young Irish women take a folic-acid supplement, and we have stubbornly high rates of NTDs.

Heart disease and stroke

The initial suggestion that low folate intake increases the risk of heart disease and stroke came from research by Kilmer McCully, in 1969. McCully noticed that children with a rare disorder, homocysteinuria, died of heart disease and stroke in their teens or early 20s. These children had very high levels of a chemical, homocysteine, in their blood, and McCully suggested this was causing their premature vascular disease.

He speculated that less severe elevations in blood homocysteine levels might increase risk of heart disease and stroke among the general population.

While his theory was given little credibility, further studies have shown possible mechanisms by which high homocysteine levels might increase risk of heart disease and stroke. Folate (and especially folic acid, the synthetic form in fortified foods) is extremely good at lowering our blood homocysteine levels.

So the question scientists are asking is whether folic-acid supplements can reduce our blood homocysteine levels, and save us from heart disease, stroke and other serious vascular conditions?

Cancer

Low folate intake has also been linked to cancer, especially cancer of the gut. Folate is intimately involved in methylation, a process that influences how the DNA in our cells gets switched on and off, determining how rapidly our cells divide. The implication is that if you have low folate intake, you will fail to ‘methylate’ your DNA. If you don’t methylate your DNA, your genes will be switched on at the wrong time, producing extra proteins that drive uncontrolled cell division. The result is tumours, often with devastating consequences.

Apart from NTDs, heart disease and cancer, low folate intake increases our risk of dementia, so it is a critical nutrient for long-term health.

Irish health

The recommended intake for folate is 300 micrograms per day. While intakes in males are generally adequate, half of all Irish females fall below this intake. Superimposed on these low folate intakes, Ireland also has notably high intakes of alcohol (which destroys folate in the body).

The rate of NTD births in Ireland is high compared to other countries, while, from 2005-9, our rates of death from heart disease were the highest among the original 15 EU-member states. In 2013, Ireland had the 14th highest rates of large-bowel cancer.

¦ Dr Daniel McCartney is a lecturer in human nutrition and dietetics at DIT

IN THE FRIDGE

Pepper salsa

Chipotle pepper salsa: Take six ripe tomatoes, remove the seeds, and place in a blender.

Add two chopped red peppers, one clove of crushed garlic, 10-15 mls of lime juice, one tablespoon of olive oil, and two teaspoons of chipotle paste. Blend until chunky, and stir-in a finely chopped red onion, a handful of roughly chopped coriander, a few sprigs of parsley, and two tablespoons of Greek-style natural yoghurt.

Serve cold from the fridge for a delicious, tangy treat.

Hot off the press

Scientists at the Waterford Institute of Technology have completed a study on nutrition and age-related macular degeneration (AMD).

This condition affects 85,000 people in Ireland and is a leading cause of blindness in older adults.

The research confirmed that daily supplementation with lutein and xeaxanthin, powerful antioxidants that neutralise damaging free radicals in the eye, not only help to prevent AMD from developing, but also improve vision in those with early-stage AMD.

A QUICK FIX

A tasty treat

Peanut-butter and carrot sticks: These two seemingly unlikely partners make a delicious treat when paired. Simply peel your carrot, slice into batons, and use the peanut butter as a readymade dip — not fancy, not exotic, but very, very tasty.


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