Folic Acid Foods, Deficiency, Benefits, Side Effects, What is Folic Acid? Pregnancy

What is Folic Acid?

Folic acid, also known as folate or folacin, is an important B vitamin that significantly lowers the risk of serious birth defects of the brain and spinal cord. Folic acid is important in the synthesis of DNA, which controls cell function and heredity as well as tissue growth. In addition, folate acts with vitamin B-12 to produce red blood cells. Preliminary studies also suggest that folacin may be helpful in preventing cervical cancer.

Most people get an adequate amount of folic acid from the foods they eat. Alcoholics, pregnant women, and people taking certain medications may be at higher risk for folate deficiency. Women of childbearing age (approximately fifteen to forty-five years) are recommended to include 400 micrograms of folic acid in their diets, particularly important before and during pregnancy to prevent birth defects.

The U.S. Recommended Dietary Allowance (RDA) for folate is 180 to 200 micrograms (mcg). Rich dietary sources of folate are recommended over supplements. They include:

  • Dark green, leafy vegetables

  • Whole wheat bread

  • Lightly cooked beans and peas

  • Nuts and seeds

  • Sprouts

  • Spinach

  • Oranges and grapefruits

  • Liver and other organ meats

  • Poultry

  • Fortified breakfast cereals and enriched grain products

One cup of orange juice provides half the RDA for folate, underscoring how easy a nutrient it is to consume. Food processing destroys 50 percent to 90 percent of the folate in foods, as it is very susceptible to heat. It is really important to eat raw foods and lightly cooked vegetables as they retain their nutrient value the best when cooked minimally in water -- through steaming, stir-frying, or microwaving. Because folic acid is so important during pregnancy, some pregnant women take a multivitamin or supplement with folic acid. However, taking too much folic acid could mask a vitamin B-12 deficiency, which could be dangerous, meaning that pregnant women should discuss their diet and whether they need folic acid supplementation with their health care provider.

Health Benefits of Folic Acid

15 Foods High in Folic Acid

There are a number of reasons it’s important to get adequate amounts of folic acid. Perhaps most importantly, cellular growth and regeneration. A recent article from the New York Times named folic acid one of the most, “luscious micronutrients” found in foods and multiple studies suggest a lack of folic acid may lead to mental conditions such as depression.

Folic acid allows the body to perform many essential functions including nucleotide biosynthesis in cells, DNA synthesis and repair, red blood cell creation, and prevention of anemia. Folic acid, also known as vitamin B9, is well known for its applications in the prevention of fetal deformities, Alzheimer’s disease, and several types of cancer. Fortunately, there are many foods that are naturally rich sources of folic acid.

Foods with Folic Acid

The following foods are great sources for folic acid. This list isn’t expansive but is a great place to get started. As always, I do recommend organic if available.

1. Dark Leafy Greens

Spinach is Folic Acid Food

It should come as no surprise that one of the planet’s healthiest foods is also one of the highest in folate. For an immediate boost in folic acid, consider adding more spinach, collard greens, kale, turnip greens and romaine lettuce into your daily diet. Just one large plate of these delicious leafy greens can provide you with almost all of your daily needs for folic acid.

Below is a short list of leafy greens that are high in folic acid.

  • Spinach — 1 cup = 263 mcg of folate (65% DV)

  • Collard Greens — 1 cup = 177 mcg of folate (44% DV)

  • Turnip Greens — 1 cup = 170 mcg of folate (42% DV)

  • Mustard Greens — 1 cup = 103 mcg of folate (26% DV)

  • Romaine Lettuce — 1 cup = 76 mcg of folate (19% DV)

2. Asparagus

Asparagus is one of the best sources of folic acid

This woody treat is perhaps the most nutrient dense foods with folic acid out of the entire vegetable kingdom. Eating just one cup of boiled asparagus will give you 262 mcg of folic acid, which accounts for approximately 65% of your daily needs. Not only is asparagus a delicious snack, but it’s also full of nutrients your body craves, including Vitamin K, Vitamin C, Vitamin A and Manganese.

3. Broccoli

Not only is broccoli one of the best detox foods you can eat, it’s also a great source for folic acid. Eating just one cup of broccoli will provide you with approximately 24% of your daily folic acid needs, not to mention a whole host of other important nutrients. We recommend eating organic broccoli raw or lightly steamed.

4. Citrus Fruits

Papaya is high in folic acid

Many fruits contain folic acid, but citrus fruits rank the highest. Oranges are an especially rich source of folic acid. One orange holds about 50 mcg, and a large glass of juice may contain even more. Other folate-rich fruits include papaya, grapefruit, grapes, banana, cantaloupe and strawberries. Here is a short list of fruits high in folic acid.

  • Papaya — One papaya = 115 mcg of folate (29% DV)

  • Oranges — One orange = 40 mcg of folate (10% DV)

  • Grapefruit — One grapefruit = 30 mcg of folate (8% DV)

  • Strawberries — 1 cup = 25 mcg of folate (6.5% DV)

  • Raspberries — 1 cup = 14 mcg of folate (4% DV)

5. Beans, Peas and Lentils

Beans are the best folic acid food

Beans and pulses especially high in folic acid include pinto beans, lima beans, green peas, black-eyed peas and kidney beans. A small bowl of any type of lentils will give you the majority of your recommended daily amounts for folate. Here is a short list of how much which beans have the most folic acid.

  • Lentils — 1 cup = 358 mcg of folate (90% DV)

  • Pinto Beans — 1 cup = 294 mcg of folate (74% DV)

  • Garbanzo Beans — 1 cup = 282 mcg of folate (71% DV)

  • Black Beans — 1 cup = 256 mcg of folate (64% DV)

  • Navy Beans — 1 cup = 254 mcg of folate (64% DV)

  • Kidney Beans — 1 cup = 229 mcg of folate (57% DV)

  • Lima Beans — 1 cup = 156 mcg of folate (39% DV)

  • Split Peas — 1 cup = 127 mcg of folate (32% DV)

  • Green Peas — 1 cup = 101 mcg of folate (25% DV)

  • Green Beans — 1 cup = 42 mcg of folate (10% DV)

6. Avocado

Avocados are high in folic acid

The most beloved vegetable of Mexican fare, the buttery avocado holds up to 90mcg of folate per cup, which accounts for approximately 22% of your daily needs. Not only are avocados one of the best foods with folic acid, but it’s also an excellent source of fatty acids, vitamin K and dietary fiber. Adding them to sandwiches or salads will make for an extra-healthy treat.

7. Okra

Okra is a Folic Acid Food

The world’s slimiest veggie is also one of the most nutrient rich. Okra has the distinct ability to simultaneously offer vitamins and minerals while cleansing the entire digestive tract from toxic build-up. When it comes to folate, Okra is a great source. Just one cup of cooked okra will give you approximately 37 mcg of folic acid.

8. Brussel Sprouts

While brussel sprouts probably isn’t your favorite vegetable, there is no denying that they are one of the best foods with folic acid. Eating one cup of boiled brussel sprouts will give you approximately 25% of your daily recommended amount. Brussel sprouts are also high in vitamin C, vitamin K, vitamin A, manganese and potassium. Even with the abundance of nutrients, it still remains incredibly difficult to convince your kid to give them a try.

9. Seeds and Nuts

Flax seeds are high in folic acid

It doesn’t matter if it’s pumpkin, sesame, sunflower or flax seeds, eating them raw or sprouted, or sprinkling them onto your next salad will add a healthy dose of folic acid. Sunflower seeds, flax seeds and peanuts are especially high in folate, with one cup offering up to 300 mcg. Nuts are also very high in folic acid, with both peanuts and almonds ranking especially high. Below is a short list of the best seeds and nuts for folic acid.

  • Sunflower Seeds — ¼ cup = 82 mcg of folate (21% DV)

  • Peanuts — ¼ cup = 88 mcg of folate (22%)

  • Flax Seeds — 2 tbs = 54 mcg of folate (14% DV)

  • Almonds — 1 cup = 46 mcg of folate (12% DV)

10. Cauliflower

This cruciferous vegetable is typically regarded as one of the best vitamin C foods, but it’s also a great source for folic acid. Eating just one cup of boiled cauliflower will give you approximately 55 mcg of folate, accounting for 14% of your recommended daily value. We recommend adding fresh cauliflower to a salad with some of the other folic acid foods on this list.

11. Beets

Beets have folate

Beets are a great source for antioxidants that provide detox support, making them one of the best liver cleanse foods on the planet. While that’s a great reason to add them to your diet, beets are also known as one of the best foods with folic acid. Eating one cup of boiled beets will provide you with approximately 136 mcg of folate, accounting for 34% of your daily needs.

12. Organic Corn

You probably have a can of corn in your pantry right now. This popular vegetable also contains plenty of folate. Just one cup of cooked corn will give you approximately 76 mcg of folic acid, accounting for almost 20% of your daily needs. We would recommend avoiding canned veggies and opting for fresh and organic.

13. Celery

Celery is commonly regarded as a great food to help with kidney stones, but did you know it’s also a great source for folic acid? Just one cup of raw celery will give you approximately 34 mcg of folate, accounting for 8% of your daily needs.

14. Carrots

Carrots are delicious

Carrots are another extremely popular vegetable that is probably in your home right now. Just one cup of raw carrots will give you almost 5% of your daily recommended needs for folic acid. Eat baby carrots as a snack or add them to your salads for a folate boost!

15. Squash

Squash may not be the most popular vegetable for your family, but there is no denying its nutritional benefits. Whether it’s summer squash or winter squash, adding this veggie to your diet will help give you a boost in folic acid. Here is a breakdown of how much folate can be found in squash.

  • Winter squash — 1 cup = 57 mcg of folate (14% DV)

  • Summer Squash — 1 cup = 36 mcg of folate (9% DV)

What is folic acid deficiency anemia?

Folic acid deficiency anemia happens when your body does not get enough folic acid. Folic acid is one of the B vitamins, and it helps your body make new cells, including new red blood cells. Your body needs red blood cells to carry oxygen. If you don't have enough red blood cells, you have anemia, which can make you feel weak and tired. So it’s important that you get enough folic acid every day.

Most people get enough folic acid in the food they eat. But some people either don't get enough in their diet or have trouble absorbing it from the foods they eat. Talk to your doctor about whether you should take a daily vitamin with folic acid.

Pregnant women who do not get enough folic acid are more likely to have babies with very serious birth defects.

What causes folic acid deficiency anemia?

You can get folic acid deficiency anemia if:

  • You don't eat enough foods that contain folic acid. These include citrus fruits, leafy green vegetables, and fortified cereals.

  • You have a greater need for folic acid. This might happen if you are pregnant or have some medical problems, such as sickle cell disease.

  • Your body doesn't absorb enough folic acid. This might happen if you drink too much alcohol or have severe kidney problems that require blood-cleaning procedures.

  • You take certain medicines, such as some used for cancer, rheumatoid arthritis, and seizures.

Symptoms of folic acid deficiency anemia

Anemia may make you:

  • Feel weak and tired.

  • Feel lightheaded.

  • Be forgetful.

  • Feel grouchy.

  • Lose your appetite and lose weight.

  • Have trouble concentrating.

How is folic acid deficiency anemia diagnosed?

Your doctor will examine you and ask questions about your past health and how you are feeling now. You will also have blood tests to check the number of red blood cells and to see if your body has enough folic acid.

The level of vitamin B12 will be checked too. Some people whose folic acid levels are too low also have low levels of vitamin B12. The two problems can cause similar symptoms.

What are the causes of folic acid deficiency?

  • Not eating enough foods containing folic acid is the most common cause. This occurs most often in elderly people who do not eat well. Another group who often don't eat properly are people who are alcohol-dependent.

  • Pregnancy causes reserves of folic acid in your body to be used by the growing baby. You are at risk of becoming low in folic acid during the later stages of pregnancy, particularly if you do not eat well during pregnancy.

  • Some uncommon conditions of the gut may cause poor absorption of folic acid. For example, coeliac disease.

  • Some blood disorders can lead to a very high turnover of red blood cells. For example, sickle cell disease and thalassaemia. Normal amounts of folic acid in the diet may then not be enough, and supplements may need to be taken.

  • Some inflammatory conditions can lead to low folic acid levels - for example, severe Crohn's disease. This is less common though.

  • Some medicines interfere with folic acid. Therefore, you may need to take extra folic acid whilst taking certain medicines. For example, colestyramine, sulfasalazine, methotrexate and some anticonvulsant medicines used to treat epilepsy.

Treatment of folic acid deficiency anemia

If you think you have anemia, it is important to see your doctor and get tested so you can get the right treatment. Being treated for a shortage of folic acid when your anemia is caused by something else can be dangerous.

To treat the anemia, you can take folic acid pills each day to bring your folic acid level back up.

After your folic acid levels are normal, eat foods rich in folic acid so you don't get anemia again. These foods include fortified breads and cereals, citrus fruits, dark green, leafy vegetables, and beans, peas and lentils.

Why is folic acid important before and during pregnancy?

Folic acid helps prevent neural tube defects, such as spina bifida. These are major birth defects in which the baby's brain or spine is not fully formed. These birth defects usually happen in the first few weeks of pregnancy, before a woman even knows she is pregnant.

If you are a woman who could get pregnant, experts recommend taking a daily vitamin to make sure you get enough folic acid. For folic acid to help, you need to take it every day, starting before you become pregnant.

Folic acid and pregnancy

Without enough folic acid in your body, your baby's neural tube may not close correctly and he or she could develop health problems called neural tube defects. These include:

  • Spina bifida: incomplete development of the spinal cord or the vertebrae

  • Anencephaly: incomplete development of major parts of the brain  

Babies with anencephaly usually do not live long, and those with spina bifida may be permanently disabled. These are scary problems, to say the least. But the good news is that getting enough folic acid may protect your baby from neural tube defects by at least 50%. According to the CDC, if you've already had a baby with a neural tube defect, getting enough folic acid may reduce your risk of having another child with a neural tube defect by as much as 70%.

When taken before and during pregnancy, folic acid may also protect your baby against:

  • Cleft lip and palate

  • Premature birth

  • Low birth weight

  • Miscarriage

  • Poor growth in the womb

Folic acid has also been suggested to reduce your risk of:

  • Pregnancy complications (One report found that women who took folic acid supplements during the second trimester had a reduced risk of preeclampsia.)

  • Heart disease

  • Stroke

  • Some types of cancers

  • Alzheimer’s disease

Good Food Sources of Folic Acid

Foods that can help you get more folic acid in your diet include:

  • 400 mg: Breakfast cereals fortified with 100% of the DV, 3/4 cup

  • 215 mg: Beef liver, cooked, braised, 3 oz

  • 179 mg: Lentils, mature seeds, cooked, boiled, 1/2 cup

  • 115 mg: Spinach, frozen, cooked, boiled, 1/2 cup

  • 110 mg: Egg noodles, enriched, cooked, 1/2 cup

  • 100 mg: Breakfast cereals, fortified with 25% of the DV, 3/4 cup

  •   90 mg: Great Northern beans, boiled, 1/2 cup

Getting Enough Folic Acid

The Centers for Disease Control and Prevention (CDC) recommends that all women of childbearing age — and especially those who are planning a pregnancy — consume about 400 micrograms (0.4 milligrams) of folic acid every day. Adequate folic acid intake is very important before conception and at least 3 months afterward to potentially reduce the risk of having a fetus with a neural tube defect.

So, how can you make sure you're getting enough folic acid? In 1998, the U.S. Food and Drug Administration mandated that folic acid be added to enriched grain products — so you can boost your intake by looking for breakfast cereals, breads, pastas, and rice containing 100% of the recommended daily folic acid allowance.

But for most women, eating fortified foods isn't enough. To reach the recommended daily level, you'll probably need a vitamin supplement. During pregnancy, you require more of all of the essential nutrients than you did before you became pregnant.

Although prenatal vitamins shouldn't replace a well-balanced diet, taking them can give your body — and, therefore, your baby — an added boost of vitamins and minerals. Some health care providers even recommend taking a folic acid supplement in addition to your regular prenatal vitamin. Talk to your doctor about your daily folic acid intake and ask whether he or she recommends a prescription supplement, an over-the-counter brand, or both.

Also talk to your doctor if you've already had a pregnancy that was affected by a neural tube defect. He or she may recommend that you increase your daily intake of folic acid (even before getting pregnant) to lower your risk of having another occurrence.

Folic Acid Side Effects

While most people do not experience problems when taking folic acid, problems may occur if you take high doses of the vitamin. It is also possible to develop an allergic reaction while taking it. If taken in high doses, side effects of folic acid may include stomach cramps, gas and bloating, diarrhea, and problems sleeping.

Does Folic Acid Cause Side Effects?

Folic acid usually does not cause significant side effects in most people, especially when taken at normal dosages. However, it can sometimes cause serious side effects, especially when taken at higher dosages.

Possible Side Effects of Folic Acid

Taking high doses of folic acid, more than 1 mg (1000 mcg) a day, can "mask" a vitamin B12 deficiency. This means that folic acid can correct anemia caused by vitamin B12 deficiency (making the deficiency hard to detect or diagnose), but it does not stop the nerve damage caused by the vitamin B12 deficiency.

Very high doses have been reported to cause the following side effects:

  • Abdominal (stomach) cramps

  • Diarrhea

  • Nausea

  • Gas and bloating

  • Rash

  • Problems sleeping

  • Irritability, excitability, or hyperactivity

  • Bitter taste in the mouth

  • Zinc deficiency

  • Psychotic behavior

  • Seizures (typically in people who already have a seizure disorder).

Early studies suggest that high doses of folic acid might actually increase the risk of cancer, cardiovascular disease, or age-related cognitive problems. A normal folic acid dosage does not seem to be associated with such problems.

Allergic Reaction to Folic Acid

Even though folic acid is added to a wide variety of foods in the United States, some people may be allergic to it. Seek medical attention right away if you develop any signs of an allergic reaction, such as:

  • An unexplained rash

  • Hives

  • Itching

  • Swelling of the mouth or throat

  • Wheezing

  • Difficulty breathing or swallowing.

Final Thoughts

If you think you are experiencing a side effect with folic acid, please let your healthcare provider know. Also, let him or her know if you develop something that "just does not seem right." While it may not be a side effect, your healthcare provider will be able to diagnose and treat the problem.
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