9 folate

Folate

Introduction

• Folate, commonly known as folic acid, functions together with a group of related water-soluble compounds, called folacin,

• It is critical to cellular division b/c it is necessary in DNA synthesis DNA synthesis

• Folate, maintains the cell’s genetic code and transfer inherited traits from one cell to another

• It is vitally important for the fetal development of nerve cells, and its deficiency during pregnancy has been linked to several birth defects

• Supplements of folic acid should be considered by all women of reproductive age

Causes of FD

• Is caused primarily by inadequate dietary intake• Typical folate intakes are suboptimal in the diets of many

women of childbearing age, • folate intake is further limited by cooking losses and

poor bioavailablity,poor bioavailablity,• Folate deficiency can also be a consequence of medical

conditions that increase the need for folate or result in increased excretion of folate, including

• pregnancy, lactation, alcoholism, malabsorption, kidney dialysis, liver disease, certain anaemias and medications that interfere with folate metabolism

Consequences

• Hemolytic and megaloblastic• Irritability • Lack of energy, Weakness • Sleeping difficulties Sleeping difficulties • Paleness • Sore red tongue • NTD in the fetus• Mild mental symptoms, such as forgetfulness and

confusion • Diarrhea

Food SourcesPLANTS ANIMALS

• Cereals (Wheat, Rice, Wheat germ)

• Legumes (Peas, Soybeans, Split peas,

Lentil, Garbanzo beans, (chickpeas)

Calves' liver

• Fruits (Orange juice, Oranges)

• Vegetables (GLV , Sprouts)

Functions

• Promotes normal red blood cell formation. • Maintains nervous system, intestinal tract, sex organs,

white blood cells, and normal patterns of growth• Regulates embryonic and foetal development of nerve

cells• Promotes normal growth and development• Promotes normal growth and development• Acts as co-enzyme for normal DNA synthesis. • Functions as part of co-enzyme in amino acid and

nucleoprotein synthesis. • Promotes normal red blood cell formation• Essential for the methylation of important substrates

(methylation of myeline basic protein) –methylation cycle

Summarized Functions

Global magnitude

• Folate deficiency is a serious problem that affects women worldwide

• Up to a third of all pregnant women reported by WHO in the world have folate deficiencies

• The problem is high in developing countries • The problem is high in developing countries with more cases from SSA

Cont…

National Status• Information on the prevalence of folate

deficiency is limited to one study ofpregnantwomen

• To date, the first large assessment of women’s nutritional status in Ethiopia was undertaken in nutritional status in Ethiopia was undertaken in 1995

• Forty-six per cent of women had severe FD (≤ 4 ng/mL) and,

• 21.2% had marginal FD(> 4–6.6 ng/mL) with unequal prevalence across the country

Risk groups

• At greatest risk for a folate deficiency are the elderly, women taking birth control pills, long-term antibiotic patients, and alcoholics

• Additionally, evidence is emerging that folatedeficiency may be implicated in the development of deficiency may be implicated in the development of osteoporosis as a result of elevated homosysteine.

• Due to the overwhelming evidence of folacin’simpact on preventing NTD, the FDA is now recommending its food fortification

Folate investigation

• RBC Morphology• Neutrophil segmentation index• Serum folic acid• vitamin B12• vitamin B12• homocysteine

Control and prevention

• Supplementation• Fortification • Dietary diversification• Education• EducationN.B: Vitamin B-12 should always be included in a

folacin supplement program b/c folacinsupplementation can mask an underlying B-12 deficiency

Folate RDA0 - 6 months 6 - 12 months 1 - 3 years 4- 6 years 7- 10 years

25mcg35mcg50mcg75mcg100mcg7- 10 years 100mcg

Females 11-14 years15+ years

150mcg 1 80mcg

Pregnant 400mcg