Medical Forum / General / Nutrition / January 2007
folic acid and B vitamins - more evidence to support us lifestyle food cultists
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TC - 19 Jan 2007 17:05 GMT http://www.forbes.com/forbeslife/health/feeds/hscout/2007/01/19/hscout601131.html
Folic Acid Boosts Cognition in Older Adults 01.19.07, 12:00 AM ET
FRIDAY, Jan. 19 (HealthDay News) -- Dutch researchers have added another chapter to the continuing debate over whether folic acid supplements can sharpen the aging mind. Their conclusion: The nutrient does improve cognitive function in older adults. Previous studies on the subject have been split, although most have suggested that folic acid supplementation in people with high levels of the amino acid homocysteine in the blood helps with cognitive function. Higher homocysteine levels are associated with an increased risk for cardiovascular disease and stroke and possibly also Alzheimer's disease.
The new study, published in the Jan. 20 issue of The Lancet, adds to the growing impression that adding folic acid can help brain functioning, at least in certain groups of people.
"We can certainly take away that folate is going to be beneficial for cognitive improvement when you have high homocysteine levels," said Maria Carrillo, director of medical and scientific relations at the Alzheimer's Association.
"This underscores the importance of B vitamins," added Richard Finnell, Regents Professor in the Center for Environmental and Genetic Medicine at Texas A&M's Health Science Center Institute of Biosciences and Technology at Houston. "They do more than protect babies against birth defects."
Folic acid, or folate, is a B vitamin probably best known for its role in helping to prevent neural-tube defects in newborns.
But folic acid also has several other functions: It helps the body digest and utilize proteins and to synthesize new proteins when they are needed; it's essential for the production of red blood cells and the synthesis of DNA; it helps with tissue growth and cell function; it helps to increase appetite when needed; and it stimulates the formation of digestive acids.
Food sources of folate include beans and legumes; citrus fruits and juices; wheat bran and other whole grains; dark, green leafy vegetables; poultry; pork; shellfish and liver, according to the National Institutes of Health.
Cognitive function, especially areas such as information processing speed and memory, decline with age. These cognitive changes have been linked to a risk of dementia.
For this study, first reported at the Alzheimer's Association's 2005 prevention conference, researchers randomly assigned 818 older adults in Holland, aged 50 to 70 years old, to receive 800 micrograms of folic acid supplementation daily or a placebo for three years.
All participants had low folate levels, as evidenced by elevated homocysteine concentrations.
Adults who received the folic acid supplementation had improved cognitive functioning, especially in the areas of memory and information processing speed. What's more, folate concentration increased 576 percent in those getting the supplements, and homocysteine levels fell 26 percent.
"Folate can help people with high homocysteine levels," Carrillo confirmed. "This is in line with what we have been thinking."
The same Dutch researchers, reporting in the Jan. 2 issue of the Annals of Internal Medicine, found that people who took a folic acid supplement had less decline in hearing low-frequency sounds over time, compared with people who didn't take the supplement.
More information
The National Institute on Aging has more on aging and dietary supplements, including vitamins and minerals.
*************
Real nutrition leads to real health.
TC
DZ - 19 Jan 2007 17:22 GMT > http://www.forbes.com/forbeslife/health/feeds/hscout/2007/01/19/hscout601131.html ...
> Folic Acid Boosts Cognition in Older Adults > Adults who received the folic acid supplementation had improved > cognitive functioning, especially in the areas of memory and > information processing speed. What's more, folate concentration > increased 576 percent in those getting the supplements, and > homocysteine levels fell 26 percent. ...
> ************* > Real nutrition leads to real health. Folic acid used for supplementation is synthetic and not the same chemically as the natural form of folate. I suppose there would be a lot of "processing" and purification involved in the making of that chemical. That doesn't really bother me, but how is it "real" food?
TC - 19 Jan 2007 17:37 GMT > > http://www.forbes.com/forbeslife/health/feeds/hscout/2007/01/19/hscout601131.html > ... [quoted text clipped - 12 lines] > lot of "processing" and purification involved in the making of that > chemical. That doesn't really bother me, but how is it "real" food? I agree. If fake manufactured processed folate shows such great results, imagine what will happen when they get enough folate-containing real foods in their diets.
My point is that we can't deny the importance of real nutrients to our health. By real nutrients, I mean those vitamins and minerals that have been shown scientifically to be essential to our survival and our thriving physically.
And the converse is that we have to understand how detrimental to our health these fake manufactured overly processed nutrient-deficient foods are.
Real nutrition equals real health.
TC
David Harmon - 20 Jan 2007 00:52 GMT On Fri, 19 Jan 2007 17:22:59 +0000 (UTC) in sci.med.nutrition, DZ <22777@145806466.2733218530.31145.24927.3955> wrote,
>Folic acid used for supplementation is synthetic and not the same >chemically as the natural form of folate. What's the difference?
DZ - 20 Jan 2007 02:57 GMT >> Folic acid used for supplementation is synthetic and not the same >> chemically as the natural form of folate. > > What's the difference? Folate in food is predominantly a mixture of 2 forms - 5-methyl-H4 folate and 10-formyl-H4 folate (http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=405403)
The synthetic one is "PGA", pteroylmonoglutamic acid. It has higher bio-availability and is converted to the 5-methyl-H4 form by the body, but the reaction is saturated at doses higher than 400 mcg (http://pmid.us/15738964) so it's probably better to take it in divided doses.
Jim Chinnis - 20 Jan 2007 19:25 GMT DZ <sc13nc3d@gmail.com> wrote in part:
>>> Folic acid used for supplementation is synthetic and not the same >>> chemically as the natural form of folate. [quoted text clipped - 10 lines] >(http://pmid.us/15738964) so it's probably better to take it in >divided doses. I'm not aware that PGA has markedly lower conversion with doses above 400 mmg. The abstract of the cited document looks like an opinion piece rather than a lab study. If you have the full text, can you quote the paragraph or so dealing with limits on folic acid conversion?
I would greatly appreciate it if you could clarify this! -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu
DZ - 20 Jan 2007 23:47 GMT > DZ <sc13nc3d@gmail.com> wrote in part: >>>> Folic acid used for supplementation is synthetic and not the same [quoted text clipped - 18 lines] > > I would greatly appreciate it if you could clarify this! I quoted that excerpt once before, so I'll just post a groups link to Michael's reply that also conatained the abstracts of the quoted studies - http://groups.google.com/group/sci.life-extension/msg/5ea918023595f373
HTH
Jim Chinnis - 21 Jan 2007 05:34 GMT DZ <sc13nc3d@gmail.com> wrote in part:
>> DZ <sc13nc3d@gmail.com> wrote in part: >>>>> Folic acid used for supplementation is synthetic and not the same [quoted text clipped - 25 lines] > >HTH Thank you. More after I've done some thinking and reading. -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu
Jim Chinnis - 22 Jan 2007 15:45 GMT DZ <sc13nc3d@gmail.com> wrote in part:
>> DZ <sc13nc3d@gmail.com> wrote in part: >>>>> Folic acid used for supplementation is synthetic and not the same [quoted text clipped - 25 lines] > >HTH This is interesting. I haven't read all the material, but if conversion is lmited above 400 mmg, all the studies that show no cardiac benefit of folic acid supplementation (above 400 mmg) may be failing to find a benefit because of the reduced conversion. Further, I gather that a divided dosing schedule might change that.
Of course, the cognitive benefits shown might be due to the unconverted synthetic form in the blood... ;-) -- Jim Chinnis Warrenton, Virginia, USA jchinnis@alum.mit.edu
Matti Narkia - 22 Jan 2007 16:37 GMT >DZ <sc13nc3d@gmail.com> wrote in part: > [quoted text clipped - 33 lines] >because of the reduced conversion. Further, I gather that a divided dosing >schedule might change that. According to the article
"What are the benefits of taking the "fancy" form of folic acid, 5-methyl tetrahydrofolate, and how would I know if it is better for me if I decide to try it?" <http://www.austinchronicle.com/gyrobase/Issue/column?oid=oid%3A269705>
mutations have been found at two locations on the gene needed to convert folic acid into 5-MTHF and that roughly a quarter of the population has one or both of the mutations. The conversion of folic acid to 5-MTHF still takes place in these people but even more slowly than normal, and there is a tendency for homocysteine to become elevated.
Using 5-methyltetrahydrofolate in supplementation instead of folic acid would overcome the conversion problem:
I don't know about the availabily of 5-methyltetrahydrofolate. It is probably available somewhere, but is not ubiquitous as the regular folic acid. Does anyoone know where to get it? About the first link my quick web search returned was <http://www.fallonpharmacy.com/prod_details.php?pid=2490>, but that is mixture, and the amount of 5-MTHF is not given.
Here's another search result, seems to be mainly informative, but badly formatted :-):
L-5-Methyl Tetrahydrofolate <http://nwclinic.com/L5.html>
 Signature Matti Narkia
William Wagner - 22 Jan 2007 16:46 GMT > I don't know about the availabily of 5-methyltetrahydrofolate. It is > probably available somewhere, but is not ubiquitous as the regular > folic acid. Does anyoone know where to get it? About the first link my > quick web search returned was > <http://www.fallonpharmacy.com/prod_details.php?pid=2490>, but that is > mixture, and the amount of 5-MTHF is not given. https://www.vitaminshoppe.com/search/en/query.jsp?q=+5-methyltetrahydrofo late&x=53&y=10&intsource=main
or
http://preview.tinyurl.com/yorfqj
Seems to be a few different manufacturers.
Bill
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RArmant - 22 Jan 2007 19:57 GMT >I don't know about the availabily of 5-methyltetrahydrofolate. It is >probably available somewhere, but is not ubiquitous as the regular >folic acid. Does anyoone know where to get it? http://www.metafolin.com/
Source Naturals Metafolin http://www.amazon.com/Source-Naturals-Metafolin/dp/B0006O2FO4
You might look into folinic acid. http://www.iherb.com/store/ProductDetails.aspx?c=Herbs&pid=SNS-02028
Matti Narkia - 22 Jan 2007 23:57 GMT >>DZ <sc13nc3d@gmail.com> wrote in part: >> [quoted text clipped - 50 lines] >Using 5-methyltetrahydrofolate in supplementation instead of folic >acid would overcome the conversion problem: A related study:
Willems FF, Boers GH, Blom HJ, Aengevaeren WR, Verheugt FW. Pharmacokinetic study on the utilisation of 5-methyltetrahydrofolate and folic acid in patients with coronary artery disease. Br J Pharmacol. 2004 Mar;141(5):825-30. Epub 2004 Feb 9. PMID: 14769778 [PubMed - indexed for MEDLINE] <http://www.nature.com/bjp/journal/v141/n5/full/0705446a.html>
Abstract:
1. Methylenetetrahydrofolate reductase (MTHFR) is a regulating enzyme in folate-dependant homocysteine remethylation, because it catalyses the reduction of 5,10 methylenetetrahydrofolate to 5-methyltetrahydrofolate (5- MTHF).
2. Subjects homozygous for the 677C right arrow T mutation in the MTHFR enzyme suffer from an increased cardiovascular risk. It can be speculated that the direct administration of 5-MTHF instead of folic acid can facilitate the remethylation of homocysteine in methionine.
3. The aim of this study was to determine the pharmacokinetic properties of orally administered 6[R,S] 5-MTHF versus folic acid in cardiovascular patients with homozygosity for 677C right arrow T MTHFR.
4. This is an open-controlled, two-way, two-period randomised crossover study. Patients received a single oral dose of either 5 mg folic acid or 5 mg 5-MTHF in each period. The concentrations of the 6[S] 5-MTHF and 6[R] 5-MTHF diastereoisomers were determined in venous blood samples.
5. All pharmacokinetic parameters demonstrate that the bioavailability of 5-MTHF is higher compared to folic acid. The peak concentration of both isomers following the administration of 6[R,S] 5-MTHF is almost seven times higher compared to folic acid, irrespective of the patient's genotype. However, at 1 week after the administration of a single dosage 6[R,S] 5-MTHF, we detected 6[R] 5-MTHF following the administration of folic acid, indicating storage of this isomer in the body.
6. Our results demonstrate that oral 5-MTHF has a different pharmacokinetic profile with a higher bioavailability compared to folic acid, irrespective of the patient's genotype. Detrimental effects of the storage of high levels of the non- natural isomer 6[R] 5-MTHF cannot be excluded."
 Signature Matti Narkia
Jim Chinnis - 23 Jan 2007 01:20 GMT Matti Narkia <mna@mbnet.fi> wrote in part:
>"Detrimental effects of the storage of high levels > of the non- natural isomer 6[R] 5-MTHF cannot be excluded." I guess we have to just eat a lot of folate-rich foods... -- Jim Chinnis Warrenton, Virginia, USA
Matti Narkia - 23 Jan 2007 12:33 GMT >Matti Narkia <mna@mbnet.fi> wrote in part: > >>"Detrimental effects of the storage of high levels >> of the non- natural isomer 6[R] 5-MTHF cannot be excluded." > >I guess we have to just eat a lot of folate-rich foods... Unless we use Metafolin, which contains only the natural isomer 6[S] and no non-natural isomer 6[R]. From its product brochure <http://www.metafolin.com/pdfs/About%20the%20Product_13.12.pdf>:
"The chemical synthesis Metafolin starts from the commercially available B-complex vitamin folic acid, which is reduced to tetrahydrofolate. This reduction step leads to the formation of a new chiral center and two diastereoisomers in an equimolar ratio. In nature, methylfolate consist only of the pure L- isomer (6S-isomer); processes were thus developed allowing the isolation of the natural L-methylfolate by selective crystallization. Metafolin is produced in accordance with cGMP using a patented process."
Other Metafolin links:
Mercks Metafolin receives EU approval <http://www.nutraingredients.com/news/ng.asp?id=66329-merck-eprova-metafolin-folate>
Metafolin ruled safe for use in supplements and foods by JECFA 2005-08-08 - Merck Eprova AG <http://www.npicenter.com/anm/templates/newsATemp.aspx?articleid=13245&zoneid=80>
JECFA Evaluations-CALCIUM L-5-METHYLTETRAHYDROFOLATE <http://www.inchem.org/documents/jecfa/jeceval/jec_326.htm>
Merck offering nature-identical folate in new markets <http://www.in-pharmatechnologist.com/news/ng.asp?id=61793-metafolin-folate-folic>
Merck Eprova AG Highlighted for Inventing Metafolin(R) With the Frost & Sullivan Product Differentiation Innovation Award of the Year. Tuesday 9 January 2007- <http://www.prnewswire.co.uk/cgi/news/release?id=187683>
Merck KGaA begins Marketing of Metafolin in the United States, opens new era in the field of dietary-supplement ingredients <http://me.merck.de/EMD/UK/uknews2.nsf/d4c60a303233fb87c1256fc500368312/f2f6088ac fb8dc42c1256fc5003a7e39?OpenDocument>
Sources:
<http://www.findarticles.com/p/articles/mi_m0KFY/is_7_23/ai_n15346554/pg_2> <http://www.lef.org/newshop/items/item00719.html> <http://vitanetonline.com/description/SN1647/vitamins/Metafolin-800-mcg/> <http://www.shopping.com/xPO-Source-Naturals-Metafolin-800-Mcg-120-Tablets>
Metafolin Medline references:
Joint FAO/WHO Expert Committee on Food Additives. Evaluation of certain food additives. World Health Organ Tech Rep Ser. 2006;934:1-145, back cover. PMID: 17069402 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R etrieve&dopt=abstractplus&list_uids=17069402>
Venn BJ, Green TJ, Moser R, Mann JI. Comparison of the effect of low-dose supplementation with L-5-methyltetrahydrofolate or folic acid on plasma homocysteine: a randomized placebo-controlled study. Am J Clin Nutr. 2003 Mar;77(3):658-62. PMID: 12600857 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/77/3/658>
Houghton LA, Sherwood KL, Pawlosky R, Ito S, O'Connor DL. [6S]-5-Methyltetrahydrofolate is at least as effective as folic acid in preventing a decline in blood folate concentrations during lactation. Am J Clin Nutr. 2006 Apr;83(4):842-50. PMID: 16600937 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/abstract/83/4/842>
Lamers Y, Prinz-Langenohl R, Moser R, Pietrzik K. Supplementation with [6S]-5-methyltetrahydrofolate or folic acid equally reduces plasma total homocysteine concentrations in healthy women. Am J Clin Nutr. 2004 Mar;79(3):473-8. PMID: 14985224 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/79/3/473>
Pentieva K, McNulty H, Reichert R, Ward M, Strain JJ, McKillop DJ, McPartlin JM, Connolly E, Molloy A, Kramer K, Scott JM. The short-term bioavailabilities of [6S]-5-methyltetrahydrofolate and folic acid are equivalent in men. J Nutr. 2004 Mar;134(3):580-5. PMID: 14988450 [PubMed - indexed for MEDLINE] <http://jn.nutrition.org/cgi/content/full/134/3/580>'
Bostom AG, Shemin D, Bagley P, Massy ZA, Zanabli A, Christopher K, Spiegel P, Jacques PF, Dworkin L, Selhub J. Controlled comparison of L-5-methyltetrahydrofolate versus folic acid for the treatment of hyperhomocysteinemia in hemodialysis patients. Circulation. 2000 Jun 20;101(24):2829-32. Erratum in: Circulation 2000 Aug 1;102(5):598. PMID: 10859289 [PubMed - indexed for MEDLINE] <http://circ.ahajournals.org/cgi/content/full/101/24/2829>
Medline references about the absorption of natural and synthetic folates:
McKillop DJ, McNulty H, Scott JM, McPartlin JM, Strain JJ, Bradbury I, Girvan J, Hoey L, McCreedy R, Alexander J, Patterson BK, Hannon-Fletcher M, Pentieva K. The rate of intestinal absorption of natural food folates is not related to the extent of folate conjugation. Am J Clin Nutr. 2006 Jul;84(1):167-73. PMID: 16825692 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/abstract/84/1/167>
"... CONCLUSION: These results suggest that the ratio of monoglutamate to polyglutamate in natural folates is not a factor that limits the extent of intestinal absorption of food folate."
Wright AJ, Finglas PM, Dainty JR, Wolfe CA, Hart DJ, Wright DM, Gregory JF. Differential kinetic behavior and distribution for pteroylglutamic acid and reduced folates: a revised hypothesis of the primary site of PteGlu metabolism in humans. J Nutr. 2005 Mar;135(3):619-23. PMID: 15735104 [PubMed - indexed for MEDLINE] <http://jn.nutrition.org/cgi/content/full/135/3/619>
 Signature Matti Narkia
Matti Narkia - 23 Jan 2007 12:39 GMT >Matti Narkia <mna@mbnet.fi> wrote in part: > >>"Detrimental effects of the storage of high levels >> of the non- natural isomer 6[R] 5-MTHF cannot be excluded." > >I guess we have to just eat a lot of folate-rich foods... Unless we use Metafolin, which contains only the natural isomer 6[S] and no non-natural isomer 6[R]. From its product brochure <http://www.metafolin.com/pdfs/About%20the%20Product_13.12.pdf>:
"The chemical synthesis Metafolin starts from the commercially available B-complex vitamin folic acid, which is reduced to tetrahydrofolate. This reduction step leads to the formation of a new chiral center and two diastereoisomers in an equimolar ratio. In nature, methylfolate consist only of the pure L- isomer (6S-isomer); processes were thus developed allowing the isolation of the natural L-methylfolate by selective crystallization. Metafolin is produced in accordance with cGMP using a patented process."
Other Metafolin links:
Mercks Metafolin receives EU approval <http://www.nutraingredients.com/news/ng.asp?id=66329-merck-eprova-metafolin-folate>
Metafolin ruled safe for use in supplements and foods by JECFA 2005-08-08 - Merck Eprova AG <http://www.npicenter.com/anm/templates/newsATemp.aspx?articleid=13245&zoneid=80>
JECFA Evaluations-CALCIUM L-5-METHYLTETRAHYDROFOLATE <http://www.inchem.org/documents/jecfa/jeceval/jec_326.htm>
Merck offering nature-identical folate in new markets <http://www.in-pharmatechnologist.com/news/ng.asp?id=61793-metafolin-folate-folic>
Merck Eprova AG Highlighted for Inventing Metafolin(R) With the Frost & Sullivan Product Differentiation Innovation Award of the Year. Tuesday 9 January 2007. <http://www.prnewswire.co.uk/cgi/news/release?id=187683>
Merck KGaA begins Marketing of Metafolin in the United States, opens new era in the field of dietary-supplement ingredients <http://me.merck.de/EMD/UK/uknews2.nsf/d4c60a303233fb87c1256fc500368312/f2f6088ac fb8dc42c1256fc5003a7e39?OpenDocument>
Sources:
<http://www.lef.org/newshop/items/item00719.html> <http://vitanetonline.com/description/SN1647/vitamins/Metafolin-800-mcg/> <http://www.shopping.com/xPO-Source-Naturals-Metafolin-800-Mcg-120-Tablets>
Metafolin Medline references:
Joint FAO/WHO Expert Committee on Food Additives. Evaluation of certain food additives. World Health Organ Tech Rep Ser. 2006;934:1-145, back cover. PMID: 17069402 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R etrieve&dopt=abstractplus&list_uids=17069402>
Venn BJ, Green TJ, Moser R, Mann JI. Comparison of the effect of low-dose supplementation with L-5-methyltetrahydrofolate or folic acid on plasma homocysteine: a randomized placebo-controlled study. Am J Clin Nutr. 2003 Mar;77(3):658-62. PMID: 12600857 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/77/3/658>
Houghton LA, Sherwood KL, Pawlosky R, Ito S, O'Connor DL. [6S]-5-Methyltetrahydrofolate is at least as effective as folic acid in preventing a decline in blood folate concentrations during lactation. Am J Clin Nutr. 2006 Apr;83(4):842-50. PMID: 16600937 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/abstract/83/4/842>
Lamers Y, Prinz-Langenohl R, Moser R, Pietrzik K. Supplementation with [6S]-5-methyltetrahydrofolate or folic acid equally reduces plasma total homocysteine concentrations in healthy women. Am J Clin Nutr. 2004 Mar;79(3):473-8. PMID: 14985224 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/79/3/473>
Pentieva K, McNulty H, Reichert R, Ward M, Strain JJ, McKillop DJ, McPartlin JM, Connolly E, Molloy A, Kramer K, Scott JM. The short-term bioavailabilities of [6S]-5-methyltetrahydrofolate and folic acid are equivalent in men. J Nutr. 2004 Mar;134(3):580-5. PMID: 14988450 [PubMed - indexed for MEDLINE] <http://jn.nutrition.org/cgi/content/full/134/3/580>'
Bostom AG, Shemin D, Bagley P, Massy ZA, Zanabli A, Christopher K, Spiegel P, Jacques PF, Dworkin L, Selhub J. Controlled comparison of L-5-methyltetrahydrofolate versus folic acid for the treatment of hyperhomocysteinemia in hemodialysis patients. Circulation. 2000 Jun 20;101(24):2829-32. Erratum in: Circulation 2000 Aug 1;102(5):598. PMID: 10859289 [PubMed - indexed for MEDLINE] <http://circ.ahajournals.org/cgi/content/full/101/24/2829>
Medline references about the absorption of natural and synthetic folates:
McKillop DJ, McNulty H, Scott JM, McPartlin JM, Strain JJ, Bradbury I, Girvan J, Hoey L, McCreedy R, Alexander J, Patterson BK, Hannon-Fletcher M, Pentieva K. The rate of intestinal absorption of natural food folates is not related to the extent of folate conjugation. Am J Clin Nutr. 2006 Jul;84(1):167-73. PMID: 16825692 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/abstract/84/1/167>
"... CONCLUSION: These results suggest that the ratio of monoglutamate to polyglutamate in natural folates is not a factor that limits the extent of intestinal absorption of food folate."
Wright AJ, Finglas PM, Dainty JR, Wolfe CA, Hart DJ, Wright DM, Gregory JF. Differential kinetic behavior and distribution for pteroylglutamic acid and reduced folates: a revised hypothesis of the primary site of PteGlu metabolism in humans. J Nutr. 2005 Mar;135(3):619-23. PMID: 15735104 [PubMed - indexed for MEDLINE] <http://jn.nutrition.org/cgi/content/full/135/3/619>
 Signature Matti Narkia
Matti Narkia - 20 Jan 2007 03:00 GMT >On Fri, 19 Jan 2007 17:22:59 +0000 (UTC) in sci.med.nutrition, DZ ><22777@145806466.2733218530.31145.24927.3955> wrote, >>Folic acid used for supplementation is synthetic and not the same >>chemically as the natural form of folate. > >What's the difference? Below some clippings from my old folate/folic acid notes:
From <http://www.cce.cornell.edu/food/expfiles/topics/stover/folicqanda.html>:
"Q. What's the difference between the terms folic acid and folate? A. In cells, folic acid exists in many chemical forms with respect to its oxidation state, one-carbon substitutions and number of glutamate residues. In general, the term folates, when used in the generic sense, refers to all chemical forms of folic acid. The term folic acid refers to the oxidized, monoglutamate form of folate otherwise known as pteroylglutamic acid. Q. Is there a difference in bioavailability between folic acid in foods versus supplements? A. The bioavailability of food folate is difficult to predict. In general, the oxidized, monoglutamate form of folate, the form found in supplements and the form used to fortify foods, has a much greater bioavailability than food folate which tends to be in a chemically reduced and in a polyglutamated form. The absorption of supplement folate during fasting is near 100%. Prior to absorption, folate polyglutamates must be enzymatically converted to folate monoglutamates, and the efficiency of this reaction varies depending upon the food source of folate. Therefore, while all sources are important, more folate is absorbed from fortified foods and supplements. Folic acid supplements are even more bioavailable if taken between meals."
From <http://europa.eu.int/comm/food/fs/sc/scf/out80e_en.pdf>:
"Folate is the generic name for a number of compounds having a similar activity as folic acid (pteroylglutamic acid, PGA), i.e. being involved in single carbon (C1-) transfer reactions. Folic acid (PGA) is a synthetic folate compound used in food supplements and in food fortification because of its stability, and becomes biologically active after reduction. Natural (dietary) folates are mostly reduced folates, i.e. derivatives of tetrahydrofolate (THF), such as 5-methyl- THF (5-MTHF), 5- formyl-THF and 5,10-methylene- THF, and exist mainly as pteroylpolyglutamates, with up to nine additional glutamate molecules attached to the pteridine ring.
[...]
Food folates, mainly present as polyglutamates, have to be hydrolysed by a (brush border associated) deconjugase enzyme in the gut before absorption can occur. Folate absorption from natural food is generally lower than synthetic forms (e.g. folic acid) contained in supplements, due to matrix effects and the presence of inhibitors of the conjugase enzyme in some foods. Folic acid (PGA) enters the folate cycle after reduction by a (dihydro-)folate reductase. This enzyme is present in the intestinal mucosal cell, but also in other tissues, such as liver and kidney. Reduction of PGA may be a slow process in some subjects and at higher intake levels (> ca 260 µg) PGA may appear unchanged in the circulation (i.e. in the postprandial state after supplement use (Kelly et al., 1997). Under normal conditions 5-MTHF (as monoglutamate) is the only form present in plasma, mainly protein-bound. Tissue uptake is carrier-mediated and/or through folate binding proteins. In tissues folates are retained as polyglutamates and the folate coenzymes can be interconverted in numerous (de-)methylation reactions, such as in DNA synthesis (formation of thymidilate from deoxyuridine), amino acid interconversions, such as the remethylation of homocysteine to methionine. In this latter methionine synthase (MS) reaction vitamin B12 is also involved as a cofactor. About 50% of the folate body store, estimated to be 13-28 mg, is considered to be present in the liver (for review see Report of the Standing Committee on the scientific evaluation of dietary reference intakes (DRIs) and its panel on folate and other B-vitamins and choline. Food and Nutrition Board, Institute of Medicine, 1998)."
From <http://users.umassmed.edu/martin.marinus/Mph200/FolicAcidMetabolism.pdf>:
"DHF and THF from natural sources are polyglutamated and need to be enzymatically converted to the monoglutamate for absorption from the small intestine."
(DHF=dihydrofolic acid; THF=tetrahydrofolic acid)
From <http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/fol_0110.shtml>:
"The term folate is used in two different ways. Folate, a member of the B-vitamin family, is a collective term for a number of chemical forms which are structurally related and which have similar biological activity to folic acid. Folate is also the term which is used for the anionic form of folic acid. Folic acid or pteroylglutamic acid (PGA) is comprised of para- aminobenzoic acid linked at one end to a pteridine ring and at the other end to glutamic acid. The pteridine-para-aminobenzoic acid portion of the molecule is called the pteroyl group. Folic acid is a synthetic folate form which is used for food fortification and nutritional supplements. It is not one of the principal naturally occurring forms of folate, used in the collective sense.
The naturally occurring forms of folate differ in the extent of the reduction state of the pteroyl group, the nature of the substituents on the pteridine ring and the number of glutamyl residues attached to the pteroyl group. The naturally occurring folates, include 5-methyltetrahydrofolate (5-MTHF), 5- formyltetrahydrofolate (5-formyl-THF), 10- formyltetrahydrofolate (10-formyl-THF), 5,10- methylenetetrahydrofolate (5,10-methylene-THF), 5,10- methenyltetrahydrofolate (5,10-methenyl-THF), 5- formiminotetrahydrofolate (5-formimino-THF), 5,6,7,8- tetrahydrofolate (THF) and dihydrofolate (DHF). Most naturally occurring folates are pteroylpolyglutamates, containing two to seven glutamates joined in amide (peptide) linkages to the gamma-carboxyl of glutamate. The principal intracellular folates are pteroylpentaglutamates, while the principal extracellular folates are pteroylmonoglutamates. Pteroylpolyglutamates with up to 11 glutamic acid residues exist naturally.
[...] PHARMACOKINETICS
Folic acid or pteroylglutamic acid (PGA) is the form of folate used in food fortification and the principal form of folate found in nutritional supplements. Natural food folates are pteroylpolyglutamate derivatives. Pteroylpolyglutamate derivatives are hydrolyzed to pteroylmonoglutamate forms prior to absorption from the small intestine. The enzyme that catalyzes the cleavage is called folate conjugase or gamma-glutamylhydrolase. The monoglutamate forms of folate, including folic acid, are transported across the proximal small intestine via a saturable pH-dependent process. Higher doses of the pteroylmonoglutamates, including folic acid, are absorbed via a nonsaturable passive diffusion process. The efficiency of absorption of the pteroylmonoglutamates is greater than that of the pteroylpolyglutamates.
Because of the difference in absorption efficiency between natural food folate and folic acid, the concept of dietary folate equivalents (DFEs) has been introduced. Folic acid taken on an empty stomach is twice as available as food folate. Folic acid taken with food is 1.7 times as available as food folate. For example, 400 micrograms of folic acid taken on an empty stomach is equivalent to 470 micrograms of folic acid taken with food and is equivalent to 800 micrograms of food folate. DFEs can be calculated as follows:
1 microgram of DFEs = 1 microgram of food folate = 0.5 micrograms of folic acid taken on an empty stomach = 0.6 micrograms of folic acid taken with meals.
Following absorption of physiological amounts of folic acid into the enterocytes, a certain percentage undergoes reduction. Reduced folate is transported to the liver via the portal circulation. Much of a pharmacological dose of folic acid is transported to the liver as such, without first undergoing metabolism in the enterocytes. The various natural pteroylmonoglutamate forms undergo some metabolism in the enterocytes to pteroylpolyglutamate forms, but for the most part are also transported as their unmetabolized forms via the portal circulation to the liver. The folates are taken up by the liver and metabolized to polyglutamate derivatives (principally pteroylpentaglutamates), via the action of folylpolyglutamate synthase. Folates are stored in tissue in their polyglutamate forms. Folate is metabolized to its various metabolic forms in the liver. The various pteroylpolyglutamate forms are the active cellular cofactor forms of folate. Folate polyglutamates are released from the liver to the systemic circulation and to the bile. When released from the liver into the circulation, the polyglutamate forms are hydrolyzed by gamma- glutamylhydrolase and reconverted to the monoglutamate forms.
The principal folate in the plasma is 5- methyltetrahydrofolate in its monoglutate form. 5- Methyltetrahydrofolate circulates in erythrocytes in its polyglutamate form. Approximately two-thirds of folate in plasma is protein bound. All tissue forms of folate are polyglutamates, while circulating forms of folate are monoglutamates. When pharmacological doses of folic acid are administered, a significant amount of unchanged folic acid is found in the plasma. The liver contains approximately 50% of the body stores of folate, or about 6 to 14 milligrams. The total body store of folate is about 12 to 28 milligrams.
Folate is excreted in the urine as folate cleavage products. Intact folate enters the glomerulus and is reabsorbed into the proximal renal tubule. Very little intact folate is excreted in the urine. Folate is excreted in the bile and much of it is reabsorbed via the enterohepatic circulation."
B12 is needed to convert circulating 5-methyltetrahydrofolate (5-methyl THFA), omce inside the cell, to THFA, the active form participating in folate-dependent enzymatic reactions. In the absence of B12, folate is "trapped" as 5-methyl THFA.
The dietary folate is either monoglutamate or polyglutamate. Most is polyglutamate and it can not be absorbed at all. All supplement folic acid is monoglutamate and it is absorbed very well. The human gut has a peptidase that hydrolyzes all of the glutamate off the polyglutamate to give the monoglutamate form. This enzyme will not work without B12. Low B12 will cause a folate deficiency unless a folic acid supplement is used. See the page
<http://www.feinberg.northwestern.edu/nutrition/factsheets/folate.html>:
"... Only about half of the folate consumed from food sources has acceptable bioavailability. Folate occurs naturally attached to multiple glutamic acid molecules which must be removed by hydrolysis prior to absorption by a vitamin B12-dependent enzyme to form pteroylmonoglutamate. In general, foods with high proportions of the monoglutamate form have higher folate bioavailability irrespective of the total amount. ..."
So B12 is needed both for the absorption of dietary folate and for the folate metabolism inside the cell.
See also
<http://www.emedicine.com/MED/topic802.htm>:
"Folic acid is composed of a pterin ring connected to p- aminobenzoic acid (PABA) and conjugated with one or more glutamate residues. It is distributed widely in green leafy vegetables, citrus fruits, and animal products. Humans do not generate folate endogenously because they cannot synthesize PABA, nor can they conjugate the first glutamate. Folates are present in natural foods and tissues as polyglutamates because these forms serve to keep the folates within cells. In plasma and urine, they are found as monoglutamates because this is the only form that can be transported across membranes. Enzymes in the lumen of the small intestine convert the polyglutamate form to the monoglutamate form of the folate, which is absorbed in the proximal jejunum via both active and passive transport. Within the plasma, folate is present, mostly in the 5- methyltetrahydrofolate (5-methyl THFA) form, and is loosely associated with plasma albumin in circulation. The 5-methyl THFA enters the cell via a diverse range of folate transporters with differing affinities and mechanisms (ie, adenosine triphosphate [ATP]–dependent H+ cotransporter or anion exchanger). Once inside, 5-methyl THFA may be demethylated to THFA, the active form participating in folate-dependent enzymatic reactions. Cobalamin (B-12) is required in this conversion, and in its absence, folate is "trapped" as 5-methyl THFA. From then on, folate no longer is able to participate in its metabolic pathways, and megaloblastic anemia results. Large doses of supplemental folate can bypass the folate trap, and megaloblastic anemia will not occur. However, the neurologic/psychiatric abnormalities associated with B-12 deficiency ensue progressively. The biologically active form of folic acid is tetrahydrofolic acid (THFA), which is derived by the 2-step reduction of folate involving dihydrofolate reductase. THFA plays a key role in the transfer of 1-carbon units (such as methyl, methylene, and formyl groups) to the essential substrates involved in the synthesis of DNA, RNA, and proteins. More specifically, THFA is involved with the enzymatic reactions necessary to synthesis of purine, thymidine, and amino acid. Manifestations of folate deficiency thereafter, not surprisingly, would involve impairment of cell division, accumulation of possibly toxic metabolites such as homocysteine, and impairment of methylation reactions involved in the regulation of gene expression, thus increasing neoplastic risks."
From <http://users.umassmed.edu/martin.marinus/Mph200/FolicAcidMetabolism.pdf>:
"*Increased excretion/loss: Increased excretion of folate can occur subsequent to vitamin B-12 deficiency. During the course of vitamin B-12 deficiency, methylene THFA is known to accumulate in the serum, which is known as the folate trap phenomenon. In turn, large amounts of folate filter through the glomerulus, and urine excretion occurs. Another mechanism of excess excretion occurs in people with chronic alcoholism who can have increased excretion of folate into the bile. Patients undergoing hemodialysis also have been known to have excess folate loss during procedures."
 Signature Matti Narkia
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