Folate, or vitamin B9, is an essential nutrient found in many foods, including vegetables, beans, fruits, nuts, meat, poultry, seafood, and eggs. Reactions involving folate are important to every system of the body. Folate supports neurological function, healthy cellular energy metabolism, cellular repair and function, and healthy fetal development. It is essential for neural tube development. It is also critical to the methylation cycle.  

Methylation is a type of biochemical reaction that facilitates certain critical functions of the human body. It refers to the movement of a methyl group through key pathways in the body. Methylation is critical for DNA synthesis and repair, cellular energy metabolism, nerve cell structure and function, and red blood cell production. It may also influence epigenetics, which refers to changes in the DNA molecule that do not alter the sequence but can still lead to differences in gene expression, potentially leading to different health outcomes. Some nutrients associated with the regulation of biochemical pathways of methylation include certain amino acids and vitamins B12, folate, and B6. 

A recently published study by Lin and colleagues explored the role of periconceptual supplementation with folic acid, an oxidized form of folate, on newborn birth weights. Periconceptual is defined as the 12 weeks before and the 12 weeks after the last menstrual period. Information was analyzed for more than 30,000 births. The newborns of pregnant participants who had received folic acid, alongside multiple micronutrients, had a comparatively lower risk of birthing small gestational age (SGA) infants and a higher median birth weight.  

The role of supplementation with folate beyond the periconceptual phase has also been explored by research. A recently published study by Ondičová and colleagues explored the impact of supplementation with folic acid on DNA methylation and the parameters related to cognitive and psychological outcomes during the second and third trimesters of pregnancy. 

The study by Ondičová and colleagues used data from the cord blood from more than 80 samples after birth. Pregnant study participants received 400 mcg of daily folic acid supplementation during the second and third trimesters and were compared to a group of participants who received a placebo; children from the group of birth parents who received the folic acid supplementation had significant improvements in cognitive performance, including language processing and psychosocial development. Folic acid supplementation was also shown to affect the DNA methylation of specific classes of genes related to brain development when compared to the placebo. 

Research indicates that certain bioidentical forms of folate may be superior to folic acid supplementation. For instance, [6S] 5-methyltetrahydrofolate ([6S]5-MTHF) is a bioidentical form of folate that has been shown in animal studies to have improved bioavailability in oral use, high solubility in water, and long-lasting stability when compared with folic acid. 

Folate may play a supportive role throughout all trimesters of pregnancy. It may also support the methylation process, cellular health, and healthy cognition.  

By Colleen Ambrose, ND, MAT