Folic Acid vs. Folate

Written by Dr. Steve Chaney on . Posted in current health articles, folic acid vs. folate, Health Current Events

Are Supplement Manufacturers Trying to Mislead You?

Author: Dr. Stephen Chaney

folic acid vs. folate questionThere has been much confusion on folic acid vs. folate.  For example, I recently received this question from a reader:

“I have gotten so much clarification about folic acid from your video – thank you!
But I have another question I was hoping you could answer.

When a supplement label states there is “folate” rather than “folic acid”, is there really a difference between the two? I hear women telling each other to only use the one that says folate because it’s made from food. And folic acid isn’t. These women are also paying more money for these products because of this. Is this true? (And I’m not talking about tetrahydrafolate, either)
I’ve been told by one manufacturer that they label it as folic acid, but they know other companies who use the exact same source of folic acid.  Still,  they put folate on their label, possibly to avoid controversy.
Are these women being duped? Should they be asking the manufacturer certain questions for clarification?”

The video, this reader is referring to is my “The Truth About Methyl Folate” video in which I debunk the many myths about methyl folate circulating on the internet, and, unfortunately, repeated by some doctors.

However, the reader is correct. I did not address the folic acid vs. folate nomenclature in that video. I will attempt to clarify it in this article.

Folic Acid vs. Folate

A Rose By Any Other Name

roseI call this section “A Rose By Any Other Name” from the famous Shakespeare quote from Romeo and Juliet “A rose by any other names would smell as sweet”.

Biochemists and nutritionists use the terms folic acid and folate interchangeably. There is a sound chemical rationale for that.

Folic acid has a glutamic acid residue on one end. Thus, folic acid is what chemists refer to as an organic acid, specifically a carboxylic acid. Under acidic conditions the appropriate suffix for an organic acid is “ic”. However, under neutral or alkaline conditions, organic acids lose their protons. Once that happens, the appropriate suffix is “ate”.

The exact pH of vitamin pills may vary from brand to brand. In our body our stomach is acidic, our intestines are alkaline, and our blood and cells are normally near neutral. Thus, vitamin B9 could correctly be labeled either folic acid or folate in supplements. It will be folic acid in our stomach and will be folate in our intestines, bloodstream, and cells.  Beginning to see the difference between folic acid vs. folate?

The bottom line is that nobody is trying to trick you by using the term folate for the vitamin B9 on their supplement label. Furthermore, whether the label says folic acid or folate, the actual vitamin B9 will be in both the folic acid and folate form as it travels through your body.

In answer to your other question, since folic acid and folate are two names for the same molecule, folate is not more natural than folic acid. If someone is charging you extra because they use the term folate on their label, they are ripping you off.

 

What About Tetrahydrofolate?

uderstanding folic acid vs. folateThe person who sent me the question also asked about tetrahydrofolates.  Here the story gets a bit murkier.  As folic acid or folate enters our cells, three things immediately happen:

  • It is reduced to tetrahydrofolate. That terminology simply means that 4 hydrogens have been added to the molecule.
  • A string of glutamic acid residues is added. That traps it inside the cells.
  • It is converted to a half dozen different derivatives that play important metabolic roles in the cell. N5-methyltetrahydrofolate (commonly referred to as methyl folate) is one of these metabolically active compounds.

This is where it gets confusing. Nutritionists also refer to all of these tetrahydrofolate derivatives as folates. My guess is that years ago some genius must have decided that the term tetrahydrofolate was too long and complicated for the general public.

In my view lumping everything together under the term folate has turned out to be more confusing in the long run. However, I do have the advantage of hindsight.  It’s easy to point out mistakes after they are made.

However, this is where all of the confusion arises.  It’s because the term folate can mean so many different things.  Here are a few fast facts to help clarify the confusion.

  • Folates in food are in the tetrahydrofolate form. Tetrahydrofolate in foods is, in fact, more natural than folic acid or folate in supplements. However, tetrahydrofolates in foods are utilized only about half as well as folic acid or folate in supplements. In addition, most of us don’t eat enough high-folate foods.
  • In contrast, tetrahydrofolate in a supplement is not more natural than folic acid. That’s because:
  • It would require one cup of lentils or two cups of spinach to provide the RDA level of tetrahydrofolate in a single vitamin tablet. That’s just one tablet.  You do the math!  If someone tells you that the folate in their supplement came from foods, they will lie to you about other things as well.
  • In fact, the tetrahydrofolate found in supplements is chemically synthesized from folic acid. It can never be more natural than folic acid.
  • Supplements containing tetrahydrofolate are no better utilized than supplements containing folic acid when you measure their ability to increase cellular tetrahydrofolate levels (the only measure that really matters).

The bottom line is that even if folate on the label were to refer to tetrahydrofolate, it is not from food.  It is not more natural than folic acid.  It is not better utilized than folic acid.  If someone is charging you a higher price for that supplement, they are ripping you off.

 

Debunking The Methyl Folate Myths

mythsMethyl folate has become an internet sensation.  If you believe all the hype, everyone should be using supplements containing methyl folate rather than folic acid.  In fact, some of the claims made by manufacturers who sell methyl folate supplements are downright deceptive.

Unfortunately, there are even medical doctors touting the wonders of methyl folate and offering all sorts of plausible sounding biochemical explanations about why it is superior to folic acid.  My take on that is that I try not to practice medicine when I write my articles.  I have neither the training nor the degree to do that.  In turn, I would ask medical doctors to stop trying to practice biochemistry.

As I said at the beginning of this article, I have produced a video, “The Truth About Methyl Folate,” in which I debunk all the many methyl folate myths circulating on the internet. If you would like the “Cliff Notes” version, here it is:

  • Supplements containing methyl folate do not get their methyl folate from foods.
  • Methyl folate in supplements is chemically synthesized and is not more natural than folic acid.
  • Folic acid and methyl folate in supplements are equally well utilized by the body, even in individuals with a MTHFR deficiency.
  • Excess folic acid does not cause cancer.

If you would like the science and the references behind those statements, I invite you to view my video.
metho folate
I hope you now understand folic acid vs. folates.  If not, please feel free to reach out to me.

 

The Bottom Line

  • A reader recently asked me to clear up the confusion about why the terms folic acid vs. folate are used interchangeably on supplement labels to describe vitamin B9.
  • That terminology is based on simple chemistry.  Folic acid and folate are two names for the same molecule. Under acidic conditions, it is called folic acid. Under neutral or alkaline conditions, it is called folate.
  • Since folic acid and folate are two names for the same molecule, folate is not more natural than folic acid.  If someone is charging you extra because they use the term folate on their label, they are ripping you off.
  • In the cell folate is reduced to tetrahydrofolate and a number of metabolically active derivatives of tetrahydrofolate are formed. Unfortunately, these compounds are also referred to as folates. This terminology has a historical basis rather than a chemical basis and is confusing.
  • If you see the term tetrahydrofolate on your supplement label,  you need to know that it is not from food.  It is not more natural than folic acid.  It is not better utilized than folic acid.  If someone is charging you a higher price for that supplement, they are also ripping you off.
  • I have produced a video called “The Truth About Methyl Folate” to debunk the many methyl folate myths on the internet. In the article above, you will find the “Cliff Notes” version of the video.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Trackback from your site.

Comments (2)

  • Peggy Turcott

    |

    Dear Mr Chaney,
    I am new 2 ur Health Tips emails. They r very educational. Thank you 4 the benefit of ur time consuming reports. I do have a suggestion, if u dont mind. It would take less sheets of paper & look more professional if u created them in Word using full width of sheets. Then send as attachments so when we open & print it won’t have email appearance if senders name, date, receivers email address & subject line. When printing sometimes there is a 3.5″ white space boarder on R side & a 1″ white space boarder on L side there pushing the words to the middle page using more sheets of paper because the words don’t spread out 2 both the sides leaving only a 1/2 boarder. Thank u 4 reading & possibly considering my suggestion 4 a more professional look but also 2 save us pages. I print & have handy 2 show 2 clients.

    Reply

    • Dr. Steve Chaney

      |

      Dear Peggy,
      If you click on the link included with each email, it will take you directly to that article on my website. You can share the link with anyone and print out the article full size if you would like to.
      Dr. Chaney

      Reply

Leave a comment

Recent Videos From Dr. Steve Chaney

READ THE ARTICLE
READ THE ARTICLE

Latest Article

Do Ultra-Processed Foods Make You Fat?

Posted June 25, 2019 by Dr. Steve Chaney

What Is The Secret For Weight Loss?

Author: Dr. Stephen Chaney

 

Do ultra-processed foods make it harder to loose weight?

ultra-processed foods questionsIt is so confusing. It seems like everyone has a magical weight loss diet. You just follow their diet and the pounds will melt away. The problem is that everyone’s recommendations are different. What is the average consumer to think? Is the best diet low fat, low carb, low sugar, Paleo, Keto, or vegan? Or is intermittent fasting the secret to successful weight loss?

What if the secret to weight loss was none of the diets mentioned above, yet was something common to all of them?

The one common feature of every popular diet is they cut out sodas and processed foods and replace them with whole unprocessed foods. What if cutting out highly processed foods was the secret to successful weight loss, and none of the other restrictions of the various diets really mattered?

There are lots of studies suggesting that ultra-processed foods might be the problem. [Note: In the scientific community the term highly processed foods has been replaced with ultra-processed foods. There are subtle differences between the two terms, but for our purposes we will consider them identical]. Consumption of ultra-processed foods has been shown to be associated with overeating, obesity, poor health outcomes, and premature death.

For example, consumption of ultra-processed foods and obesity have increased in parallel. Today ultra-processed foods constitute the majority of calories consumed in America, and 40% of Americans are now obese.

However, associations don’t prove cause and effect. In the words of the authors of the latest study: “There has never been a randomized controlled trial demonstrating any beneficial effects of reducing ultra-processed foods or deleterious effects of increasing ultra-processed foods in the diet.”

The latest study (KD Hall et al, Cell Metabolism, 30: 1-11, 2019 ) was the first randomized controlled trial designed to test the hypothesis that consumption of ultra-processed foods leads to obesity.

 

How Was The Study Done?

ultra-processed foods studyTwenty overweight subjects (10 men and 10 women) volunteered for the study. Their average age was 31 and their average BMI was 27, which means they were overweight, but not obese. All were weight-stable in the months preceding the study.

They were admitted to the metabolic ward at the NIH where every aspect of what they ate and the exercise they got was controlled. The subjects were randomly assigned to consume an ultra-processed or an unprocessed diet for two weeks followed by the alternative diet for the final two weeks.

During the study the subjects were given three meals a day that provided twice the calories they were accustomed to eating plus unlimited snacks. They were instructed to eat as much or as little as they desired. The calories consumed were calculated based on how much food they left on their plates.

The ultra-processed diet and unprocessed diets were matched with respect to:

  • Total calories in the food portions given to the subjects.
  • Caloric density (calories per serving size).
  • Macronutrients (carbohydrate, fat, & protein).
  • Sugars, fiber, and sodium.

The ultra-processed and unprocessed diets were neither low fat, low carb, or high protein. The caloric composition was around 48% carbohydrate, 35% fat, and 17% protein.

However, because of the differences between ultra-processed and unprocessed foods, it was impossible to match all parameters. For example, the ultra-processed and unprocessed diets differed significantly in:

  • Added sugar: 54% of the sugar in the ultra-processed diet was added sugar versus only 1% added sugar in the unprocessed diet.
  • Insoluble fiber: 16% of the fiber in the ultra-processed diet was insoluble fiber versus 77% in the unprocessed diet.
  • Saturated fat: 34% of the fat in the ultra-processed diet was saturated versus 19% in the unprocessed diet.
  • Omega-6 to omega-3 ratio: The ratio was 11:1 in the ultra-processed diet versus 5:1 in the unprocessed diet.

To give you an example of what the two diets looked like, dinner one night for the unprocessed diet group consisted of beef tender roast with barley and spinach and a parfait made of fresh berries and nonfat, unflavored Greek yogurt while the ultra-processed diet group got processed turkey and cheese sandwiches (on white bread) with baked chips, canned peaches and nonfat vanilla Greek yogurt. For breakfast one morning the unprocessed diet group got omelets made from fresh eggs while the ultra-processed diet group got omelets made from Fresh Start liquid.

 

Do Ultra-Processed Foods Make You Fat?

ultra-processed foods make you fatThe results of the study were quite interesting:

  • Subjects ate an additional 508 calories per day when on the ultra-processed diet.
  • Those extra calories came from both carbohydrate and fat, not from protein.
  • Subjects gained 2 pounds in just two weeks on the ultra-processed diet and lost 2 pounds in two weeks on the unprocessed diet.
  • Subjects ate their food more quickly on the ultra-processed diet (50 calories/minute) than on the unprocessed diet (32 calories/minute).

The authors of the study asked the participants several subjective questions about the two diets to better understand why they consumed more calories on the ultra-processed diet. However, those questions did not provide any useful insights. For example, the subjects rated the two diets equally with respect to:

  • Palatability and familiarity of the foods in the diet.
  • Hunger prior to eating and both fullness and satisfaction when they were finished eating.

These findings surprised the authors. The authors had assumed their subjects would eat more ultra-processed foods because they liked them better.

With respect to the overall study results, the authors concluded: “Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.”

In short, their study confirms what many experts have long suspected, but does not provide a mechanistic explanation of why ultra-processed foods lead to overconsumption and obesity.

 

What Is The Secret For Weight Loss?

 

ultra-processed foods secretThe arguments over which diet is best for weight loss never end. Everyone claims they have the secret, and everyone quotes studies showing their diet works.

Yet the diets are as different as night and day. They shouldn’t all work, but they do. For example, weight loss is virtually identical on a very low-fat vegan diet and a very low carb keto diet. That tells us that the secret can’t be either low-fat or low carb.

The secret must be something all these diets have in common. When you ask what they have in common, the answer is simple. All the popular diets start by eliminating sodas and ultra-processed foods and replacing them with unprocessed foods.

Could it be that something as simple as eliminating sodas and ultra-processed foods and replacing them with unprocessed foods is the secret to successful weight loss? Many experts have hypothesized that ultra-processed foods were the cause of the obesity epidemic, but this is the first randomized controlled clinical trial to prove that hypothesis.

Like any individual study, this study needs to be confirmed by additional randomized controlled studies. One might hope for longer duration studies with more subjects, but it would be very difficult to duplicate the precision of this study. Asking volunteers to enter a metabolic ward where every aspect of their life is controlled for multiple weeks is both expensive and a huge commitment by the volunteers.

My recommendation is simple. You don’t have to choose radical diets that eliminate whole food groups to lose weight successfully. They are hard to follow and may not be healthy long-term. Just ditch the sodas, junk foods, and highly processed foods. Rediscover the pleasures of whole unprocessed foods. You will lose weight gradually and safely. You will be healthier.

Of course, it is not quite that simple.

  • Portion control is essential. You can eat too much unprocessed food.
  • Caloric density (calories per serving) is important. This is one reason why primarily plant-based diets are generally more successful for long-term weight control.
  • Practice mindful eating. Savor your food and eat it slowly. You will be less likely to overeat.
  • And, of course, don’t neglect the exercise component.

For a more detailed analysis of the pros and cons of popular diets, read my book, “Slaying The Food Myths.”

 

The Bottom Line

 

It seems like everyone has a magical weight loss diet. You just follow their diet and the pounds will melt away. The problem is that everyone’s recommendations are different. What is the average consumer to think? Is the best diet low fat, low carb, low sugar, Paleo, Keto, or vegan? Or is intermittent fasting the secret to successful weight loss?

What if the secret to weight loss was none of the diets mentioned above, yet was something common to all of them? The one common feature of every popular diet is they cut out sodas and processed foods and replace them with whole unprocessed foods.

For years experts have claimed that the consumption of highly processed foods is responsible for the obesity epidemic and replacing  ultra-processed foods with unprocessed foods was the secret to successful weight loss. However, those claims are based on associations, and association studies do not prove cause and effect.

Finally, the first randomized controlled trial to test this hypothesis has been published. The study showed:

  • Subjects ate an additional 508 calories per day when on the ultra-processed diet.
  • Subjects gained 2 pounds in just two weeks on the ultra-processed diet and lost 2 pounds in two weeks on the unprocessed diet.

My recommendation is simple. Just ditch the sodas, junk foods, and highly processed foods. Rediscover the pleasures of whole unprocessed foods. You will lose weight gradually and safely. You will be healthier.

Of course, it’s not quite that simple. I discuss other aspects of successful weight loss in the article above.

For a more detailed analysis of the pros and cons of popular diets, read my book, “Slaying The Food Myths.”

For more details read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

UA-43257393-1