Causes of Folate Deficiency Dietary

The most common cause of folate deficiency is undoubtedly due to inadequate dietary intake. The naturally occurring folates, unlike the synthetic form of the vitamin folic acid, are chemically unstable (Figure 3). The folate in food after harvesting or during processing is subject to deterioration.

Folic acid nh2—C C

CO— glutamate

CO— glutamate

I H CHO

Tetrahydrofolate

CO— glutamate

CO— glutamate

10-Formyltetrahydrofolate

10-Formyltetrahydrofolate

OH CH3

5-Methyltetrahydrofolate Figure 3 The structure of synthetic folic acid and the naturally occurring forms of the vitamin.

Furthermore, folate can be lost from food during cooking. While the prevalence of overt folate deficiency in those on adequate mixed diets is relatively uncommon, it is now clear that many people have elevations of the biochemical marker homocysteine, which can be decreased by increased status of folic acid or folate, certainly where such diets are not fortified with folic acid. This has led many to conclude that more people than previously suspected are at increased risk of impaired folate function, such as might put them at increased risk of cardiovascular disease and other chronic diseases.

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