Folate is a generic term used to describe a water-soluble compound and is known as vitamin B9. It is essential for cell functioning, metabolism, growth and multiplication through a key role in the DNA, histone and protein production. Folate is also an important biological compound in the body which helps to break down homocysteine, a natural metabolite that needs to be removed from the plasma due to its toxicity (Moll and Davis, 2017).
The role of folate in the human body
Demands for folate rapidly increase during periods of intense growth and development, such as pregnancy and early infancy. Given that our bodies are not able to produce folate, the best way to get this nutrient is through our diet and consumption of folate-rich foods, including dark green leafy vegetables, citrus fruits and their juice, legumes/pulses, animal liver, fermented dairy products and eggs.
The recommended daily amount of folate for adults is 50 mcg but your body can store up to 10–20 mg of this vitamin – in the liver, the blood and body tissues – , which is generally enough to last for 2–3 months (Moll and Davis, 2017).
The role of iron in the human body
Iron is a mineral that plays an essential role in many bodily functions, including oxygen transport, energy production, DNA synthesis and body detoxification (Moll and Davis, 2017).
Body iron content is around 40 mg per kg body weight in women and 50 mg/kg in men. Approximately 30 mg/kg of this amount is stored in red cells in the form of an oxygen-carrying protein, known as haemoglobin.
Iron can be stored in the body, predominantly in the liver, but also in the spleen and bone marrow in the form of storage proteins, namely ferritin and hemosiderin (Moll and Davis, 2017).
How iron and folate work together in the body
Iron and folate are essential nutrients our body needs to maintain optimal health. They work together to help our red blood cells function properly, i.e. haemoglobin production and oxygen transport within the body.
People with iron deficiency usually have too little folate in their blood, which can explain why iron and folate deficiencies often occur at the same time (O’Connor, 1991).
Iron-folate supplementation to prevent iron-deficiency anaemia during pregnancy
Anaemia refers to low haemoglobin levels and is a medical condition in which the number of red blood cells or their ability to provide oxygen to the tissues is reduced(Chaparro and Suchdev, 2019). Women are more likely to get iron-deficiency anaemia in pregnancy as they need more oxygen to support the growing baby.
Studies were conducted to compare the effects of iron-folate supplementation versus placebo or no supplementation during pregnancy. The results showed that iron-folate supplementation reduced maternal anaemia by 69%. Mothers, who were given supplements containing both iron and folate had a significantly lower risk of iron deficiency anaemia throughout the pregnancy and were less likely to need a blood transfusion. Therefore, iron-folate supplementation during pregnancy was associated with a significantly reduced risk of low birthweight and a significantly greater mean birthweight compared to placebo or no supplementation (Imdad and Bhutta, 2012).
Based on evidence showing the benefits of iron-folate supplementation to prevent iron-deficiency anaemia in pregnant women (Juarez-Vazquez et al., 2002), using a biologically active form of folate like Quatrefolic® is the most efficient way to make sure folate is readily available to give the body what it needs during pregnancy.
Moll R, Davis B. Iron, vitamin B12 and folate. Medicine, 2017; 45(4); 198-203.
O’Connor D. L. (1991). Interaction of iron and folate during reproduction. Progress in food & nutrition science, 15(4), 231–254.[Saut de retour à la ligne][Saut de retour à la ligne]Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries. Ann N Y Acad Sci. 2019 Aug;1450(1):15-31. doi: 10.1111/nyas.14092. Epub 2019 Apr 22. PMID: 31008520; PMCID: PMC6697587.
Imdad A, Bhutta ZA. Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes. 2012. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995. Available from:https://www.ncbi.nlm.nih.gov/books/NBK109972/
Juarez-Vazquez, J., Bonizzoni, E., & Scotti, A. (2002). Iron plus folate is more effective than iron alone in the treatment of iron deficiency anaemia in pregnancy: a randomised, double blind clinical trial. BJOG: an international journal of obstetrics and gynaecology, 109(9), 1009–1014. https://doi.org/10.1111/j.1471-0528.2002.01378.x