Jen Walpole is a registered Nutritional Therapist who splits her time between her Hertfordshire clinics and online clients. She suffered with hormonal imbalances throughout her 20’s and was later diagnosed with PCOS at the age of 28. This lead her to nutritional therapy, and it was her self-learning about the importance of nutrition and a love of cooking that helped her to gain a more balanced lifestyle. Jen’s aim is to help clients realise their health goals, and improve their nutrition and wellbeing when trying to conceive, whilst supporting any health issues or concerns alongside. In this fertility blog we hear her take on folate and folic acid, and what she thinks is better for those TTC (trying to conceive).
Most women are told about the importance of folic acid or folate for pregnancy, but can you tell us a little bit more about what it is and why it is important?
Folic acid or folate is one of the many B vitamins – it is called Vitamin B9. It is widely known for its importance during pregnancy due to its role in developing the neural tube during early foetal development. The neural tube is the precursor for the central nervous system of the foetus, which forms the brain and spinal cord. Low folate status may lead to neural tube defects in the foetus, such as Spina Bifida, which is why your health care provider will advise you to take this if you’re trying to conceive or pregnant.
When should women who are trying to conceive start taking Folate or Folic Acid and how much?
Due to its importance in early foetal development, it is advisable to supplement this ahead of conceiving and at least during the first 12 weeks of pregnancy. Whilst the dosage may differ between some countries 400 micrograms (mcg) is the recommended dosage in the UK and USA.
Why is it advised to supplement, rather than obtain it from the diet? What are the foods which help with fertility and give you folate?
It can be hard to obtain the recommended dosage from diet alone and so supplementation is advised, alongside obtaining folate from those food sources. The richest food sources of folate (which also help with fertility) include beans, chickpeas and lentils, dark green leafy veg such as spinach, pak choy, broccoli, sprouts, kale and other veg such as edamame and asparagus. These are fantastic foods to include in your pre-conception diet not just for their role in pregnancy but due to them being an important source of fibre and of other B vitamins, which are essential for energy production. In addition, one study highlighted an increased chance of pregnancy in women who increased their plant-based protein intake, of which folate-rich beans and lentils are an excellent source (Chavarro et al, 2008).
What’s the difference between Folate and Folic Acid?
Folic acid and
folate are often used interchangeably, despite the fact they are different, which can be confusing. Folic acid is the synthetic (man-made) form, whilst folate is the natural and bioavailable form. Whilst most health care providers will advise supplementation of ‘folic acid’, about 40-60% of the population have a genetic modification, which makes them unable to convert this synthetic form into the active form. Therefore, a large number of the population may not be meeting the recommended level of folate required in pregnancy, increasing the risk for neural tube defects. In addition, a study comparing the difference between women that took folic acid versus folate also found that they were less likely to suffer with anaemia during pregnancy (Bentley et al, 2011).
How would we know if we cannot convert folic acid to its active form?
Testing every woman is not always practical to find out this information and it can be costly. That being said, private tests can be run, and this is definitely something we look at in my clinic if necessary, but it is often more practical to supplement the active form of folate instead.
Are there any fertility supplements and brands that you like to recommend in particular?
A fertility supplement is advisable to take during your fertility journey, to ensure you optimise your fertility diet ahead of conception. Brands such as Wild Nutrition, Cytoplan and Terranova are food formed supplements, meaning they are not synthetically made and are therefore much more bioavailable. This means that they will be absorbed and utilised by the body easily. Alternatively, if your supplement is not ‘food-formed’, check that it contains the bioavailable form of folate, Methlyfolate.
Are there any other supplements you would recommend?
Often, fertility clients either come to me having not taken any supplements before, or they are so confused that they are taking much more than they need. Of course, there are benefits to taking additional fertility supplements, but this is never a one size fits all approach. What might be right for your friend, may not be right for you. This is why it’s really helpful to work 1:1 with a Registered Nutritional Therapist, who will be able to support your specific requirements and probably save you some money in the long run too!
Jen is offering a 10% discount to her readers on her initial consultation and follow up package. Quote FHH when booking to redeem.