The folate status of women and health

Folate is a “B” vitamin required for the synthesis of DNA, RNA, and protein, prime events for cellular replication and growth. Thus, any stage in the life cycle characterized by cell replication and growth, such as pregnancy, lactation, and infancy, is a period of enhanced folate requirement. During the past 25 years, the issue of whether women are consuming adequate amounts of dietary folate has been debated by both clinicians and researchers alike. The incidence of folate inadequacy among women in either developed or developing countries is not known with certainty; however, it has been suggested that on a global scale up to one-third of pregnant women may be affected with various levels of folate undernutrition. Less than optimal folate nutrition is a risk factor for a number of negative maternal and fetal outcomes including low birthweight, neural tube defects (NTDs), cervical dysplasia, and cardiovascular disease. In this paper we provide an overview of the current dietary folate recommendations for women of reproductive age, bases for such recommendations and current concerns. The consequences of suboptimal folate status to woman’s health and that of the unborn are discussed, as are common and good dietary sources of folate. Finally, we assess whether it is possible for North American women to consume the quantity of folate currently recommended for women of reproductive age and strategies to improve folate status during childbearing years.