The Importance of Eating Folates

Inaugural Lecture “The importance of Eating Folates” as Lecturer of the Faculty of Medicine at the University of Zürich, March 16, 12:30 pm, KOL G 201 Aula.

Dr. Visentin described the development of folates for nutrition in a historical timeline.

Importance of folates
The human body cannot produce folate and therefore depends on the daily consumption of foods containing folates. Vegetables, especially broccoli, tomatoes, legumes, nuts, wheat germ, and eggs are considered good sources of dietary folate. Folate is important for preventing neural tube defects (spina bifida). A link between folate levels and depression, dementia and autism has also been reported. In his fascinating lecture, he described the parallel development of "antifolates" for the treatment of various types of cancer, such as leukemia, breast cancer and soft tissue cancer (mesothelioma). Antifolates are also used to treat chronic diseases such as psoriasis and rheumatoid arthritis. Antifolates work by blocking cell proliferation, which stops cancer growth.

Folate supplementation of food to prevent neural tube defects (spina bifida)
To prevent spina bifida, several countries, including the United States, fortify foods with folic acid, the oxidized form of folate. In Europe, foods like flour, pasta, rice are not fortified with folic acid. The highest prevalence for spina bifida was found in Eastern Europe and Turkey.

Does folic acid cause cancer?
Study results suggest that folic acid supplementation does not increase cancer rates. However, folate deficiency is associated with an increased risk of certain cancers, such as colorectal cancer.

Different types of folate deficiency: Hereditary and sporadic folate deficiency
Dr. Visentin has categorized the different types of folate deficiency and their effects. While low levels of folate in the blood are hereditary or dietary, a deficiency can develop in certain organs, such as the brain, despite normal folate intake. Several folate metabolism enzymes and their mutations play an important role in this process.
The hereditary loss of the proton-coupled folate transporter (PCFT) in the intestine significantly reduces the absorption of folate from food and supplements. As a result, organs such as the brain are not adequately supplied with folate. Folate deficiency in the brain prevents normal brain development in children. Dr. Visentin also referred to cerebral folate deficiency, which can be caused by loss-of-function mutations of the folate receptor 1 (FOLR1, also called folate receptor alpha) gene or by high blood levels of autoantibodies to FOLR1, and leads to altered brain development. The concentration of folate in the blood plays an important role in its uptake into the brain. Special barriers, such as the blood-brain barrier, act as filters for folate uptake. Therefore, in the absence of specialized transport systems (i.e., PCFT and FOLR1), higher circulating levels of reduced folates and the presence of "non-folate-specific" transporters are required to achieve the normal folate gradient across these barriers.

This multifaceted insight into the world of folates provides a powerful explanation for why eating folates is important.

Recording of the Inaugural Lecture: https://vimeo.com/924091648