The due date for folate innovation has arrived

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Leverage consumer education to make your mark in the prenatal health space.

Photo © AdobeStock.com/nataliaderiabina

Photo © AdobeStock.com/nataliaderiabina

Women across the Western Hemisphere are choosing to have children later in life, with the average maternal age in the U.S. steadily rising over the past few decades. In 2021, the Centers for Disease Control and Prevention (CDC) reported that nearly 20% of births in the U.S. were to mothers over the age of 35. Additionally, the proportion of first-time mothers in their 30s and 40s continues to grow each year.1 At these ages, women are often more financially stable and willing to invest in premium prenatal products that support their baby’s growth and development. This demand for high-quality ingredients,2 personalized needs, and differentiating claims, presents a significant opportunity for innovation in the premium supplement space. The market for prenatal nutrition is projected to grow steadily, with an estimated 3.5% compound annual growth rate (CAGR) through 2027.3 At the same time, as research and product development in this space advance, consumers are seeking clearer education and guidance to make informed decisions and give their babies the best start.4,5,6

One of the most sought-after nutrients in prenatal supplements is Vitamin B9, also known as folate.7 However, not everyone is aware that folate exists in multiple forms, including folic acid and 5-methyltetrahydrofolate (L-5 MTHF), each with varying levels of bioavailability. Here’s what manufacturers need to know to help moms and babies thrive and lead in this growing market.

The ABCs: Folate for the building blocks of life

Folate supplementation is widely recognized for its critical role from preconception through pregnancy and breastfeeding. During pregnancy, folate requirements surge, yet over half of expectant mothers (52%) fall short of the necessary intake,8 highlighting a significant nutritional gap with potential implications for maternal and fetal health.

In its bioactive form (L-5 MTHF), this powerhouse nutrient supports the overall well-being of moms and babies every step of the way. For example, it plays a crucial role in DNA and RNA synthesis – a process that is in high demand during rapid growth periods such as pregnancy and infancy, when folate sustains cell replication. The key to folate’s impact is its role in one-carbon metabolism and methylation reactions. Folate acts as a donor, providing methyl (CH3) groups to be added to various molecules in the body such as DNA and proteins. This process contributes to multiple vital functions, such as maintaining the integrity and stability of genetic material and helping to control which genes are expressed by acting as an “on and off” switch on DNA.9

Folate is also important for brain health. By regulating homocysteine levels through its methyl donor function, this ingredient contributes to supporting healthy brain tissues10 and promoting normal cognitive function.11 What’s more, during the early weeks of pregnancy – often before a woman knows she’s expecting – adequate folate combined with a healthy diet can help reduce the risk of having a child with brain or spinal cord birth defects.12 But the benefits of folate don’t stop there. It also works overtime to support the cardiovascular system, supporting the formation of healthy red blood cells that carry oxygen throughout the body.13

It's elementary: Folic acid versus folate

It’s clear that adequate folate levels are important for the health of both moms and babies, so how can we help them achieve this?

Many prenatal dietary supplements contain folic acid or folate.14,15 These terms are often used interchangeably, but this is not the whole story and hides an important bioavailability issue. While many expecting women integrate folic acid supplements into their routines – sometimes even exceeding recommended doses 16,17 – they might not be reaping the full benefits.That’s because without an active and bioavailable form of folate, the results might fall short, and excessive folic acid can even pose potential health risks.

L-5-MTHF is the bioactive form of vitamin B9, which is naturally found circulating in the body. Whereas folic acid is a synthetic, biologically inactive form found in dietary supplements and fortified foods. To provide important benefits for expecting mothers, folic acid needs to undergo multiple enzymatic conversions to be transformed into L-5-MTHF. But with excessive intake of folic acid, this metabolism can quickly become overwhelmed. Plus, genetic variations carried by up to 40% of the U.S. population can also reduce the activity of the enzymes responsible for the conversion of folic acid,18 leading to unmetabolized folic acid building up and entering the blood stream.19 Not only does this mean that many mothers who take folic acid supplements aren’t getting the same benefits as they would from an active folate, but circulating unmetabolized folic acid (UMFA) has been linked to health risks. Although the long-term effects are uncertain, high levels of UMFA have been linked to impaired immune function20 and could even interfere with the activity of active folate.21

L-5-MTHF on the other hand, doesn’t require any enzymatic processing to be absorbed and begin supporting various vital biological processes. So, when taking supplements containing this active form, moms can get the full health benefits they expect from folate supplementation, without the risks associated with UMFA.

Reaching the next level: Understanding the difference between folate forms

Even when choosing an active folate ingredient, there are different options to choose from – such as calcium folate and glucosamine folate – which have differing levels of stability. Choline-enriched folate is an innovative solution that offers additional benefits compared to other folates. With choline-enriched folate, one folate molecule is combined with two molecules of choline, to provide a total of seven methyl groups compared to the one in L-5-MTHF. This means that each molecule has more methyl groups available to donate for DNA and RNA synthesis and homocysteine metabolism.

Choline-enriched folate also provides advantages for formulators in terms of stability and solubility, opening up new opportunities for supplement manufacturers to explore new innovations. Most L-5-MTHF product forms on the market today can be tricky to work with - recent data from the National Institutes of Health reported that over 40% of products containing L-5-MTHF failed dissolution criteria, and shelf-life testing showed variances ranging from –42% to >100%.22 So, a more stable ingredient like the choline-enriched folate form helps to ensure supplements maintain their efficacy and safetythroughout their shelf-life and continue to support the health of expecting moms.

It’s time to equip moms-to-be with the knowledge they need

For years there have only been a few folate options to choose from, but thanks to increased investment in the understanding of maternal health, new, improved ingredients are now available – so it’s time to shake things up. With a growing number of women now willing to invest in premium prenatal supplement products, nutraceutical brands have the opportunity to innovate and keep improving the health of moms-to-be. To do this, it’s essential to pair innovation with education, empowering expectant moms to make choices on the best ingredients to support their own health and the well-being of their babies – and the right form of folate is the place to start.

About the Author

Lauren Eisen is Senior Marketing & Business Development Manager, Minerals and Nutrients at Balchem Human Nutrition & Health. Balchem is a premium ingredient supplier on a mission to make the world a healthier place through innovative, science-based health solutions like Optifolin+, the supercharged folate.

References

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