Hello and welcome to PREKURE’s weekly snippet of science, where on a weekly basis we share emergent research related to extending the human healthspan.



Vitamine B9, or folate as many of us know it, is a water-soluble vitamin. It plays a role in DNA and RNA formation, aids in the production of red blood cells, and plays an extremely important role in protein metabolism. Folate is involved in breaking down the amino acid homocysteine and transforming it into methionine [1]. This is an important process because excessive levels of homocysteine are harmful to humans, in fact, a 2017 meta-analysis illustrated a dose-response relationship between homocysteine levels and all-cause mortality [2]. It is important to note that most research in this area is observational in nature and there are limited clinical trials to date. The recommended daily intake of folate is 400mcg per day for healthy adults, 600mcg for pregnant women, and 500mcg for breastfeeding women [3]. As you can see, folate requirements increase markedly during periods where energy requirements are significantly elevated – during pregnancy and while breastfeeding. This is why many of us associate folate with these periods in a woman’s life, due to its crucial role in ensuring that fetal neural tubes form appropriately. However, in recent years there has been increased interest in the role that serum folate (and serum homocysteine as a proxy for folate status which is not as accurate as actual folate serum levels) play in cognitive decline and the pathogenesis of neurodegenerative diseases like Alzheimer’s and dementia. This study adds to the growing body of observational studies which illustrate that folate deficiency is linked to an increased risk of cognitive decline as neurodegenerative diseases including Alzheimer’s and Dementia [1].


Methods & Results

This large prospective cohort study (27, 188 individuals) examined the serum folate levels of individuals who were between 60-75 years old and had no pre-existing diagnosis of dementia for at least 10-years. The researchers monitored the records of these individuals for either a dementia diagnosis or mortality. They found that approximately 13% of the participants could be considered folate deficient. Interestingly among the individuals who were deficient in folate the rate of a dementia diagnosis was 3.4% while the all-cause mortality (or death occurring from any cause) was just below 8%. While those who had sufficient folate levels had dementia rates of 3.2% and all-cause mortality rates of 4%. This illustrates that there seems to be a stronger link between folate levels and all-cause mortality than cognitive decline or neurodegenerative diseases in particular. This same observation is made by the American National Institute of Health when considering the observational, trial, and meta-analytic data [1]. The researchers concluded that;

“The participants with folate deficiency had three times the risk of dying from any cause”

The authors noted that reverse causation (i.e. that dementia causes folate deficiency rather than folate deficiency causing dementia) cannot be ruled out. Remember, this is an observational study – these are very common in public health research because you can analyse large numbers of participants on a tight budget (something many researchers are all too aware of – the struggle of trying to make a meaningful contribution within the bounds of what is feasible). Due to the observational nature of this study, the authors cannot (and did not) conclude that low serum folate causes dementia or premature death, rather that there is a link between them. Further, it is important to note that, given metabolism and food intake change serum folate levels, the concentrations on any given day (i.e. the day blood samples were drawn) might not be indicative of long-term serum levels.



Does this mean we should all dash off to our nearest supplement store and load up on folic acid to prevent cognitive decline and our risk of neurodegenerative diseases like dementia? Not exactly. While folic acid is more easily absorbed than folate from food (85% compared to 50%) this doesn’t mean we need to jump straight to supplements, there is no reason to run out to your nearest supplement store IF you are eating a well-balanced diet predominantly centred around whole real food. Here at PREKURE we call those foods that are low in human interference. These are the foods that were recently alive or running around, not the foods that come in packets and bear no resemblance to the ingredients they are made up of. After all, research to date suggests that even when folic acid supplementation occurs, the risk for cognitive decline does not decline [1]. So what can you eat to boost your folate levels? Below is a list of foods that are rich in folate.


Best Folate-Rich Foods

  • Dark leafy green vegetables (spinach, brussels sprouts, asparagus)
  • Beans (Black-eyed, kidney)
  • Liver (particularly beef)

Eating unprocessed food is often thought to be expensive; however, the foods listed above are generally low-cost. A great way to incorporate liver into your weekly meal plan is to freeze it and grate it into a bolognaise or slow-cooked meal. It will give your meal a hearty kick and boost your folate levels. While the evidence for folate and cognitive decline is associational and not causational, getting adequate nutrients should be a priority regardless.



PREKURE is all about applying cutting-edge, evidence-based science into practice and we hope that by equipping you with new knowledge on a weekly basis you can incorporate this into your own life and share it with your clients when appropriate. Each week will bring with it new and exciting research, however, if there is something you are itching to know more about please email us and we will keep it on our radar as we curate our weekly snippets. 
We will only be sharing open-access, freely available journal articles and blogs with you. However, we wanted to make you aware of the academic workaround for getting your hands on the latest research. When looking for research you might find yourself browsing PUBMED or Google Scholar and happen upon a research article that you want to read, unfortunately, the publishers want you to pay to access it. Oh well, guess you should just keep looking right? Wrong. You can use another website called ResearchGate to access journal articles. Here, researchers create a profile and upload their work. If the PDF you are after isn’t available you can simply click the ‘request PDF’ button and the researcher will email you a copy! As an example, here is our very own Prof Schofield’s ResearchGate profile.