Folic Acid Deficiency

Introduction

Folic acid deficiency, a critical health issue affecting various populations worldwide, predominantly impacts pregnant women, individuals with certain medical conditions, and those following specific dietary patterns, such as veganism or alcohol dependence (Novo-Veleiro et al., 2023; Sapehia et al., 2023). This deficiency leads to a range of serious health problems, notably megaloblastic anemia, characterized by the production of abnormally large and dysfunctional red blood cells. Megaloblastic anemia is characterized by the presence of megaloblasts, which are unusually large, immature red blood cell precursors in the bone marrow. This occurs because folic acid is crucial for the synthesis and repair of deoxyribonucleic acid (DNA). Folic acid deficiency disrupts the normal process of cell division and DNA synthesis, particularly affecting rapidly dividing cells such as those in the bone marrow, where red blood cells are produced (D. P. Wu et al., 2023). In pregnant women, inadequate folic acid levels are particularly concerning because they significantly increase the risk of neural tube defects (NTDs) in newborns, conditions such as spina bifida and anencephaly, which can result in lifelong disability or even infant mortality (Caceres & Blount, 2023). NTDs are birth defects of the brain, spine, or spinal cord that occur when the neural tube fails to close completely during early fetal development, typically within the first month of pregnancy—often before a woman knows she is pregnant (Force, 2023). In addition to its role in pregnancy, folic acid is essential for DNA synthesis and repair, making its deficiency a potential contributor to genomic instability and thus increasing the risk of cancer, particularly in rapidly dividing tissues (Wang & Su, 2023). The insidious nature of folic acid deficiency is compounded by its often subtle early symptoms, such as fatigue and irritability, leading to underdiagnosis and undertreatment (Akduman et al., 2023). This issue underscores the critical need for improved public health strategies, including dietary education, food fortification, and targeted supplementation programs, to effectively combat this widespread but preventable nutritional deficiency (Kancherla et al., 2022).

The aims of this chapter are as follows:

• 1)

  To elucidate the biological functions of folic acid and its critical role in human physiology, with a particular focus on its importance during pregnancy and embryonic development.

• 2)

  To examine the epidemiology of folic acid deficiency, encompassing its global prevalence, and to identify high-risk groups and their specific vulnerabilities.

• 3)

  To explore the various causes and risk factors for folic acid deficiency, including dietary patterns, nutritional gaps, malabsorption disorders, and interactions with certain medications.

• 4)

  To describe the clinical manifestations of folic acid deficiency, the text details its symptoms and health implications and addresses the challenges and techniques used in its diagnosis.

• 5)

  To propose effective management and prevention strategies for folic acid deficiency, which include dietary modifications, supplementation programs, and broader public health interventions such as food fortification.

• 6)

  To offer insights into future perspectives in the field, highlighting ongoing research, emerging trends, and the importance of interdisciplinary collaboration in advancing our understanding and management of folic acid deficiency.

• 7)

  To conclude, this chapter synthesizes the key findings presented in the chapter and outlines the future scope of related research and public health strategies in the context of folic acid deficiency and its implications.