Folate and folic acid are not the same thing — and where you live determines which one you're getting
One is found in food. The other is added by governments. Europe chose not to add it, and the consequences are measurable.
science
Vitamin B9 goes by several names — folic acid, vitamin B9. They are often used interchangeably, but they refer to chemically different compounds with meaningfully different behaviour in the body. is the naturally occurring form found in leafy greens, legumes, eggs and liver. Folic acid is a synthetic, oxidised version that does not exist in nature. It is manufactured and added to food during processing.
The difference matters because the body handles them differently. Natural from food arrives in a reduced form that the body can absorb and use directly in the small intestine. Folic acid, being oxidised, requires conversion by an enzyme called dihydrofolate reductase before the body can use it. This conversion is slow in humans. When folic acid intake is high, unconverted folic acid accumulates in the bloodstream — a state that does not occur with natural food
Roughly 10 to 15 percent of people carry a variant of the MTHFR gene that further slows this conversion, meaning synthetic folic acid is significantly less effective for a substantial portion of the population
The US introduced mandatory folic acid fortification of wheat flour in 1998, following evidence that adequate B9 intake before and during early pregnancy reduces neural tube defects like spina bifida by more than 50 percent
Canada, Chile, South Africa and Australia followed with mandatory programmes. Neural tube defect rates in these countries dropped by 25 to 50 percent after fortification was introduced
As of 2024, Bulgaria and almost every EU country have no mandatory folic acid fortification. Moldova is the only European country with a mandatory programme. The UK plans to introduce it for non-wholemeal wheat flour by the end of 2026
The neural tube defect rate in Germany is roughly double that of Chile. Mothers in Sweden are 50 percent more likely to lose a child to a neural tube defect than those in Canada. This gap is largely attributed to the absence of mandatory fortification in Europe
When fortification does occur, it happens at the mill, not the farm. Folic acid is added as a dry powder blend directly into the flour stream during milling, before the flour is bagged. This allows precise control over concentration — typically 140 micrograms per 100 grams of flour in the US standard. More recent techniques including nanoencapsulation and microencapsulation improve nutrient stability during baking and storage.
If you live in Bulgaria or most of the EU, the flour, oats and rice you buy almost certainly contain no added folic acid unless the manufacturer has voluntarily fortified and labelled the product. Your B9 intake comes from whole food sources — which for most purposes is preferable. Natural food does not cause unconverted accumulation in the bloodstream, is absorbed efficiently at normal dietary amounts, and is available in the same foods that carry and other nutrients that support metabolism. Dark leafy greens, lentils, chickpeas, eggs and liver are your most reliable sources.