How to Choose Vitamin D Supplements? What is The Safe Range Regarding The Recommended Daily Intake?

    – The difference between vitamin D3 and vitamin D2 is that animals can synthesize vitamin D3 whereas plants synthesize vitamin D2. – When choosing vitamin D supplements, for the optimal result, vitamin D3 is the best choice. Recommended Vitamin D Intake There is no doubt about the benefits of vitamin D to our health, but there is still no unified recommendation for how much we should take for the ideal amount. In 2010, the Institute of Medicine (IOM) recommended a daily dose of 600 IU for adults. However, some studies pointed out that this is not enough. A study found that even 2000 IU per day may not be able to maintain normal blood levels. In addition to increasing the recommended intake to 600 IU, the Institute of Medicine also increased the Tolerable Upper Intake Levels (UL) to 4000 IU per day; meanwhile, IOM has also increased NOAEL (No Observed Adverse Effects Level) (the highest consumption without observing toxicity) value to 10,000 IU per day. In the light of a study by JAMA Internal Medicine, 77% of people in the United States have vitamin D deficiency, which may be more severe in winter. According to a statistical survey conducted by Chi Mei Hospital in Taiwan, more than 60% of Chinese people are vitamin D deficient. Vitamin D supplements on the market can be divided into two main categories, vitamin D2 and vitamin D3, but which vitamin D is more effective? A study published in the Journal of Clinical Endocrinology & Metabolism in 2011 indicated that for 33 testing subjects, it was found that vitamin D3 performed 87% better than vitamin D2 in increasing vitamin D content in the body (Robert P. Heaney, 2011 ). Vitamin D3 is also more efficient for storing fat cells in the body. Base off of another study published in the European Journal of Clinical Nutrition in 2015 (Beatriz Oliveri, 2015), compared to the testing subjects who take vitamin D2, those who take vitamin D3, even after they stop the supplementation, the effect could remain high for 77 days in their body. Sources of Vitamin D in Food Common food sources containing vitamin D3 are egg yolks, beef liver, deep-sea fish rich in fat (such as salmon, sardines). Common food sources containing vitamin D2 are mushrooms, nutrient-fortified breakfast cereals or milk. Advice for Vitamin D Supplementation It is difficult to obtain enough vitamin D from a normal diet. Synthesis through sunlight cannot meet daily needs either, because it is affected by the season, climate, exposure time and specific wavelengths of sunlight. If you want to supplement vitamin D, vitamin D3 is the best choice. It’s recommended 600 IU daily for adults, and the recommendations for children including infants and young children is 400 IU per day. If you are extremely deficient in vitamin D and want to supplement a higher dose, it is recommended to consult a physician, nutritionist or professional first.  

該如何挑選維生素 D 補充品? 每日建議量,多少才是安全範圍?

    – 維生素 D3 與維生素 D2 的差異在於動物可以合成維生素 D3,而植物合成維生素 D2 – 當選擇含維生素 D 補充品時,為了能有最佳效果,維生素 D3 是最好的選擇 維生素 D 建議食用量 : 維生素 D 對於健康的助益,已經無庸置疑,但是應該食用多少才是理想用量,仍然尚無統一的建議。在 2010 年,美國國家醫學院 (IOM, Institute of Medicine) 針對成人建議用量為每日 600 IU。然而,有些研究指出這是不夠的。在一研究發現,即使每日 2000 IU 仍可能無法維持正常血液中濃度。除了建議食用量提升至 600 IU 外,美國國家醫學院 (Institute of Medicine) 同時將每日食用上限攝取量 (Tolerable Upper Intake Levels. UL) 提高到每日 4000 IU,以及將 NOAEL (No Observed Adverse Effects Level) (未觀察到毒性的最高食用量) 數值提高到每日 10,000 IU。 根據 JAMA Internal Medicine 的研究,美國有 77% 的人維生素 D 不足,而冬季可能更為嚴重。台灣根據奇美醫院的統計調查,國人則有超過六成維生素 D 不足。市面上維生素 D 補充品主要可分為兩類,維生素 D2 與維生素 D3,但哪一種維生素 D 效果比較好呢? 在 2011 年發表於 Journal of Clinical Endocrinology & Metabolism 期刊的研究指出,針對33名的受測者,發現維生素 D3 對於提升體內維生素 D 含量的效果,比維生素 D2 高了 87% (Robert P. Heaney, 2011)。 維生素 D3 對於儲存在體內脂肪細胞的效率也較高。根據 2015 年發表於 European Journal of Clinical Nutrition期刊的另一篇研究發現 (Beatriz Oliveri, 2015),食用維生素 D3 的受測者,即使停止補充後,比食用維生素 D2 的人相比,可以維持體內較高濃度達 77 天。 食物中維生素 D 來源 : 含維生素 D3 的常見食物來源 : 蛋黃、牛肝、富含油脂的深海魚,例如鮭魚、沙丁魚。 含維生素 D2 的常見食物來源 : 菇蕈類、營養強化的早餐穀片或牛奶。 維生素 D 補充建議 : 光從正常飲食中,很難獲取足夠的維生素 D,而經由日曬合成,也無法滿足每日所需,因為這跟季節、氣候、日曬時間和陽光特定波長有關。如果你想補充維生素 D,維生素 D3 是最好的選擇,成年人建議每日補充 600 IU,兒童包含嬰幼兒建議每日 400 IU。若你是維生素 D 極度缺乏者,欲補充較高劑量,建議可以先諮詢醫師、營養師或專業人員。    

What is The Difference between Yeast B-Complex and Active Form B-Complex?

    How to tell if your dietary supplements are natural or not? Does so-called “nature” mean original food type? In fact, this is a concept that is easy to get confused. At present, according to the regulations of the Taiwan Food and Drug Administration, nutritional supplements can no longer be directly marked as "natural". After all, many raw materials are derived from food, but in order to extract or maintain stability, other ingredients have to be added in the making process. As a result, it is currently prohibited in Taiwan to announce being “natural” directly. You might wonder if the supplements claim to come from food types really easier to absorb? In fact, this statement is tricky. To determine whether the nutrients are absorbed well, and whether they are consistent with the natural food pattern, the form of the ingredient must be checked. For example, rumor has it that the vitamin B complex contains quinoa or yeast fermentation has better absorption rate due to the natural food origin. As the matter of the fact, this view is both right and wrong. Correct Understanding : The absorption rate is better when the ingredients derived from nature. Explanation : For example, Methylcabalamin is the natural form of vitamin B12 found in food, whereas Cyanocobalamin is the synthetic form of vitamin B12. According to researches and studies, the loss of synthetic form after consumption is 3 times faster than the natural form. Normally, the price of the natural active form of Methylcobalamin is more than 100 times higher than the synthetic Cyanocobalamin. Folate is another vitamin component that can be distinguished immediately. When only Folic Acid is written on the label, that is a synthetic form. Currently, the scientific name of the active Folate type approved by the Ministry of Health and Welfare in Taiwan is (6s)-5-methyltetrahydrofolic Acid Glucosamine Salt [(6s)-5-Methyltetrahydrofolic Acid]. In a study conducted by the University of Bonn in Germany in 2009, it was also confirmed that compared with traditional synthetic Folic Acid, active Folate is 98% more absorbable than traditional Folic Acid after 8 hours of consumption. (r prinz-langenohl, s brämswig, o. 2009) Vitamin E is also a good example we could look into. On the supplement facts label, you could not tell if the ingredient is natural and synthetic by Chinese description; however, English scientific names would give you the fact. The scientific name of the natural form of vitamin E is “d-alpha-tocopherol”, which is easily absorbed by the human body and is a biologically active form. On the contrary, the synthetic form is called “dl-alpha-tocopherol”. Next time, when you want to purchase vitamin E supplements, remember to check on the label to know is it “d-“ form or “dl-“ form. Misconception : Coming from yeast means it’s certainly a natural form? Explanation : Made from yeast or quinoa refers to the source used to cultivate and produce vitamin Bs during fermentation. However, most of the common vitamin B12 in this kind is the synthetic form, which is cyanocobalamin. As a result, coming from yeast doesn’t not equal to be the natural form, nor represent high absorption rate. If on the label of the supplement you purchased only marked vitamin B12 in Chinese, it is likely that it is mainly in the form of artificial synthesis. Otherwise, you have to have the vendor provided the CoA from the raw material suppliers, then you would be able to tell the form of the vitamin B12. Key Point : Natural-sourced yeast fermentation ≠ active form. The active form is the guarantee of the highest absorption rate. Natural origin or artificial synthesis has always been a topic of hype. However, the actual form existence in food or human body can only be determined by the English scientific names of the ingredients. This is a must-learn topic for consumers if you want to shop smart; otherwise, you could be fooled by some unscrupulous manufacturers. The active form can really achieve the best results after consumption. If a product cannot achieve the expected benefits after consumption, no matter how cheap it is, it is actually a waste of money. Next time, before you buy any dietary supplements, take your time and read the label clearly. Be a wiser shopper for your own health.    

錯把 ”天然” 當成 "高吸收率" ? 營養品宣稱天然食物型態的陷阱?

    營養品如何判斷天然呢? 天然就是食物型態嗎? 其實這是很容易混淆的觀點。目前根據衛福部食藥署的規範,營養補充品不能再直接宣稱「天然」兩字,畢竟很多原料雖然來自食物,但為了萃取或是維持穩定性,還是會添加其他成分,因此直接宣稱天然其實目前在台灣是禁止的。 但號稱來自食物型態的營養品確實好吸收嗎? 這句話其實隱藏陷阱。要判斷營養成分人體是否好吸收,是否與天然食物型態相符合,必須要看營養成分的型式。舉例而言,維生素 B 群在坊間有號稱來自藜麥或是酵母發酵的 B 群,並宣稱來自食物好吸收。其實這一觀點既正確但又錯誤。 正確觀點:來自天然吸收率較高 說明:例如食物中存在的天然活性型式維生素 B12 是甲鈷胺 (Methylcabalamin),而合成型式的維生素 B12 是氰鈷胺 (Cyanocobalamin),根據研究文獻,其食用後,合成型式流失是活性形式的 3 倍快。而通常活性型式的甲鈷胺與合成的氰鈷胺原料也價差百倍以上。也因為活性維生素 B12 的絕佳成效以及特性,所以在美國無論是網購主要品牌或是醫療線品牌,其實也都是將甲鈷胺的維生素 B12 列為維生素上的使用首選。 葉酸,也是另一個可以立刻判斷的維生素成分。當營養品標示上只寫葉酸,或是 Folic Acid,這都是人工合成的型式。目前在台灣衛福部核准的活性葉酸型式學名是 (6s)-5-甲基四氫葉酸葡萄糖胺鹽 [(6s)-5-Methyltetrahydrofolic Acid]。而在 2009 年德國波昂大學的研究上,也證實活性葉酸跟傳統的合成葉酸相比,食用 8 小時後,比傳統葉酸還要多出 98% 的吸收量。(r prinz-langenohl, s brämswig, o. 2009) 此外,如維生素 E,中文無法區分來自天然或人工合成。但看英文學名就一目了然。天然型式的維生素 E 學名是 d-alpha-tocopherol,人體好吸收,是具生物活性的型式。人工合成型式則是 dl-alpha-tocopherol。看清楚了嗎? 所以下次要補充維生素 E,記得看清楚是 d-型式還是 dl-型式。 錯誤觀點:來自天然酵母就一定是活性型式?! 說明:來自酵母或藜麥,是指發酵時用來培養與製造 B 群的來源。但其裡面大部分常見都還是合成型式的葉酸 (Folic Acid) 或維生素 B12,也就是氰鈷胺 (Cyanocobalamin),所以來自酵母不等於是活性型式,當然,天然來源已經比人工合成的效果較佳,也不代表吸收率是最高的,但把天然來源跟活性形式的高吸收率畫上等號,是常發生的誤解,即使有些專業人員也常誤會。所以實際上必須確認是哪一種型式的維生素,才能判定。若您購買的產品彩盒上,只有標示中文維生素 B12,那很有可能就是人工合成型式為主,或是請廠商公佈原料商所提供的 CoA 證明其維生素 B12 的型式,才能判斷。 重點:天然來源酵母發酵 ≠ 活性形式。活性形式才是最高吸收率的保證。 天然來源或人工合成,一直是被拿來炒作的議題,也常常被廠商拿來當神主牌,但卻容易誤導消費者。真正存在於食物中或是人體的型式,還是必須要看英文的成分學名才能判斷,這是消費者必須學習的課題,不然就只是一直被有心的廠商消費。活性型式才能真正達成食用後的最佳成效,一個產品若無法達成食用後預期的成效,那無論多便宜,其實都是浪費錢。下次記得挑選您食用的營養補充品時,停下來多看一下營養標示,聰明選擇您所食用的營養品。    

How Much Weight Gain is Considered Normal during Pregnancy?

    Pregnancy is a painstaking process. Due to the changes in hormones, some women gain appetite and feel bottomless hunger all the time while pregnant; others suffer from nausea and vomiting and experience appetite loss in contrary. Meanwhile, some pregnant women believe they can temporarily enjoy food and eat whatever they want, which could lead to a continuing increase in weight. This eating behavior could not only cause abnormal blood sugar, obesity during pregnancy may also cause other complications. Besides, it would make your weight back to original slim figure more difficult after delivery. As for how much weight gain is considered normal during pregnancy? According to the recommendations from the National Health Administration of the Ministry of Health and Welfare, during pregnancy, the weight of pregnant women should be adjusted appropriately according to their pre-pregnancy weight. A healthy range of weight gain is between 10-14 kg; and please pay attention to the rate of weight gain. In addition, it is not suitable to think of weight loss during pregnancy. Moms-to-be can use the following charts as reference : BMI Before Pregnancy * Suggested Weight Gain (lb) Weight Gain Per Week during The Second and Third Trimester of Pregnancy : kg/week (lb/week) <18.5 12.5 – 18 (28 – 40) 0.5 – 0.6(1 – 1.3) 18.5 – 24.9 11.5 – 16 (25 – 35) 0.4 – 0.5 (0.8 – 1) 25.0 – 29.9 7 – 11.5 (15 – 25) 0.2 – 0.3 (0.5 – 0.7) ≥ 30.0 5 – 9 (11 – 20) 0.2 – 0.3 (0.4 – 0.6) *Metric Units: BMI = weight (kg) ÷ height2 (m).  US Units: BMI = (weight (lb) ÷ height 2 (in)) * 703.  Source : The American Congress of Obstetricians and Gynecologists, ACOG Expected Number of Births Suggested Weight Gain (lb) Weight Gain Per Week After 12 Weeks of Pregnancy : kg/week (lb/week) Twins Weight 15.9 – 20.4(34 – 45) 0.7 Triplets Total Weight 22.7(50)   Source : American Dietetic Association, ADA In terms of daily calories and the calorie intake during pregnancy, based on the Dietary Reference Intakes (DRIs) recommendations, from the second trimester, 300 calories should be added from the daily diet. However, the total calories per person per day should be adjusted according to the age, activity level, health status and weight gain of the pregnant woman.
 As for the calorie needs during lactation, it is recommended to increase 500 kcal per day. If you have any need or concern regarding diet during pregnancy, it is recommended to consult a dietitian, who is specialized in obstetrics and gynecology, for dietary advice.    


    懷孕是一個辛苦的歷程,因為賀爾蒙的改變,有些孕媽咪會食慾大增,彷彿無底洞般的飢餓,有些孕媽咪則是反胃嘔吐,一點食慾都沒有,初期反而瘦了好幾公斤。也有些孕媽咪因為懷孕,認為可以暫時享受美食盡情大吃,而導致體重直線上升,此舉不僅可能會導致血糖異常,孕期肥胖也可能導致其它併發症,並且在產後更難將體重回復到原本曼妙的身材。 至於孕期增加多少體重算是正常呢?根據衛生福利部國民健康署的建議指出,懷孕期間,孕婦體重應依懷孕前體重做適當調整,以增加 10-14 公斤為宜;且須注意體重增加的速度。此外,懷孕期間不適合減重。孕媽咪可以參考以下標準: 懷孕前的身體 質量指數(BMI)* 建議增重量 公斤(磅) 孕期第二和三期每週增加重量 公斤/週(磅/週) <18.5 12.5 – 18 (28 – 40) 0.5 – 0.6 (1 – 1.3) 18.5 – 24.9 11.5 – 16 (25 – 35) 0.4 – 0.5 (0.8 – 1) 25.0 – 29.9 7 – 11.5 (15 – 25) 0.2 – 0.3 (0.5 – 0.7) ≥ 30.0 5-9 (11 – 20) 0.2 – 0.3 (0.4 – 0.6) * 身體質量指數 BMI = 體重(公斤)/身高 2(公尺 2) 資料來源:美國婦產科學會 (The American Congress of Obstetricians and Gynecologists, ACOG) 懷孕胎數 建議增重量 公斤(磅) 12 週後每週增加重量 公斤/週(磅/週) 雙胞胎 體重 15.9 – 20.4(34 – 45) 0.7 (1 – 1.3) 三胞胎 總重 22.7(50)   資料來源:美國營養學會 (American Dietetic Association, ADA) 而在每日熱量部分,孕期的熱量攝取,依據國人膳食營養素參考攝取量(Dietary Reference Intakes, DRIs)建議,自懷孕第二期起,每日飲食需增加 300 卡的熱量。但每個人每天的總熱量,則視孕婦的年齡、活動量、健康狀況及體重增加情形,而再加以調整。 至於在哺乳期的熱量需要則建議每日增加 500 大卡為佳。若在孕期飲食上有任何需求,也建議找婦產科專科營養師諮詢飲食建議。    

The Need for Iron during Pregnancy? How to Supplement Iron during Pregnancy?

    According to the National Taiwan University National Nutrition Survey commissioned by the Ministry of Health and Welfare, the nutritional deficiencies, particularly folate, vitamin B1, B2 and iron, etc. were discovered by the blood analysis of 2346 pregnant women. In addition, the deficiency increased along with the process of pregnancy. Especially in the third trimester (≧ 25 weeks), the prevalence of folate deficiency was about 4%, the prevalence of vitamin B1 deficiency was 37%, and the prevalence of vitamin B2 deficiency was 14%; furthermore, the iron deficiency has reached the prevalence of 50%. The need for vitamin B complex and iron during pregnancy is essential. As your baby grows gradually, the demand cannot be overlooked. The iron requirement during pregnancy is the same as that for general women in the first and second trimester – 15 mg per day. However, in the third trimester and also breastfeeding period, it is recommended to add an additional 30 mg everyday in order to reach the 45 mg daily requirement. However, clinically, doctors often hear complaints from pregnant patients about the feeling of nausea and vomiting in early pregnancy, which could be aggravated by the consumption of iron-containing multivitamins. Therefore, in the early stages of pregnancy, we usually recommend pregnant women to take iron-free multivitamins or B-complexes. As for the demand of iron in the meantime, we suggest to supplement by normal diet, such as eating more red meats (cattle, sheep, pork, etc.). When it comes to the second trimester of a pregnancy, you do need to increase the supplementation of iron. Generally speaking, the common source of iron for pregnancy is Ferrous Fumarate or Ferrous Sulfate, both are popularly used in clinic for iron treatments. However, studies have confirmed that these types of iron can easily cause side effects such as stomach discomfort and even constipation, so the acceptance is not high. In contrary, Ferrous Bisglycinate has been clinically proven to have the lesser side effects, and the lower amount requirement of doses will hardly cause discomfort. Meanwhile, taking low-dose supplement multiple time per day is more effective than a single high-dose. Besides, the absorption rate of Ferrous Bisglycinate is higher than the other forms of iron, so the consumption is relatively smaller. In short, if a pregnant woman has red meat often and have no symptoms of iron deficiency, they can start to supplement 15 mg of Ferrous Bisglycinate once a day in the second trimester of pregnancy. During third trimester and the breast-feeding period, please take 15 mg of Ferrous Bisglycinate twice a day. If you eat less red meat, or if you are diagnosed with iron deficiency by a medical professional, you should supplement 45 mg of Ferrous Bisglycinate daily. However, it is recommended to take iron supplements in divided doses, which can increase iron absorption and reduce the potential discomforts.    


    依據衛生福利部之前委託台灣大學的孕婦營養現況調查,分析 2346 名孕婦血液,發現葉酸、維生素 B1、B2、鐵等普遍都呈現缺乏情形,且缺乏之情況隨孕期增加而加大,尤其是到懷孕第三期 (≧ 25 週) ,葉酸的缺乏率約 4%,維生素 B1 的缺乏率達 37%,維生素 B2 的缺乏率達 14%,鐵的缺乏率則高達 50%。 孕期間對於維生素B群及鐵的需求非常重要。由於寶寶逐漸生長,需求量更不容忽視。孕期對於鐵的需求,第一期與第二期與一般女性相同,為每日 15 毫克;到孕期第三期以及哺乳期,則建議每天額外增加 30 毫克,至每日 45 毫克。 但在臨床上,常常會遇到部分孕婦反應,在懷孕初期的嘔心孕吐感,可能由於食用了含鐵的孕婦綜合維他命導致噁心反胃的不舒服感加劇。因此,在懷孕初期,我們會建議孕婦以食用不含鐵的綜合維他命或是B群為主,至於對於鐵的需求,改以正常飲食中的食物來源為主,包括多吃紅肉(牛、羊,豬肉等)。 等到孕期中期,即開始加強鐵的補充。一般孕期鐵的來源,常見的有丁烯二酸亞鐵,又稱為富馬鐵(Ferrous Fumarate)或硫酸亞鐵(Ferrous Sulfate) 都是臨床上常使用的補鐵來源。但研究上已證實,這些型式的鐵容易造成胃不舒服,甚至便秘等副作用,所以接受度不高。而甘胺酸亞鐵(Ferrous Bisglycinate)是經過臨床證實副作用最低的鐵型式,低劑量幾乎不會引起不適感。而低劑量多次的補充,也比單一高劑量補充來的效果更好,副作用更低。此外,甘胺酸亞鐵的吸收率比其他形式的鐵吸收率來的更高,因此食用量相對不需要太多。 總之,若孕媽咪平時都有食用紅肉,且沒有缺鐵的症狀,可以到孕期第二期再開始每日補充一次 15 毫克的甘胺酸亞鐵。到孕期第三期與哺乳期,改為每日補充兩次,每次 15 毫克的甘胺酸亞鐵。若較少吃紅肉,或是經過醫事人員診斷有缺鐵症狀,則可每日補充 45 毫克的甘胺酸亞鐵;但建議分次食用,可以提高吸收率,也能降低食用鐵可能引起的不適症狀。    


    葉酸,是維生素 B 群中的一種,也是公認對於孕期最重要的營養素之一。葉酸能幫助紅血球的形成,亦有助於胎兒的正常發育與生長。 孕期葉酸營養品最主要的來源有兩種:人工合成葉酸 (Folic Acid) 與活性葉酸 (5-Methyltetrahydrofolate; 5-MTHF)。活性葉酸 (5-MTHF) 與天然存在於食物中的葉酸相同,同時也是人體血液中與腦脊液中主要存在的葉酸型式。人工合成葉酸 (Folic Acid),由於廉價,常使用在營養強化的食物,如早餐穀片;或者某些營養補充品,像是綜合維他命或 B 群中。人工合成葉酸食用後需要在體內轉化為活性型式,人體才能利用;但不幸的是,很多人體本身無法代謝葉酸轉化成活性的型式。 一般的合成葉酸若食用後無法代謝,會持續累積於血液中,造成 “未代謝葉酸過多症後群 ” (UMFA Syndrome);特別是高劑量的使用,可能產生許多嚴重的後遺症,包含免疫功能失調、腫瘤增生 (特別是大腸癌與前列腺癌) 等。未代謝葉酸過多症 (UMFA Syndrome),也會影響正常活性葉酸與體內葉酸受體與葉酸轉運蛋白的結合,導致人體無法真正利用葉酸。 活性葉酸有分為第三代的鈣鹽 (Calcium Salt) 與第四代的葡萄糖胺鹽 (Glucosamine Salt) 型式。目前第三代鈣鹽型式葉酸在台灣尚未通過衛生署福利部的安全性評估,屬於不合法成分。而第四代的活性葉酸 Quatrefolic® 不僅安全,食用後溶解度與吸收率都比第三代活性葉酸來的更佳,在台灣也已經核准為可食用的食品成分。孕媽咪在選擇備孕或孕期補充品時,選擇活性葉酸,是更為有效的補充方式,更可確保胎兒的正常發育與生長。    

Potential Side Effects and Risks of Synthetic Folate

    Folate, one of the B vitamins, is also considered to be one of the most important nutrients during pregnancy. It helps the formation of red blood cells and helps the normal development and growth of the fetus. In terms of the folate supplements for pregnancy, there are two main sources: one is synthetic folic acid, the other is active folate (5-Methyltetrahydrofolate; 5-MTHF). Active folate (5-MTHF) is the same as the folate naturally found in food, and it is also the form of folic acid mainly found in human blood and cerebrospinal fluid. Due to the low price, synthetic folic acid is often used in nutritionally fortified foods, such as breakfast cereals, or many nutritional supplements, such as multivitamin or B-complex. Artificially synthesized folic acid needs to be converted into an active form in the body before it can be used by the body. Unfortunately, many people are incapable of converting folate into an active form. If the general synthetic folic acid cannot be metabolized after consumption, it will continue to accumulate in the blood and result in "UMFA syndrome”. Especially the use of high doses may produce many serious sequelae, including immune dysfunction or tumor hyperplasia (especially colorectal cancer and prostate cancer), etc. UMFA Syndrome could also affect the binding of normal active folate to the folate receptor and folate transporter in the body, causing the body to be unable to truly utilize folate. Active folate includes two forms : the third-generation calcium salt and the fourth-generation Glucosamine salt. At present, the third-generation calcium salt form of folic acid is still an illegal ingredient in Taiwan because it has not passed the sanitation by Security assessment of the Department of Welfare Department. The fourth-generation active folate – Quatrefolic is safe, and its solubility and absorption rate after consumption are much better than the third-generation. It has also been approved as an edible food ingredient in Taiwan. For women trying to conceive or during pregnancy, supplementing active folate is a more effective choice, which can ensure the normal development and growth of the fetus better.