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 20 April 2018

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News

Food supplementation with folic acid could substantially reduce neural tube defects

A public-health initiative to enrich cereal grain foods in Canada with folic acid has halved the prevalence of neural tube defects among both unborn and newborn children, find researchers in this week's issue of the Lancet.

News image

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Folic acid tablet supplementation near the time of conception is known to reduce the risk of neural tube defects in unborn infants.

Canada introduced folic acid fortification of grain foods in 1998, increasing daily folate in the Canadian population by 0.1 to 0.2 mg per day.

Following fortification, neural tube defects reduced from 1.13 to 0.58 per 1000 births.
Lancet
This program was implemented in response to concern that women were not taking tablet supplements until after they had become pregnant, or not at all.

In this study, Dr Joel Ray and colleagues from the University of Toronto, Canada, assessed the effect of food fortification on the prevalence of open neural tube defects.

The research team screened approximately 300,000 women for fetal neural tube defects over 6 years before and after the fortification policy was introduced.

They found that the risk of neural tube defects was halved. Rates reduced from around 1.13 to 0.58 per 1000 births, after fortification was fully introduced.

Dr Ray comments, "Even under quite suitable conditions, neural tube defect prevention program based solely on periconceptional folic acid tablet supplementation seem to fall far short of achieving their potential effectiveness".

"On the basis of our results, and those of others, we recommend that other countries consider adopting a program of folic-acid food fortification, in addition to encouraging increased use of periconceptional folic acid tablets".

"Epidemiological surveillance of the general population might also be initiated to monitor for any untoward effects related to folic acid fortification and to allow for modification of the program necessary".

Lancet 2002; 360(9350): 2047
20 December 2002

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