Experts Call For Mandatory Folic Fortification Of Flour, Bread In Europe To Prevent Neural Tube Defects

A new study found that the number of babies diagnosed with neural tube defects in Europe has not plummeted over the past 20 years amid the ongoing policies suggesting women to take in folic acid supplements if they plan to get pregnant.

In 1991, the UK Medical Research Council released promising data that showed how folic acid supplementation prior to delivery can help women decrease their chances of having a baby with neural tube defects by up to 72 percent.

In November 2015, experts from the UK government sent a letter to ministers, saying that the folic acid supplementation recommendations they made in 2000, 2006 and 2009 have not translated to significant results.

The situation has led experts to raise questions about the long term trends of neural tube defects among total births and total live births in Europe. Experts noted that while folic acid supplements are recommended, programs focusing on folic fortification of food do not exist.

In a new study published in The BMJ on Tuesday, Nov. 24, researchers performed a population-based observational investigation utilizing data from 28 European Surveillance of Congenital Anomalies (EUROCAT) registries. The data bank contained 11,353 cases of neural tube defects without chromosomal abnormalities, 4,162 cases of anencephaly and 5,776 cases of spina bifida. The data was collated in 19 countries from 1991-2011.

The findings of the study showed that neural tube defects had a prevalence of 9.1 per 10,000 births during the research period. Slight fluctuations in prevalence was noted, however, it did not cause an apparent downward trend. In brief, the prevalence of neural tube defects in 2011 is similar to that of 19991's.

While it may seem disappointing, the situation is now here and the best way to deal with it is to find a solution. One of the ways that experts are looking at to address the problem is to implement food fortification. Much have been said about the health benefits of the intervention but to sum it up, it can help reduce the number of neural tube defects by up to 50 percent.

Aside from its health advantages, folic fortification may also contribute benefits to the financial aspect.

In the U.S., where 50 percent of pregnancies are unplanned and women are not motivated to take folic acid supplements, the government initiated mandatory fortification of all enriched cereal grains, such as breads, pasta, rice and cereals.

About 80 other countries that have similar programs and statistics show that these countries have drastically decreased the rates of neural tube defects.

"Food fortification will reach women most at risk due to poor dietary habits or socio-economic status as well as those women who may not have planned their pregnancy," said Professor Alan Cameron, vice-president of clinical quality from the Royal College of Obstetricians and Gynaecologists (RCOG).

Cameron then said that the findings of the research warrants mandatory folic acid fortification of bread or flour in the UK, accompanied by appropriate protective measures such as voluntary fortification control and enhanced assistance on supplement administration.

Photo: Jarrod Lombardo | Flickr

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