Mandatory folic fortification to protect babies from defects

Listen to this post, see below According to today’s Sunday Independent (May 27, 2007), Ireland will become the first country in Europe to implement mandatory folic acid food fortification next year.

“The move will result in a 24 per cent drop in the number of babies born with neural tube defects such as spina bifida and anencephaly, doctors say. Ireland has one of the highest rates of neural tube defects in Europe with between 49 and 93 affected babies born here every year. Folic acid is a vitamin that, when taken prior to a woman becoming pregnant, can help prevent neural tube defects in babies.” (Quote)

A recently (May 2007) published ((SEE Norwegian study on folic acid supplements and risk of facial clefts)) Norwegian study on folic acid supplements and risk of facial clefts concluded that folic acid supplements during early pregnancy seem to reduce the risk of isolated cleft lip (with or without cleft palate) by about a third.

A US study (January 2007) ((SEE Reduction in orofacial clefts following folic acid fortification of the U.S. grain supply)) reported that folic acid fortification in the United States was associated with a small decrease in orofacial cleft prevalence, with the timing of the decline consistent with the introduction of fortification. The report concluded that the decline suggests an additional benefit of this public health intervention.

Mandatory fortification with folic acid of most white, brown and wholemeal breads on sale in Ireland was the policy recommendation contained in a report presented to An Tánaiste and Minister for Health and Children, Mary Harney T.D., in July 2006 by the National Committee on Folic Acid Food Fortification. ((SEE and SEE ALSO March of Dimes))

Folic acid is a B vitamin, which, if taken for at least eight weeks prior to, and 12 weeks, after conception, is known to reduce by up to 70% the risk of NTDs, a group of severe birth defects such as spina bifida that can develop in babies during the first weeks of pregnancy.


Folic Acid and Clefts
Folic acid, or rather the lack of it, has been identified as contributing to the high incidence of neural tube defects (NTD), most specifically spina bifida and anencephaly, a fatal condition whereby a baby is born with a severely underdeveloped brain. It is also suggested that folic acid supplementation may reduce the incidence of orofacial clefting, and research continues into the possible relationship between low maternal folate status during pregnancy and the risk of the baby being born with an oral cleft.

What is Folic Acid?
Folic acid is a member of the B-complex family of vitamins. It is the synthetic version of the natural existing folate. Folic Acid is needed to metabolize sugar and amino acids, aid digestion, and to eliminate homocysteines (an amino acid). It is also necessary for proper cell growth and the formation of red blood cells. It plays an important part in fetal growth during pregnancy – in the development of the nervous system and the blood cells.

“acid is commonly deficient in the modern western diet, as light, heat, and storage at room temperature can easily destroy it”. ((Scott-Moncrieff, Christina. The Vitamin Alphabet, London, Collins & Brown, 1999, p.24 ISBN 1855856816))

Occurrences of Folate

Folate occurs naturally in leafy green vegetables (eg. spinach, broccoli), beans, peas, nuts, lentils, carrots, mushrooms, liver, egg yolks, orange juice, citrus fruits, apricots, avocados, melons, wholegrain bread, wheat germ, fortified cereals, rice and pasta.

Folic acid is twice as potent as folate as it is considerd more easily absorbed.

It is important to remember that most pregnancies are unplanned, therefore it is recommended that women of childbearing age should supplement a diet rich in folate with a multi-vitamin supplement containing folic acid. This will help reduce the risk of having a baby with a neural tube development (NTD) and may as studies suggest reduce the incidence of orofacial clefting.

Folic acid supplementation should begin before conception in order to be effective. NTDs develop very early in pregnancy, often before a woman realises she is even pregnant.

The recommended daily intake of Folic Acid is 400 mcg.

High dosage of folic acid (above 1000 mcg) can mask vitamin B12 deficiency and consequently symptoms of pernicious anemia caused by such deficiency

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