Spina Bifida Family Support
"Families Helping Families"
LONDON, ENGLAND -- February 18, 2005 -- Recommendations on use of folic acid
consumption have had no detectable impact on the incidence of neural tube
defects, according to an international study published on bmj.com yesterday.
These results support a move towards food fortification in addition to
recommending use of supplements.
Trials showed, more than a decade ago, that folic acid can reduce the occurrence
of neural tube defects, such as spina bifida, by half or more. Since then, many
countries have tried to promote use of folic acid, either by fortifying foods
or, more often, by recommending the use of supplements.
Although studies have shown that fortification of flour is effective, the impact
of recommendations alone is not known.
Researchers examined data from over 13 million births in Europe and Israel from
1988 to 1998. For each country, cases of neural tube defects were identified,
and policies and recommendations regarding folic acid were ascertained.
Recommendations alone did not seem to influence trends in neural tube defects,
despite the proved effectiveness of folic acid. The authors estimate that
thousands of pregnancies that would otherwise have been healthy were affected by
neural tube defects in the study area alone since 1992.
The most likely explanation for these results is that recommendations were not
implemented widely enough to produce a sustained change in behaviour in a
sufficiently large proportion of women to cause measurable effects, say the
authors.
These findings underscore the ongoing missed opportunities for prevention. In
addition to recommending use of supplements, public health agencies and medical
professionals should strongly consider implementing food fortification
programmes, they conclude.
SOURCE: BMJ-British Medical Journal