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US study shows that folic acid fortification decreases neural tube defects

BMJ 2005; 331 doi: (Published 15 September 2005) Cite this as: BMJ 2005;331:594
  1. Janice Hopkins Tanne
  1. New York

    The incidence of neural tube defects in infants fell by about a third in some ethnic groups when the United States gradually increased enrichment of grain products with folic acid in the 1990s, a study has found (Pediatrics 2005;116:580-6).

    The March of Dimes, a charity active in efforts to prevent birth defects, has called for a doubling of fortification of food with folic acid to further reduce neural tube defects. In 1996 the charity recommended that grain products should be enriched with 350 micrograms for each 100 g of grain. Two paediatricians argue in a commentary to the paper that the concentration of folic acid in grain products in the US should be at least doubled from the current level of 140 micrograms per 100 g of grain and that vitamin B-12 should also be added to flour (Pediatrics 2005:116:753-5). The paediatricians argued that such fortification was worthwhile, because fears that folic acid supplementation might mask vitamin B-12 deficiency in elderly people were based on a misunderstanding of the biochemistry involved.

    The paper's lead author, Sonja Rasmussen, told the BMJ that in the US about 3000 pregnancies a year were affected by neural tube defects such as …

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