« A study published in the British Medical Journal concludes that EU authorities should take note of work done on the relationship between folic acid consumption and the reduction of neural tube defects and look at compulsory fortification.
In 1991 the UK Medical Research Council published the finding that women who took folic acid before conception could reduce their babies’ risk of a neural tube defect by as much as 72 %, notes an editorial in the BMJ (British Medical Journal).
The US Public Health Service met and quickly issued a recommendation that all women of childbearing age capable of becoming pregnant should take 400 µg folic acid daily. Some of us who attended the meeting, the authors continue,had doubts that women would take folic acid as instructed.
Half of pregnancies are unplanned, and these women could be less motivated to take folic acid. In fact, many folate related neural tube defects were not prevented despite this recommendation and voluntary fortification in the United States. This led the United States to institute mandatory fortification of all enriched cereal grains (cereal, bread, rice, pasta) in 1998.
Almost 80 countries have now instituted similar programs, and countries that fortify have experienced dramatic falls in rates of neural tube defects. Given that the recommendation that women take supplements had a modest effect in the United States, it is not surprising that Khoshnood and colleagues have shown that the European Union’s current strategy of recommending supplements, although useful, is failing to prevent many folate related neural tube defects. » (…)