Volume 6, Issue 4, July 2018, Page: 66-72
Mandatory Folic Acid Food Fortification to Prevent Neural Tube Defects: The Pro or Con Debate
Evangelia Chrysanthopoulou, Department of Intensive Care Unit, Attiko University Hospital, Haidari, Greece
Irene Karampela, Department of Intensive Care Unit, Attiko University Hospital, Haidari, Greece
Chrysi Diakaki, Department of Intensive Care Unit, Attiko University Hospital, Haidari, Greece
Maria Theodorakopoulou, Department of Intensive Care Unit, Attiko University Hospital, Haidari, Greece
Apostolos Armaganidis, Department of Intensive Care Unit, Attiko University Hospital, Haidari, Greece
Received: Jun. 15, 2018;       Accepted: Jul. 9, 2018;       Published: Aug. 4, 2018
DOI: 10.11648/j.ajim.20180604.14      View  796      Downloads  73
Abstract
Neural tube defects are the second most common congenital anomaly. Among the known risk factors, low levels of folic acid rank first as responsible for the majority of cases recorded worldwide. In 1986, the mandatory folic acid food fortification in the U.S.A. led to dramatic reduction of disease incidence, while for many people it was considered as one of the most successful interventions in the history of public health promotion. Despite the satisfactory results from all countries that adopted similar policies, a significant number of countries, including the EU, preferred alternative ways to address it, considering the very limited safety data for such an intervention. Today, after 20 years of mandatory fortification from a sufficiently representative sample (1/3 of the planet), the necessity to apply this at global level should probably be reviewed, since until now no correlation with unfavourable impacts has been demonstrated. Objective of the present review was to assess the necessity of mandatory folic acid food fortification in the context of congenital neural tube defects (NTDs) prevention. Material – Method: an extensive search in the electronic database PubMed was performed. Animal or in vivo studies and articles were excluded, due to the inability to draw conclusions that is frequently observed, as well as the strong suspicion of failure to respond to clinical data. Furthermore, part of the studies was derived from searches to the References of the articles of the aforementioned database. Conclusions: the decision of mandatory folic acid food fortification should be determined by specific factors as: disease prevalence, rates of planned pregnancies, efficiency of existing measures to decrease significantly the overall disease’s incidence and the folate level in the general population.
Keywords
Neural Tube Defects, Spina Bifida, Anencephaly, Folic Acid Food Fortification, Folic Acid and Carcinogenicity
To cite this article
Evangelia Chrysanthopoulou, Irene Karampela, Chrysi Diakaki, Maria Theodorakopoulou, Apostolos Armaganidis, Mandatory Folic Acid Food Fortification to Prevent Neural Tube Defects: The Pro or Con Debate, American Journal of Internal Medicine. Vol. 6, No. 4, 2018, pp. 66-72. doi: 10.11648/j.ajim.20180604.14
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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