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Precaution: Were upper limits for folic acid a mistake?


The accumulation of folic acid in grain products can save lives

Bread and flour are already fortified with folic acid in 81 countries to prevent newborns from being born with neural tube defects such as anencephaly and spina bifida. So far, there is no obligation to enrich grain products in Germany, although the folic acid supply of women of childbearing age is classified as inadequate. Among other things, the previously recommended upper limit for taking folic acid is an obstacle. A British study now shows that the maximum recommended folate intake of 1 mg per day is based on an incorrect analysis. According to the latest analyzes, a folate upper limit is not necessary. Various institutions are now calling for flour to be fortified in the UK.

The widely used upper limit is based on a study by the American Institute of Medicine (IOM), which concluded that higher doses of folic acid could lead to an increased risk of neurological damage. The new British re-analysis of the data finds no relationship between the folic acid dose and the development of neurological damage. According to current knowledge, the neurological damage was not caused by folic acid, but by incorrect treatment of a vitamin B12 deficiency. The upper limit of folate is therefore no longer applicable. The results of the study were recently published in the "BMC Public Health Reviews" journal.

Protective effect is not used

"With the lifting of the cap, there is no scientific or medical reason to delay the introduction of mandatory folic acid fortification," said lead author Professor Sir Nicholas Wald of the Wolfson Institute of Preventive Medicine at Queen Mary University of London in a press release on the study results . This applies not only to the UK, but to all other countries that have not yet adopted this proven public health measure. Germany is one of these countries. If you don't add flour to folic acid to prevent neural tube defects, it's like having a polio vaccine and not using it.

Two abortions every day due to neural tube defects

According to Wald, an average of two women in England have an abortion every day due to a neural tube defect. In addition, two more women would give birth to an affected child each week. The example of the USA shows that around 1,300 neural tube defects could be prevented there every year by introducing mandatory folic acid enrichment. This is the result of calculations in the Morbidity and Mortality Weekly Report.

Co-author Professor Joan Morris estimates that introducing folic acid fortification in England and the United States would have prevented around 3,000 cases of neural tube defects. This is a totally avoidable tragedy.

The neural tube defects anencephaly and spina bifida

Spina bifida is spinal cord damage that forms in the embryo during pregnancy. The severity of the malformation ranges from walking problems to paralysis of the legs to paraplegia. The most severe form of malformation of a neural tube defect is anencephaly, in which there is malformation in the skull and parts of the meninges, scalp and brain are missing to different extents. The brainstem is also only developed in about a quarter of the cases. With this severe malformation, the life expectancy of a newborn is only a few hours. (vb)

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Video: Hi9. फलक एसड क महतव. Folic Acid in Hindi. Bindra. Laparoscopic surgeon (August 2020).