Folic Acid Update
The Public Health Service
strongly recommends that women of childbearing age take steps to consume 0.4
milligrams of the folic acid vitamin per day in order to reduce their risk of
having a pregnancy affected with spina bifida (or other neural tube disorders).
This prevention strategy works best if the folic acid and the resultant folate
level in the blood is sufficient during the early months of a pregnancy.
In 1996, the federal Food and Drug Administration took the step of mandating
that all flour and enriched cereal grain products manufactured in the U.S. be
fortified with folic acid. This was required as a method for raising the levels
of this protective vitamin within the general public. This order was to be
implemented in all manufactured grain pro-ducts by January 1998.
The Centers for Disease Control and Prevention announced this fall a finding
showing that the folate levels of American women of child-bearing age are on the
rise. As reported in the October 27th issue of the MMWR, the CDCís latest
National Health and Nutrition Examination Survey found that the average level of
folic acid found in the blood during 1999 almost tripled from levels measured in
nutrition surveys conducted during the early 1990s.
The most common neural tube birth defect (NTD) is spina bifida. Another defect
is annencephaly which affects the brain and most often results in a miscarriage
or early death. Data on NTD occurrence derived from the birth certificates of
babies born in 1999 (conceived in 1998, after fortification became mandatory) is
scheduled to be released before the end of this year. These data will provide
the necessary information to evaluate the preventive impact of the folic acid
fortification within the United States.
(Folate Status in Women of Childbearing Age Ė United States,
1999; MMWR Weekly, October 27, 2000 / 49(42);962-5)