The Mediterranean diet, rich in folates from its high leafy vegetable content, has previously been credited with longer life and improving heart health. A new report now indicates that the diet may also prevent against birth defects.
According to the new report from voluntary health agency March of Dimes, eight million babies are born with defects every year, equivalent to about six per cent of all births worldwide.
Dr. Jennifer Howse, March of Dimes president, said: "Our report identifies for the first time the severe, and previously hidden global toll of birth defects. This is a serious, vastly unappreciated and under-funded public health problem."
One of the most common birth problems identified was neural tube defects such as spina bifida and anencephaly - most of which could be avoided if mothers were eating more folate-rich foods or taking supplements.
In 1998 the FDA required the addition of folic acid to enriched breads, flours, cereals, and other grain products to increase folic acid intake in the whole population. Birth defects have declined by 26 percent since 1998.
Similar strategies in Canada have seen the instance of birth defects cut in half.
Since bread is a staple in most diets, flour has been seen as the ideal vehicle to improve folate intake for a population. Studies have shown that folic acid is more easily absorbed from fortified foods (85 per cent) and supplements (100 per cent) than the folate found naturally in foods (50 per cent).
The report has also highlighted the gulf between the richer and poorer nations.
France has the lowest rate with birth defects affecting only 3.97 per cent of newborns. Spain and Italy are also listed in the top ten. The highest rate of birth defects was measured in Sudan with 8.2 per cent.
Less than 250 000 babies are born in Europe with inherited birth defects, a figure that could be reduced further if mothers ate more of a Mediterranean-type diet, a rich source of olive oil, fruit and vegetables, or increased their folate intake.
In the UK, ranked ninth on the list, expectant mothers are prescribed and recommended to take folate supplements to reduce the risk of neural tube defects. However, a recent study (British Medical Journal, Vol. 330, pp. 571) reported that the advice did not result in people actually taking the supplements.
Calls for flour fortification in Britain have been getting louder and led the Food Standards Agency to hold a meeting to discuss the situation.
Chris Whitehouse, an industrial lobbyist with the Whitehouse Consultancy, said: "What was clear is that the benefit of folate consumption in addressing the problem of neural tube defects is now universally accepted."
Whitehouse now predicts that it is now a question of 'when' and not 'if' the UK government will introduce compulsory fortification of some flour products with folic acid.
The US fortification program has not been a total success story however with a commentary published in the journal Pediatrics (Sept. 2005, Vol. 116, pp.753-755) echoing March of Dimes claims that more needs to be done.
Authors, Robert Brent and Godfrey Oakley Jr., wrote, "It is a tragic failure of public policy, both in the United States and around the world, that a single case of folic acid-preventable spina bifida and anencephaly occurs."