Special edition: Battling malnutrition

Time for mandatory folic acid fortification to go truly global?

By Shane Starling

- Last updated on GMT

Food fortification with neural tube defect (NTD)-reducing folic acid is mandatory in 75 nations, but concerns over cancer and other health issues mean Europe lags far behind  – a situation that needs to change and quickly, says DSM thinktank, sightandlife.

Sightandlife director Dr Klaus Kraemer said folic acid supplementation was not enough as many women did not know they were pregnant at the time that boosted folic acid consumption can deliver the greatest benefit – in the first weeks of pregnancy.

“They start taking supplements when the doctor tells them, ‘oh you are pregnant, you need your folic acid or your multivitamin’,”​ said Dr Kraemer.

“Many developing countries have adopted mandatory fortification because they know about the benefits – that fortification is reducing neural tube defects by 50-70%.”

“Our governments in Europe and in many parts in Asia have so far neglected fortification.”

The most effective fortification form came via flour.

Dr Kraemer said the concern that folic acid fortification masked vitamin B12 deficiency was based on outdated and widely discredited data from the 1940s.

Folic acid intake before and during early pregnancy ensures that the foetus does not develop the neural tube defect – commonly known as spina bifida.

Women of child-bearing age need sufficient body stores of folate before conception to prevent folate-sensitive neural tube defects (NTDs), which make up 20% to 60%of all NTDs.

Dr Kraemer said sightandlife and other NGOs continued to educate and lobby governments about the benefits of mandatory folic acid fortification.

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