A new report in the United Kingdom revealed that the country's failure to add vitamin B9 or folic acid to flour has resulted in about 2,000 cases of infant mortality and disability since 1998, all of which could have been significantly prevented.
The deficiency of folic acid in babies has already led to neural tube defects (NTDs). One such is called spina bifida, where the closing of the backbone and spinal cord membranes is underdeveloped.
The most serious type of spina bifida could cause severe disabilities such as loss of sensation in the feet and legs, and consequently, being unable to move them.
In a study published in the journal Archives of Disease in Childhood, researchers from Oxford University, Queen Mary University of London and Public Health England examined data from Wales and England to identify children who were born with birth defects over a 20-year period.
The team looked into the ratio of women who took folic acid supplements before pregnancy, and calculated how many cases of birth defects could have been avoided if folic acid was available in the form of flour.
Folic acid is vital during the time of conception and the early stages of gestation. A 1991 study found that administering 400 microgram folic acid supplements lowered the risk of NTDs by 72 percent, experts said.
However, in the new study, UK researchers estimated that there would have been 2,014 fewer pregnancies affected by birth defects had the government strongly implemented compulsory flour fortification.
This would have indicated a 21 percent reduction in cases of babies with NTD, instead of just a 7 percent decrease observed as a result of taking folic acid supplements, authors said.
In the United States, compulsory flour fortification in cereal products took effect in 1998. An estimated 200 mg of folic acid per day is provided to women in the U.S. who consume these cereal products.
Previous studies showed that only about 25 to 33 percent of women in the UK actually take folic acid supplements as suggested at the beginning of pregnancy. Experts said this happens because a number of pregnancies are unplanned and that most soon-to-be moms may not realize that they are pregnant for several weeks, thus missing the crucial period for spinal cord development.
If the fortification of flour were implemented, the researchers said, then cases such as the one above would be prevented without the need for supplements.
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