Folate supplementation as a strategy to reduce Neural Tube Defects
DOI:
https://doi.org/10.47203/IJCH.2022.v34i02.002Keywords:
Folic Acid, Neural Tube Defects, FortificationAbstract
Folic acid is a vitamin known to prevent neural tube defects, megaloblastic anaemia, cardiovascular morbidity and mortality, etc. The main natural sources of folate are plant and vegetables e.g. green leafy vegetables, broccoli, asparagus, citrus fruits (orange, strawberry), beans, nuts, cauliflowers, beets, corn etc. and meat products like liver. The primary function of folate is its contribution in the synthesis and repair of the DNA. The bioavailability of food folate is approximately 50%. The bioavailability of folic acid taken with meal compared to with water on empty stomach is 85% and 100% respectively.(1) Hence, it is easier to achieve the recommended daily allowances with fortified food as compared to natural food due to higher stability and bioavailability of synthetic folate when compared to natural food.(2)
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Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline [Internet]. Washington (DC): National Academies Press (US); 1998 [cited 2019 Jul 16]. (The National Academies Collection: Reports funded by National Institutes of Health). Available from: http://www.ncbi.nlm.nih.gov/books/NBK114310/
Sanderson P, McNulty H, Mastroiacovo P, McDowell IFW, Melse-Boonstra A, Finglas PM, et al. Folate bioavailability: UK Food Standards Agency workshop report. Br J Nutr. 2003;90(2):473–9.
Shane B. Folate status assessment history: implications for measurement of biomarkers in NHANES12345. Am J Clin Nutr. 2011;94(1):337S-342S.
Nutrient requirements for Indians – ICMR-NIN, 2020 [Internet]. Metabolic Health Digest. 2020 [cited 2022 June 18]. Available from: https://www.metabolichealthdigest.com/nutrient-requirements-for-indians-icmr-nin-2020/
Chanarin I, Macgibbon BM, O’sullivan WJ, Mollin DL. Folic-acid deficiency in pregnancy. The pathogenesis of megaloblastic anaemia of pregnancy. Lancet Lond Engl. 1959;2(7104):634–9.
Hibbard BM, Hibbard ED, Jeffcoate TN. Folic acid and reproduction. Acta Obstet Gynecol Scand. 1965;44(3):375–400.
Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med. 1992;327(26):1832–5.
Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. MRC Vitamin Study Research Group. Lancet Lond Engl. 1991;338(8760):131–7.
De-Regil LM, Fernández-Gaxiola AC, Dowswell T, Peña-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev. 2010;(10):CD007950.
World Health Organization. Iron Deficiency Anaemia; Assessment, Prevention, and Control A guide for programme managers. 1993.
Greene NDE, Copp AJ. Neural Tube Defects. Annu Rev Neurosci. 2014;37:221–42.
Blencowe H, Kancherla V, Moorthie S, Darlison MW, Modell B. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Ann N Y Acad Sci. 2018;1414(1):31–46.
Bhide P, Sagoo GS, Moorthie S, Burton H, Kar A. Systematic review of birth prevalence of neural tube defects in India. Birt Defects Res A Clin Mol Teratol. 2013;97(7):437–43.
WHO | Periconceptional folic acid supplementation to prevent neural tube defects [Internet]. WHO. [cited 2012 June 21]. Available from: http://www.who.int/elena/titles/folate_periconceptional/en/
Gomes S, Lopes C, Pinto E. Folate and folic acid in the periconceptional period: recommendations from official health organizations in thirty-six countries worldwide and WHO. Public Health Nutr. 2016;19(1):176–89.
6 Interventions of the Anemia Mukt Bharat Programme [Internet]. Anemia Mukt Bharat Dashboard. [cited 2022 June 21]. Available from: https://anemiamuktbharat.info/home/interventions/
Charles DHM, Ness AR, Campbell D, Smith GD, Whitley E, Hall MH. Folic acid supplements in pregnancy and birth outcome: re-analysis of a large randomised controlled trial and update of Cochrane review. Paediatr Perinat Epidemiol. 2005;19(2):112–24.
Fekete K, Berti C, Trovato M, Lohner S, Dullemeijer C, Souverein OW, et al. Effect of folate intake on health outcomes in pregnancy: a systematic review and meta-analysis on birth weight, placental weight and length of gestation. Nutr J. 2012;11:75.
Wang S, Ge X, Zhu B, Xuan Y, Huang K, Rutayisire E, et al. Maternal Continuing Folic Acid Supplementation after the First Trimester of Pregnancy Increased the Risk of Large-for-Gestational-Age Birth: A Population-Based Birth Cohort Study. Nutrients. 2016;8(8):493.
Crider KS, Bailey LB, Berry RJ. Folic acid food fortification-its history, effect, concerns, and future directions. Nutrients. 2011;3(3):370–84.
Dugbaza J, Cunningham J. Estimates of total dietary folic Acid intake in the Australian population following mandatory folic Acid fortification of bread. J Nutr Metab. 2012;2012:492353.
Centers for Disease Control and Prevention (CDC). CDC Grand Rounds: additional opportunities to prevent neural tube defects with folic acid fortification. MMWR Morb Mortal Wkly Rep. 2010;59(31):980–4.
Food, Administration (FDA) D. Food Standards?: Amendment of Standards of Identity for Enriched Grain Products to Require Addition of Folic Acid?; Final Rule (21 CFR Parts 136, 137, and 139). Fed Regist. 1996;61:8781–97.
Rice fortification is an effective way to combat anemia | NITI Aayog [Internet]. [cited 2022 JUne 18]. Available from: https://www.niti.gov.in/rice-fortification-effective-way-combat-anemia
Honein MA, Paulozzi LJ, Mathews TJ, Erickson JD, Wong LY. Impact of folic acid fortification of the US food supply on the occurrence of neural tube defects. JAMA. 2001;285(23):2981–6.
Williams LJ, Mai CT, Edmonds LD, Shaw GM, Kirby RS, Hobbs CA, et al. Prevalence of spina bifida and anencephaly during the transition to mandatory folic acid fortification in the United States. Teratology. 2002;66(1):33–9.
Boulet SL, Yang Q, Mai C, Kirby RS, Collins JS, Robbins JM, et al. Trends in the postfortification prevalence of spina bifida and anencephaly in the United States. Birt Defects Res A Clin Mol Teratol. 2008;82(7):527–32.
Baylin SB, Herman JG. DNA hypermethylation in tumorigenesis: epigenetics joins genetics. Trends Genet TIG. 2000;16(4):168–74.
Sachdev HPS, Gera T. Preventing childhood anemia in India: iron supplementation and beyond. Eur J Clin Nutr. 2013;67(5):475–80.
National Iron Plus Initiative for Anemia Control | National Health Portal Of India. Available from: https://www.nhp.gov.in/national-iron-plus-initiative-for-anemia-control_pg
National Family Health Survey (NFHS-5) 2019-21 Compendium of Fact Sheets: Key Indicators – India and 14 States/UTs (Phase-II) [Internet]. 2021. Available from: https://ruralindiaonline.org/en/library/resource/national-family-health-survey-nfhs-5-2019-21-compendium-of-fact-sheets-key-indicators---india-and-14-statesuts-phase-ii/
Gernand AD, Schulze KJ, Stewart CP, West KP, Christian P. Micronutrient deficiencies in pregnancy worldwide: health effects and prevention. Nat Rev Endocrinol. 2016;12(5):274–89.
Lanou HB, Osendarp SJM, Argaw A, De Polnay K, Ouédraogo C, Kouanda S, et al. Micronutrient powder supplements combined with nutrition education marginally improve growth amongst children aged 6–23 months in rural Burkina Faso: A cluster randomized controlled trial. Matern Child Nutr. 2019;15(4):e12820
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