December 21, 2015

21/12/2015: Nigeria adds folic acid to fortification standard

Now only 5 of 84 countries omit this essential vitamin

In October the FFI received official documentation that Nigeria has added folic acid to its standard for wheat flour fortification. The national standard previously included iron and other nutrients but not folic acid (vitamin B9).

This change represents extensive advocacy work by multiple partners and national leaders in Nigeria. It is worth celebrating as fortifying flour with folic acid reduces the risk of children having severe neural tube birth defects by an average of 46 percent, according to one meta-analysis.

Now the only countries which omit folic acid from wheat flour fortification standards are the Congo, the Philippines, the United Kingdom, and Venezuela. Papua New Guinea also omits folic acid from its rice fortification standard. Globally 84 countries have legislation that mandates fortification of wheat flour, maize flour, or rice with at least iron or folic acid.
Image: Mishimoto
Folic acid helps a baby’s neural tube close very early in the pregnancy. The neural tube forms the child’s brain and spine. Neural tube defects include:

  •     Anencephaly, which is fatal
  •     Spina bifida, which causes paralysis and loss of sensation
  •     Encephalocele, which is rare
In this new video, Godfrey Oakley, Director of the Emory University Center for Spina Bifida Research, Prevention and Policy, describes fortifying flour with folic as “the best thing since sliced bread.” 
He notes that fortification with folic acid also prevents anemia caused by folate deficiency. Another study from China suggests that supplementing with folic acid is instrumental in preventing first-time strokes as well.

In addition, preventing these birth defects has economic benefits. Children with spina bifida undergo a lifetime of surgeries and treatments. Preventing spina bifida averts these healthcare expenses.

The following recent publications illustrate challenges where fortification is not practiced:
  • A study published in November showed “no obvious downward trend,” in NTDs over 20 years in Europe. The study was based on data from the European Surveillance of Congenital Anomalies. No country in this surveillance system has a mandate to fortify wheat flour with folic acid.
  • That study found that “only a small minority” of women took a daily folic acid supplement if they might become pregnant. The author of an accompanying article noted that women may have 30 child-bearing years, and expecting them to take a supplement every day for 30 years is not realistic.
  • In Venezuela folate deficiency affects over 70% of the female population of child-bearing age, according to a summary of available studies. In contrast, nine years after fortification with folic acid began in Canada, less than 1% of the population aged 6-79 years had folate deficiency.  Folate is the form of vitamin B9 that is in unfortified foods. The Venezuela summary was part of a supplement in the Anales Venezolanos de Nutrición.  
Visit the FFI site HERE

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