Recommendations for accelerating global action to prevent folic acid–preventable birth defects and other folate-deficiency diseases: Meeting of experts on preventing folic acid–preventable neural tube defects

Authors


  • This document was prepared by Godfrey Oakley, Karen Bell and Mary Beth Weber (the writing committee) and then circulated to the entire group of experts who participated in the meeting and/or the review process. Participants included: Karen Bell, Rollins School of Public Health, Emory University, Atlanta, Georgia; Adrianne Bendich, GlaxoSmithKline Consumer Healthcare, Parsippany, NJ; Shirley A. A. Beresford, Department of Epidemiology, University of Washington, Seattle, Washington; Barry Borman, Public Health Intelligence, Ministry of Health, Wellington, New Zealand; Carol Bower, Centre for Child Health Research, and School of Population Health, The University of Western Australia, West Perth, Australia; Erick Boy, The Micronutrient Initiative, Ottawa, Ontario, Canada; Jenny Cervinskas, The Micronutrient Initiative (consultant), Ottawa, Ontario, Canada; Jose Cordero, National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention; Atlanta, Georgia; Halinka Dybka, General Mills Canada, Mississauga, Ontario, Canada; J. David Erickson, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta GA; Gordon Harrison, Canadian National Millers Association, Ottawa, Ontario, Canada; David P. Haxton, Consultant, Greensboro, North Carolina; Eva Hertrampf , Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile; John Jenkins, General Mills Canada, Mississauga, Ontario, Canada; Richard B. Johnston, University of Colorado School of Medicine, Denver, Colorado; Miriam Levitt, Elisabeth Bruyere Research Institute, Ottawa, Ontario, Canada; Barbara Macdonald, Canadian International Development Agency, Hull, Quebec, Canada; Glen Maberly, Flour Fortification Initiative, Rollins School of Public Health, Emory University, Atlanta, Georgia; Venkatesh Mannar, The Micronutrient Initiative, Ottawa, Ontario, Canada; Godfrey P. Oakley, Rollins School of Public Health, Emory University, Atlanta, Georgia; Carolyn O'Brien, Food and Consumer Products Manufacturers of Canada (FCPMC), Toronto, Ontario, Canada; Ibrahim Parvanta, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Georgia; Peter Ranum, Consultant, Grand Island, New York; Joel G Ray, Department of Medicine and Inner City Health Research Unit, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Rajan Sankar, The Micronutrient Initiative, New Delhi, India; Lyall Thurston, New Zealand CCS, Wellington, New Zealand; Lolkje TW de Jong-van den Berg, Department of Social Pharmacy and Pharmacoepidemiology, University of Groningen, Groningen, the Netherlands; Salvador Villalpando, Center for Research on Nutrition and Health, Instituto Nacional de Salud Publica, Cuernavaca, Mor, Mexico; Nicholas Wald, Wolfson Institute of Preventive Medicine, Barts & The London, Queen Mary School of Medicine & Dentistry, London, England; Mary Beth Weber, Rollins School of Public Health, Emory University, Atlanta, Georgia; Wladamir Wertelecki, World Alliance of Organizations for the Prevention of Birth Defects, Ukrainian-American Birth Defects Program, Department of Medical Genetics, University of South Alabama, Mobile, Alabama.

Abstract

BACKGROUND

In April of 2003, The Micronutrient Initiative, in collaboration with several other organizations, convened a group of knowledgeable scientists and policy experts to discuss ways to accelerate the global pace at which countries implement effective and sustainable programs to prevent folic acid–preventable birth defects and other folate-deficiency diseases. Programs implemented to date by fewer than 40 countries have prevented only 10% of the estimated 240,000 annual cases of folic acid–preventable spina bifida and anencephaly.

METHODS

Participants in this meeting summarized and presented scientific evidence showing that increased consumption of synthetic folic acid prevents a large proportion of spina bifida and anencephaly cases. They also reviewed related guidance and endorsements issued by national professional societies and advisory bodies as well as policies and programs implemented by some countries that have already demonstrated successful results in terms of reduced rates of neural tube defects and improved folate nutrition.

CONCLUSIONS

The group formulated and discussed recommendations and strategies for increasing the pace of neural tube defect prevention globally. The recommendations and strategies are published here. Birth Defects Research (Part A), 2004. © 2004 Wiley-Liss, Inc.

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