Case for mandatory fortification of food with folate in Australia, for the prevention of neural tube defects
Article first published online: 2 NOV 2004
Copyright © 2004 Wiley-Liss, Inc.
Birth Defects Research Part A: Clinical and Molecular Teratology
Volume 70, Issue 11, pages 842–843, November 2004
How to Cite
Bower, C. and Stanley, F. J. (2004), Case for mandatory fortification of food with folate in Australia, for the prevention of neural tube defects. Birth Defects Research Part A: Clinical and Molecular Teratology, 70: 842–843. doi: 10.1002/bdra.20074
- Issue published online: 10 NOV 2004
- Article first published online: 2 NOV 2004
- Manuscript Accepted: 12 JUL 2004
- Manuscript Received: 7 JUL 2004
- National Health and Medical Research Council Program. Grant Numbers: 003209, 172303
Since the publication of randomized controlled trials demonstrating the prevention of neural tube defects (NTDs) with periconceptional folate, several Australian states have promoted an increase in periconceptional use of folic acid supplements. Since 1996, voluntary fortification of food with folate has been allowed in Australia and New Zealand for the purpose of preventing NTDs.
For this report, we synthesized published and unpublished data on folic acid supplement use, voluntary fortification, and trends in NTDs.
There has been an increase in the proportion of women (up to 30–40%) taking periconceptional folic acid supplements in Australia, and many foods (mainly breakfast cereals) are fortified. Supplement use is strongly correlated with educational and socioeconomic status; consumption of voluntarily fortified foods is not. There has been a fall in NTDs of about 30% in the non-Aboriginal population, but no change has been seen in the Aboriginal population.
These data support mandatory fortification of food as a more equitable approach to achieving sufficient folate intake in the periconceptional period for all women in Australia and New Zealand to prevent the majority of NTDs in their offspring. In May 2004, based on these and other considerations, the Australia and New Zealand Food Regulation Ministerial Council agreed that mandatory fortification of food with folate should be considered as a priority. Birth Defects Research (Part A), 2004. © 2004 Wiley-Liss, Inc.