Precautionary goods folic acid upper limits a mistake?

The accumulation of folic acid in cereal products can save lives

Bread and flour are already fortified with folic acid in 81 countries to prevent newborns born with neural tube defects such as anencephaly and spina bifida. In Germany, there is no obligation to fortify cereal products, although the supply of folic acid to women of childbearing age is considered insufficient. Among other things, the previously recommended upper limit in the intake of folic acid is an obstacle. A British study now shows that the maximum recommended folate intake of 1 mg per day is based on a faulty analysis. According to recent analyzes, a folate upper limit is not required. Now, various institutions are calling for the introduction of flour fortification with folic acid in the UK.

The frequently used upper limit is based on a study by the American Institute of Medicine (IOM), which concluded that higher doses of folic acid could lead to an increased risk of neurological damage. The new British re-analysis of the data finds no relationship between the folic acid dose and the development of neurological damage. According to the latest findings, the neurological damage was not caused by folic acid, but by an incorrect treatment of vitamin B12 deficiency. Thus, the folate upper limit is obsolete. The results of the study were recently published in the journal "BMC Public Health Reviews".

Protective effect is not used

"With the abolition of the upper limit, there is no scientific or medical reason to delay the introduction of compulsory folic acid fortification," said lead author Professor Sir Nicholas Wald of the Wolfson Institute of Preventive Medicine at Queen Mary University of London in a press release on the study's findings , This is true not only for Great Britain, but for all other countries that have not yet adopted this well-established public health measure. Germany also counts among these countries. If you do not enrich flour with folic acid to prevent neural tube defects, it's like having a polio vaccine and not using it.

Two abortions every day due to neural tube defects

According to the forest, on average, two women in England suffer a termination of pregnancy every day because of a neural tube defect. In addition, every week two more women would give birth to an affected child. The example of the USA shows that around 1,300 neural tube defects could be prevented there annually by introducing mandatory folic acid fortification. This is the result of calculations from the Morbidity and Mortality Weekly Report.

Co-author Professor Joan Morris estimates that the introduction of folic acid fortification in England, along with the US, would have already prevented around 3,000 cases of neural tube defects. This is a completely avoidable tragedy.

The neural tube defects anencephaly and spina bifida

Spina bifida is a spinal cord injury that forms in the embryo during pregnancy. The severity of the malformation ranges from walking problems to paralysis of the legs to paraplegia. The most severe form of malformation of a neural tube defect is anencephaly, which causes malformations in the cranium, and to varying degrees, parts of the meninges, scalp, and brain are missing. The brain stem is only developed in about a quarter of the cases. In this severe malformation, the life expectancy of a newborn is only a few hours. (Vb)