Foods fortified with folic acid can prevent neural tube defects

Jun 21 2012

Wheat flour milled in Nigeria will soon be fortified with folic acid, a B vitamin known for preventing serious or fatal birth defects of the spine and brain. Women who may become pregnant are encouraged to daily choose foods fortified with this essential vitamin because it can prevent the majority of these devastating birth defects known as neural tube defects.    

Foods already fortified with folic acid in Nigeria include Blue Brand margarine made by Unilever, Dangote pasta, Bournvita, Ovaltine, and some brands of powdered milk.

Flour has been fortified with iron and vitamin A in Nigeria for years. Adding folic acid means that all the bread and pasta made with fortified flour will also contain this vitamin. More than 60 countries fortify wheat flour with folic acid, and they report 30 to 70 percent declines in neural tube defects as a result.

Spina bifida is the most common birth defect that can be prevented with folic acid. It causes the baby's spine to not form correctly, and it cannot be cured. Children with spina bifida almost always have some form of paralysis and problems controlling their bowel and bladder functions. Children with spina bifida undergo a lifetime of surgeries and face many health issues.

Two other types of neural tube defects affect the brain. With anencephaly, the brain does not form properly. These pregnancies are often miscarried, but if the infants are delivered, the babies die shortly after birth. Encephalocele is an opening of the skull which allows parts of the brain and brain membrane to protrude through the opening. The severity of encephalocele depends on its location.

It is difficult to determine exactly how many pregnancies in Nigeria are affected by neural tube defects because no single group tracks birth defects in the country. Also, pregnancies that are miscarried or terminated due to a neural tube defect are often not reported.

Two studies at Lagos State University Hospital in Ikeja, Lagos, found that more than half the children treated for defects of the central nervous system had neural tube defects. In 2005, 33 of 61 children treated had neural tube defects. A two-year study in 2008 and 2009 showed 54 children with neural tube defects among the 94 children treated.

"The number of Nigerian children with neural tube defects reported in these two studies may seem small compared to some of the other health challenges our country faces, but that is because these are the only ones out of the vast majority of the probable cases that reach our attention." said Dr. Amos Olufemi Adeleye, Lecturer and Consultant Neurosurgeon in the Department of Neurological Surgery at University College Hospital in Ibadan. "Even so, the lifelong burden of these birth defects in those who live with them after their initial medical and surgical care, is just impossibly staggering. And this is both in human and financial terms. The children need multiple surgeries and rehabilitation, and in many cases this is more than the parents can afford. The need for prevention could not therefore be more imperative."

The U.S. based March of Dimes estimates that more than 300,000 neural tube defects happen every year worldwide, including an estimated 12,695 in Nigeria. Based on that estimate, the prevalence of neural tube defects in Nigeria is 27 per 10,000 births. In countries where foods fortified with folic acid are widely consumed, the prevalence is often less than 10 per 10,000 births.

Women need folic acid within the first three weeks of pregnancy because that is when the infant's neural tube is formed. Many women do not realize they are pregnant during this time. Consequently, it is important that women consume foods fortified with folic acid every day if there is any chance they could become pregnant.

Women are still encouraged to take vitamin supplements with folic acid and to eat a variety of healthy foods if they may become pregnant. Foods fortified with folic acid provide a way for women to consume more folic acid just by eating what they normally eat every day.

Foods fortified with folic acid will include the words folic acid or vitamin B9 on the nutrition label. With more fortified foods on the market, Nigerians can expect healthier infants if women consistently read the labels on food products, then purchase and consume foods fortified with folic acid.