such as "Introduction", "Conclusion"..etc
the benefits of supplementation are clear, the possible harms of such a
policy are not, as there is no trial evidence of the efficacy and
safety of the intervention, write child health experts, Brian Wharton
and Ian Booth.
In the United States, a 19% reduction in the
prevalence of neural tube defects has been reported following folic
acid fortification of grain products. However, this reduction is less
than half that seen in England and Wales in the 1980s without a
fortification programme. These data are hardly a substitute for a
controlled field trial, they argue.
Furthermore, mandatory and
universal fortification does not, at present, need the same trial
evidence as for a drug. Yet a drug is not given in imprecise doses to
all members of the population without choice or indication, they add.
1998, 399 pregnancies in England and Wales were affected by central
nervous system malformation. Although a field trial would not be easy,
say the authors, is it acceptable to increase the folic acid intake of
50 million people to prevent a third to two thirds of these affected
pregnancies before there is firm evidence of efficacy and safety in
people who are not pregnant?
Source : British Medical Journal (BMJ)
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