Gomes Sandra, Lopes Carla, Pinto Elisabete
1Institute of Public Health of the University of Porto (ISPUP),Porto,Portugal.
2Department of Clinical Epidemiology,Predictive Medicine and Public Health,University of Porto Medical School (FMUP),Porto,Portugal.
Public Health Nutr. 2016 Jan;19(1):176-89. doi: 10.1017/S1368980015000555. Epub 2015 Apr 16.
To summarize the recommendations on folate intake and folic acid supplementation and fortification in the periconceptional period, aimed at prevention of neural tube defects (NTD), provided by official health organizations in different countries worldwide and WHO.
Information on recommendations for folate and folic acid intake in the periconceptional period was gathered from the websites of official national health organizations of several countries worldwide and from the WHO website.
WHO, selected developed countries and emerging economies, totalling thirty-six countries worldwide (some European, BRICS, G8, Asian Tiger/Asian Dragon and Australia).
Recommendations differ between countries, although the majority (69·4 %) recommend a healthy diet plus a folic acid supplement of 400 µg/d from preconception (4-12 weeks) until the end of the first trimester of pregnancy (8-12 weeks). The same recommendation is issued by the WHO. Dosages for women at high risk of NTD are up to 4-5 mg/d (for 41·7 % of studied countries). The recommended intake for folate is in the range of 300-400 µg/d for women of childbearing age and 500-600 µg/d for pregnant women in different countries and WHO. Five countries emphasize the importance of a healthy diet rendering supplementation needless. By contrast, five others advise a healthy diet and supplementation plus mandatory fortification. Only one mentions the importance of ensuring an adequate folate status and refers to checking with a health-care provider on the need for supplements.
Different recommendations regarding folate and folic acid, seeking NTD prevention, are available worldwide; however, most countries and WHO focus on a healthy diet and folic acid supplementation of 400 µg/d periconceptionally.
总结全球不同国家官方卫生组织及世界卫生组织（WHO）针对围孕期叶酸摄入、叶酸补充剂及强化措施提出的建议，旨在预防神经管缺陷（NTD）。
从全球多个国家官方国家卫生组织网站及WHO网站收集围孕期叶酸和叶酸摄入建议的信息。
WHO、部分发达国家及新兴经济体，全球共36个国家（一些欧洲国家、金砖国家、八国集团、亚洲四小龙/亚洲四小虎及澳大利亚）。
各国建议存在差异，不过多数国家（69.4%）建议从孕前（4 - 12周）至妊娠早期结束（8 - 12周）保持健康饮食并每日补充400微克叶酸。WHO也发布了相同建议。神经管缺陷高风险女性的剂量高达每日4 - 5毫克（在所研究国家中占41.7%）。不同国家及WHO建议育龄女性叶酸摄入量在每日300 - 400微克，孕妇为每日500 - 600微克。五个国家强调健康饮食的重要性，认为无需补充；相比之下，另外五个国家建议健康饮食、补充叶酸并强制强化。只有一个国家提到确保叶酸水平充足的重要性，并建议咨询医疗保健人员是否需要补充剂。
全球针对预防神经管缺陷的叶酸和叶酸相关建议各不相同；然而，多数国家及WHO关注围孕期健康饮食及每日补充400微克叶酸。
