Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA.
Department of Neurology, University of Wisconsin-Madison, Madison, WI 53706, USA.
Nutrients. 2020 Jan 18;12(1):247. doi: 10.3390/nu12010247.
The United States implemented mandatory fortification of cereal grains with folic acid in 1998 to prevent neural tube defects (NTDs) during pregnancy. The health benefits of folate (vitamin B9) are well documented; however, there are potential risks of exceeding the upper tolerable limit, particularly in vulnerable populations. We conducted a population-based analysis of the Food Fortification Initiative dataset to determine the strength of the evidence regarding reports of decreased NTDs at the national level in response to mandatory folic acid fortification of cereal grains. We found a very weak correlation between NTD prevalence and the level of folic acid fortification, irrespective of the cereal grain fortified (wheat, maize or rice). Stratification of the data based on socioeconomic status (SES) indicated a strong linear relationship between reduced NTDs and better SES. We conclude that national fortification with folic acid is not associated with a significant decrease in the prevalence of NTDs at the population level.
1998 年，美国开始强制在谷物中添加叶酸以预防孕妇神经管缺陷（NTD）。叶酸（维生素 B9）的健康益处已有充分的记录；然而，超过可耐受上限的潜在风险，尤其是在脆弱人群中。我们对食物强化倡议数据集进行了基于人群的分析，以确定有关全国范围内 NTD 报告减少的证据强度，以响应谷物中强制添加叶酸。我们发现，无论强化的谷物（小麦、玉米或大米）如何，NTD 患病率与叶酸强化水平之间的相关性非常弱。根据社会经济地位（SES）对数据进行分层表明，NTD 减少与 SES 改善之间存在很强的线性关系。我们的结论是，全国范围内叶酸强化与人群中 NTD 患病率的显著降低无关。
