Coined the ‘Commitment’ project, the new initiative was introduced jointly by supplement trade body Council for Responsible Nutrition (CRN) and the national Healthy Mothers, Healthy Babies Coalition (HMHB).
The aim is to spread the word about the need for women to take a daily multivitamin containing 400 micrograms of folic acid. The message is being particularly targeted to women preparing to get married, the logic being that they may become pregnant “sooner than [they] think”.
Folate, which is found in foods such as green leafy vegetables, chick peas and lentils, has been linked by an overwhelming body of evidence to a reduced rate of a specific birth defect that affected the development of the spinal cord and central nervous system.
This connection led to the 1998 introduction of public health measures in the US and Canada, where all grain products are fortified with folic acid - the synthetic, bioavailable form of folate.
Preliminary evidence indicates that the measure is having an effect with a reported reduction in the incidence of neural tube defects (NTD) in the US of 26 percent.
Nevertheless, two separate reports published over the past year found that awareness of the benefits of folic acid in preventing birth defects remains low among American women – indicating that there is still room for education efforts and continued promotion of folic acid consumption.
CRN and HMHB said they will be spreading the message via outreach to bridal publications and women’s health media outlets, including a series of e-postcards available on the organizations’ websites.
This, they hope, will make it easy for consumers to “share the message”.
Awareness and use
A 2007 Gullup Organization survey, which was funded by the government body Centers for Disease Control and Prevention (CDC), found that 40 percent of women reported taking daily supplements containing folic acid in 2007.
This percentage is equal to that observed in 2004, and is an increase from 33 percent in 2005 and 32 percent in 2003, said Gullup, which has been conducting the survey annually since 2003.
Approximately 61 percent of women aged 18-24 reported being aware of folic acid, compared with 87 percent of women aged 25-34 and 89 percent of women aged 35-45 years.
Another survey commissioned by the Grain Foods Foundation and conducted by Schulman, Ronca & Bucuvalas Inc (SRBI) last year, found that most women have misleading perceptions of the folic acid content of bread.
The survey found that two-thirds of women believe that whole wheat and multigrain breads contain the most folic acid.
Only 12 percent perceive enriched white bread as having high levels of folic acid, despite the fact that it actually has twice as much folic acid as whole grain or whole wheat bread.
Although folic acid has been long established to reduce incidence of NTD, Spanish researchers reported in 1998 that folic acid supplementation may increase the selection of embryos with a mutation in the methylenetetrahydrofolate reductase (MTHFR) gene, which has been linked to an increase in the risk of the offspring developing disease.
Partly as a result of these concerns, mandatory folic acid fortification has not yet been introduced in Europe.
However, a study new study published in July this year claims these fears are unfounded.
The study, published in BJOG: An International Journal of Obstetrics and Gynaecology, was an observational prospective cohort study involving 1,234 women and 1,083 infants.
"Folic acid is known to be effective in reducing the incidence of [NTD], but concerns over possible effects on embryo selection continue to be cited as a potential reason for not fortifying the diet with folic acid and reservations about the use of folic acid supplements," wrote lead author Paul Haggarty from Rowett Research Institute, Aberdeen. "We found no evidence to support these concerns."