Food Fortification Ineffective in Preventing Neural Tube Defects in India due to Regulation Promoting Inadequate Levels of Folic Acid and Vitamin B12

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2025-06-28 DOI:10.1002/bdr2.2498

Vijaya Kancherla, Parveen Bhalla, Subrata Kumar Dutta, Rajesh Mehta, Ravindra M. Vora, Santosh Karmarkar

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引用次数: 0

Abstract

Background

There is a high prevalence of neural tube defects (NTDs) and nutritional anemias that increase the risk of birth defects in India. The current staple food fortification regulations for folic acid and vitamin B12 are ineffective in the country. We provide an evidence-based viewpoint urging for WHO-recommended levels of fortificants (i.e., 1300 mcg of folic acid and 10 mcg of vitamin B12 per kilogram of wheat flour or rice) to be included in the regulation.

Methods

Micronutrient fortified foods are being distributed through various governmental safety-net programs under the National Food Security Act in India. Packaged flour produced by some private companies is fortified.

Results

Food fortification regulation, recommended in 2018 by the Food Safety and Standards Authority of India, allows adding 75–125 micrograms (mcg) of folic acid per kilogram (kg), and 0.75–1.25 mcg of vitamin B12 per kg, as fortificants in wheat flour or rice. These levels are 90% lower than what WHO recommends based on daily consumption of staple foods in India.

Conclusion

Re-setting fortification standards for folic acid and vitamin B12 to levels recommended by the WHO in India will avert thousands of NTD-associated pregnancies each year, as well as morbidity and mortality associated with them.

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在印度，由于叶酸和维生素B12水平不足，食品强化在预防神经管缺陷方面无效

背景在印度，神经管缺陷（NTDs）和营养性贫血的患病率很高，这增加了出生缺陷的风险。目前的主食叶酸和维生素B12强化规定在国内是无效的。我们提供了一个基于证据的观点，敦促将世卫组织推荐的强化剂水平（即每公斤小麦粉或大米1300微克叶酸和10微克维生素B12）纳入该法规。方法根据印度《国家食品安全法》，通过各种政府安全网项目分发微量营养素强化食品。一些私人公司生产的包装面粉是强化的。印度食品安全和标准局于2018年推荐的食品强化法规允许在小麦粉或大米中每公斤添加75-125微克的叶酸和0.75-1.25微克的维生素B12作为强化剂。这些水平比世卫组织建议的印度主食每日消费量低90%。在印度，将叶酸和维生素B12的强化标准重新设定到世界卫生组织建议的水平，将每年避免数千例与热带病相关的怀孕，以及与之相关的发病率和死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.