Neural tube defects in Latin America and the impact of fortification: a literature review

Abstract

Objective: Data on the prevalence of birth defects and neural tube defects (NTD) in Latin America are limited. The present review summarizes NTD prevalence and time trends in Latin American countries and compares pre-and post-fortification periods to assess the impact of folic acid fortification in these countries. Design: We carried out a literature review of studies and institutional reports published between 1990 and 2010 that contained information on NTD prevalence in Latin America. Results: NTD prevalence in Latin American countries varied from 0?2 to 9?6 per 1000 live births and was influenced by methods of ascertainment. Time trends from Bogota, Costa Rica, Dominican Republic, Guatemala City, Mexico and Puerto Rico showed average annual declines of 2?5 % to 21?8 %. Pre-and postfortification comparisons were available for Argentina, Brazil, Chile, Costa Rica, Puerto Rico and Mexico. The aggregate percentage decline in NTD prevalence ranged from 33 % to 59 %.

Stability of microencapsulated L-5-methyltetrahydrofolate in fortified noodles

“…Some countries, have not implemented mandatory FA fortification. Numerous epidemiological studies have shown the strategy of fortifying foods with FA has led to a pronounced reduction in neural tube defects (NTD) in many countries (De Wals et al, 2007;Honein, Paulozzi, Mathews, Erickson, & Wong, 2001;Rosenthal et al, 2013). Although mandatory FA fortification of cereal products was first put in place in the US to lower the incidence of NTD, there is a renewed requirement to fortify specifically recognised ethnic food sources in order to prevent racial disparity towards preventing NTD (Hammer & Tinker, 2014).…”

Maternal and child nutrition – Authors' reply

“…Several reports of waterborne epidemics attest to this-the largest aff ecting more than 400 000 (mostly im muno competent) people. 3 Cryptosporidiosis aff ects young children, 4 and it is well known now to have adverse effects on nutritional outcomes. Growth pledges need to be tracked.…”

“…Yet, physicians do not sufficiently investigate for Cryptosporidium as a cause of diarrhoea in immunocompetent individuals in India. 3 Despite its…”

“…We believe that evidence shows the benefit of folic acid fortification and does not support Dadhich's claim that it leads to an increased risk of colorectal cancer. There is strong evidence that folic acid fortifi cation reduces neural tube defects 3 and has protective benefits against colorectal cancer in at-risk populations. 4 Uma Lele's comment echoes that of Per Pinstrup-Andersen, 5 which points …”

Efeitos do ácido fólico não metabolizado na metilação global do DNA, na expressão de RNAm dos genes de DHFR, MTHFR, interferon-γ, TNF-α e interleucina-8, e na citotoxicidade das células NK

“…No mundo, a prevalência de DFTN é estimada em mais de 300.000 novos casos por ano, com mais de 40.000 mortes e altas taxas de incapacitação (Rosenthal et al, 2013). No Brasil, são escassas as publicações sobre a prevalência dos DFTN.…”