To reduce neural tube closure anomalies in newborns, wheat flour should be enriched with folic acid, the synthetic form of vitamin B9, according to ANSES.
- Neural tube closure anomalies affect more than one in a thousand pregnancies in France. They can have very serious consequences on the development of the baby’s brain and spinal cord.
- In order to improve the prevention of these anomalies, ANSES recommends enriching wheat flour with folic acid, the synthetic form of vitamin B9.
- This measure would make it possible to compensate for women’s insufficient intake of vitamin B9, which constitutes one of the main risk factors for AFTN.
In France, more than one in a thousand pregnancies present with neural tube closure anomalies (NFTN). These congenital malformations occur during the 4th week of embryonic development. They can lead to incomplete development of the spine (spina bifida), a lack of cranial vault (anencephaly) or even nerve damage.
The identified risk factors for this disorder are family history, taking certain treatments, particularly antiepileptic drugs, diabetes, obesity, as well as insufficient vitamin B9 levels in the mother. It is for this last element that ANSES believes it has the solution. The health safety agency suggests enriching flour with folic acid, the synthetic form of vitamin B9.
Pregnancy: flours enriched with folic acid reduce the risk of neural tube closure anomalies
To ensure the good health of the fetus, it is recommended that pregnant women have an intake of 600 micrograms per day of vitamin B9, also called folate, at least 4 weeks before conception and up to 12 weeks of amenorrhea. However, this rate is rarely reached. Another worrying element noted by health authorities: less than a third of women wanting a child took vitamin B9 supplementation before pregnancy, as is recommended.
Faced with this observation in its report on the prevention of AFTN, ANSES recommends systematic enrichment of folic acid at 200 µg/100 g in white and wholemeal wheat flours. “Wheat flour was chosen as the food to be enriched for two reasons: it is an ingredient used in many commonly consumed products (breads, biscuits, etc.) and these products are economically accessible for all women targeted”explains Vincent Bitane, scientific coordinator of the expertise, in a press release published on December 19.
The organization specifies that this systematic enrichment of flours with folic acid would also increase the intake of the rest of the population. “without however exposing it to a health risk”. But given the socio-economic questions that the measure could raise, he recommends “to provide for a consultation of the stakeholders concerned, as has been the case in other countries, in the United Kingdom for example.”
Several countries have already adopted flours enriched with folic acid such as the United States and Canada in 1998, Hungary as well as most nations of South and Central America.
AFTN and vitamin B9 deficiency: improving prevention among women
The addition of folic acid to wheat flour would not replace the current recommendation to supplement with vitamin B9 in the event of a baby plan. The measure is complementary. ANSES also notes that more awareness needs to be raised about the risks of neural tube closure anomalies in newborns. Its experts ask health professionals to strengthen prevention of this malformation “among women of childbearing age”.
To ensure sufficient levels of vitamin B9, it is recommended to consume:
- dried vegetables: chickpeas, red beans, lentils, broad beans;
- dark green vegetables: spinach, broccoli, lettuce, watercress, Brussels sprouts;
- of the liver.
