Folic acid fortification prevents neural tube defects and may also reduce cancer risks
Folic acid fortification prevents neural tube defects and may also reduce cancer risks
复制标题
DOI：
10.1111/j.1651-2227.2012.02781.x
复制
发表时间：
2012-10-01
期刊：
影响因子：
3.8
通讯作者：
Jagerstad, Margaretha
中科院分区：
文献类型：
--
作者：
Jagerstad, Margaretha
在欧盟，受神经管缺陷（NTD）影响的妊娠的患病率在0.4/1000至2/1000之间。NTD导致严重畸形，有时甚至流产。出生时患有NTD的儿童在其余生中遭受残疾和慢性医疗保健问题，因此，如果产前诊断出NTD，许多妇女选择终止妊娠。建议计划怀孕的妇女每天摄入400微克叶酸，而欧洲的平均数字表明育龄妇女的摄入量接近250微克/天，这一差距可以通过实施叶酸强化来弥补。在美国和加拿大引入的强制性叶酸强化的结果是NTD妊娠减少了25%至45%。结论：循证NTD预防目前已在全球60多个国家实施。欧盟国家担心可能的癌症风险，但忽视了大量的研究报告，这些研究报告表明，叶酸摄入量在推荐水平下可以降低癌症风险。目前，有迹象表明存在U形关系，即叶酸摄入量低（1 mg/天）时癌症风险较高。然而，全球世界癌症研究审查和欧盟欧洲食品安全局的报告都没有提供生理叶酸摄入量增加癌症风险的数据。因此，欧盟应尽快实施叶酸强化作为NTD预防措施。
The prevalence of neural tube defect (NTD)-affected pregnancies ranges between 0.4 and 2/1000 pregnancies in EU. NTDs result in severe malformations and sometimes miscarriages. Children born with NTD suffer for the rest of their life of disability and chronic healthcare issues, and many women therefore choose termination of pregnancy if NTD is diagnosed prenatally. Women planning for pregnancy are recommended to eat 400 mu g folic acid/d, whereas average figures across Europe indicate intakes of similar to 250 mu g/d for women of fertile age, a gap that could be bridged by implementation of folic acid fortification. The results of mandatory folic acid fortifications introduced in USA and Canada are a decrease between 25 and 45% of NTD pregnancies. Conclusion: Evidence-based NTD prophylaxis is now practised in more than 60 countries worldwide. EU countries worry over possible cancer risks, but ignore a wealth of studies reporting decreasing cancer risks with folate intakes at recommended levels. Currently, there are indications of a U-shaped relationship, that is, higher cancer risks at low folate intakes (1 mg/day), respectively. However neither the global World Cancer Research review nor EUs European Food Safety Authority report present data on increased cancer risk at physiological folate intake levels. Therefore, EU should act to implement folic acid fortification as NTD prophylaxis as soon as possible.