It seems topical to discuss folic acid fortification as it has recently been in the news and by the end of the year it will be a legal requirement that breads contain approximately 135µg of folate per 100g. I will actually not wade into the debate directly, fortuitously a study was published mid last month on one of the potential benefits of folate supplementation. The study looked at the effect of supplementation on the number of very preterm births and found that it had a protective effect.

First a little background might be in order, Folic acid is one of the B vitamins and is important in cellular metabolism. As a vitamin it is a nutrient that we must obtain through our diet. Food stuffs such as leafy vegetables and liver (mmm, liver) are good sources of folate however it is still a part of our diet that tends to be lacking. Because of this many western countries now mandate fortification of grain products with the vitamin. This is because of the important role it also plays in pregnancy and in particular the prevention of Neural Tube Defects, notably Spina bifida.

The study looking at folate supplementation and preterm births found that the important factor seemed to be duration of supplementation prior to pregnancy rather than the dosage of supplementation. In particular durations of greater than 12 months seemed to be most beneficial. However as the study was undertaken in the US the supplementation was taking place in conjunction with an existing fortification of bread products, this implies that the fortification alone was not sufficient to prevent all preterm births and that women that are planning pregnancies should continue to supplement with folate even after fortification is introduced.

In addition the folate supplementation was self reported by the women in the study at enrolment and after pregnancy had begun rather than being proscribed prior to attempts to conceive. This seems to mean that we must rely on the memory of the women to be accurate regarding the duration of supplementation. Despite this limitation there still seems to be a good correlation between supplementation and reduction in preterm births. Bottom line appears to be that supplementation in addition to fortification is a good idea for the childbearing among us.