§ Mr. CohenTo ask the Secretary of State for Health what link has been ascertained between the lack of folic acid in the diet and the incidence of spina bifida and anencephaly; and what recommendations the Medical Officer of Health has made on this matter. [35135]
§ Mr. BowisThere is no good evidence that the incidence of neural tube defects—NTDs—is related to an habitual lack of folic acid in the diet. However, a Medical Research Council—MRC—trial published in 1991 showed that supplements of 5 mg daily of folic acid reduce the rate of recurrence of NTD in babies of women who have already had an affected pregnancy. The Chief Medical Officer wrote to doctors in August 1991 advising them to prescribe a folic acid supplement for the purpose of preventing reoccurrence of NTDs. Further data since then suggest that supplements as low as 0.4 mg daily might also reduce the risk of first occurrence.
Following the publication of the MRC trial results, the chief medical officers of the UK health Departments set up an expert advisory group. Its report "Folic Acid and the 1143W Prevention of Neural Tube Defects", published in 1992, confirmed that, for the prevention of recurrence, women should take folic acid supplements of 5 mg daily, or 4 mg when these became available. For the prevention of first occurrences, the expert advisory group recommended that all women planning pregnancy should consume additional folate/folic acid prior to conception and during the first 12 weeks of pregnancy by eating more folate rich foods including those fortified with folic acid, and by taking a daily supplement of 0.4 mg of folic acid.
The chief medical officers wrote to all doctors and to other health professionals in December 1992 commending the expert advisory group's recommendations.
A copy of the expert advisory group report is available in the Library.