ATLANTA, GEORGIA, U.S. — Nigeria, which has had mandatory wheat flour fortification legislation in place since 2002, is now adding folic acid to its list of required nutrients for wheat flour, the Flour Fortification Institute (FFI) said on July 13.
Folic acid is a B vitamin known for preventing serious or fatal birth defects of the spine and brain called neural tube defects (NTDs). Cassava is the most commonly consumed food in Nigeria, according to the Food and Agriculture Organization (FAO) of the United Nations. Cassava is not fortified; consequently a number of other foods will need to be fortified to have a health impact. Foods already fortified with folic acid in Nigeria include Blue Brand margarine made by Unilever, Dangote pasta, Bournvita, Ovaltine and some brands of powdered milk.
Now the breads and pasta made with fortified flour will also contain this vitamin. Countries that fortify flour with folic acid report 30% to 70% declines in neural tube defects as a result.
Two studies undertaken at Lagos State University Hospital in Ikeja, Lagos, found that more than half the children treated for defects of the central nervous system had neural tube defects. In 2005, 33 of 61 children treated had neural tube defects. A two-year study in 2008 and 2009 showed 54 children with neural tube defects among the 94 children treated.
“The number of Nigerian children with neural tube defects reported in these two studies may seem small compared to some of the other health challenges our country faces, but that is because these are the only ones out of the vast majority of the probable cases that reach our attention,” said Dr. Amos Olufemi Adeleye, lecturer and consultant neurosurgeon in the Department of Neurological Surgery at University College Hospital in Ibadan.
“Even so, the lifelong burden of these birth defects in those who live with them after their initial medical and surgical care, is just impossibly staggering. And this is both in human and financial terms,” Adeleye said. “The children need multiple surgeries and rehabilitation, and in many cases this is more than the parents can afford. The need for prevention could not therefore be more imperative.”
Of the 75 countries with mandatory legislation to fortify flour, now only Venezuela, the United Kingdom, the Philippines, and Trinidad and Tobago do not include folic acid, according to FFI records.