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Providing perspectives on recent research into vitamins and nutritionals


WHO Issues Folate Recommendations to Prevent Neural Tube Defects

By Michael McBurney

The World Health Organization (WHO) issued new recommendations on the prevention of neural tube defects (NTDs). With approximately 300,000 newborns being born annually with NTDs, it is important that women who may become pregnant consume recommended amounts (400 µg folic acid daily).

The WHO recommendations are:

  1. At the population level, red blood cell (RBC) folate concentrations in women of reproductive age should exceed 906 nmol/L (400 ng/mL).
  2. RBC folate concentration of >906 nmol/L can be used an indicator of folate insufficiency in women of reproductive age
  3. No serum folate threshold is recommended for prevention of NTDs in women of reproductive age at the population level.

Countries which have legislated mandatory folate fortification of cereal grains has dramatically improved RBC folate concentrations. Mandatory fortification resulted in a sharp increase in blood and RBC folate concentrations in the US followed by modest declines in status between 1999-2010.

Main Citation

Cordero AM, Crider KS, Rogers LM, Cannon MJ, Berry RJ. Optimal serum and red blood cell folate concentrations in women of reproductive age for prevention of neural tube defects: World Health Organization Guidelines. 2015 CDC MWWR 64(15):421-423

Other Citation

Pfeiffer CM, Hughes JP, Lacher DA, Bailey RL, Berry RJ, Zhang M, Yetley EA, Rader JI, Sempos CT, Johnson CL. Estimation of trends in serum and RBC folate in the US population from pre-to post-fortification using assay-adjusted data from NHANES 1988-2010. 2012 J Nutr doi: 10.3945/jn.111.156919