Abstract
Objective: To outline specific challenges facing public health in Canada that need to be addressed to ensure that all women of childbearing years can attain optimal folate status for prevention of NTDs.
Methods: The new Dietary Reference Intake (DRI) for folate was examined in terms of the literature on the effective form of the vitamin, the level of folic acid provided by the Canadian food supply and the folic acid content of available supplements.
Findings: There are six major challenges facing public health in Canada on this issue. These include confusion among health professionals and the general public on the effective form of the vitamin, requirements, and the necessity of taking supplements. Further obstacles to ensuring optimal folate status in all women of childbearing age in Canada include the limited amounts of folic acid that are currently permitted in foods and the difficulties involved in identifying the amount of folic acid provided in these foods in relation to needs.
Interpretation: These challenges must be addressed to enable women in Canada to make an informed choice about folic acid. This has the potential to prevent up to 70% of the 300 births affected by NTDs each year.
Résumé
Objectif: Décrire les défis particuliers que doit relever la santé publique au Canada pour que toutes les femmes en âge de procréer aient un niveau de folate optimal pour la prévention des anomalies du tube neural (ATN).
Méthode: Nous avons examiné le nouvel Apport nutritionnel de référence (ANREF) pour le folate à la lumière de la documentation sur les formes efficaces de la vitamine, du niveau d’acide folique dans l’alimentation canadienne et du contenu en acide folique des suppléments nutritifs disponibles.
Constatations: Les responsables de la santé publique au Canada ont six grands défis à relever dans ce dossier, notamment la confusion, parmi les professionnels de la santé et dans le grand public, sur la forme la plus efficace de cette vitamine, sur les besoins en folate et sur la nécessité ou non de prendre des suppléments. Les autres obstacles à surmonter sont les faibles quantités d’acide folique actuellement autorisées dans les aliments et la difficulté de déterminer la quantité d’acide folique dans l’alimentation par rapport aux besoins.
Interprétation: Il faut se pencher sur ces questions pour permettre aux Canadiennes de faire un choix éclairé au sujet de l’acide folique. On pourrait éventuellement prévenir jusqu’à 70 % des ATN, qui touchent 300 naissances chaque année.
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