From 1998 to 1999, the University of North Carolina at Chapel Hill School of Public Health convened a blue ribbon panel to develop a strategic plan to encourage women of childbearing age to increase their intake of folate and folic acid.
Randomized controlled trials have demonstrated that 50 to 70 percent of neural tube defects—serious birth defects involving incomplete development of the brain and spinal cord—can be prevented if women increase their intake of folate and folic acid before they become pregnant and continue during pregnancy.
The panel, which included national experts from the fields of pediatrics, women's health, and health education, reviewed the available evidence and outlined the best strategies to promote consumption of folate and folic acid.
- In their report, A Strategic Plan to Prevent Birth Defects by Promoting Folate and Folic Acid Intake Among Women of Childbearing Age, the panel recommended the creation of a national educational program for health professionals, combined with a national intervention campaign targeted at various populations of women.
The goal was to encourage women of childbearing age to consume 400 micrograms (mcg) of folic acid or its equivalent daily in foods naturally rich in folates, in foods fortified with folic acid, or in vitamin supplements.
The plan also included a policy initiative that would:
- Forge partnerships with industry.
- Pursue other opportunities to evaluate interventions to increase folic acid intake.
- Develop new research proposals, such as examining the cardiovascular benefits of folic acid consumption.
- The panel was not able to agree on any immediate action regarding the increased fortification of the food supply with folic acid. The proposed strategic plan was estimated to cost $90 to $115 million in its entirety.
- Because the full program may be beyond the funding potential of a single entity, the plan was structured as an interlocking set of individual programs and assessments, each of which could be funded separately.