Only about 25 per cent of women in many countries voluntarily take folic acid
tablets before conception, says a U of T
Dr. Joel Ray, along with fellow researchers Gita Singh of McMaster University
in Hamilton and Robert Burrows of Monash University in Australia, reviewed
nearly 50 studies conducted in about 20 countries between 1992 and 2001. Their
findings are published in the May 2004 edition of BJOG: an International
Journal of Obstetrics and Gynaecology.
By taking folic acid before pregnancy or during the first few weeks after
conception, women can markedly lower the risk of neural tube defects in their
offspring; the defects commonly manifest themselves as a debilitating health
condition known as spina bifida. The neural tube is fully developed 22 to 28
days after conception, but many women are not aware they are pregnant until
after this time. While starting folic acid supplements after this period is too
late to realize benefits, Ray believes the answer is to fortify the food supply
with folic acid, something that has been done in Canada, the U.S., Chile and
"There's an incredible debate overseas, in the United Kingdom and Europe,"
says Ray, a professor in the Department of Medicine and a physician in the Inner
City Health Research Unit at St. Michael's Hospital. "There has been a heated
discussion about the long-term safety of folic acid and, while no harm is
evident, we are just beginning to study the effects of long-term exposure. But
as a society, where's the greater good versus the lesser harm? Fortification is
probably the best way to reach most women worldwide, given that not enough women
take tablet supplements alone."