The Prevention of Neural Tube Defects: A Public Health Approach

Abstract

The recent media debate about the MRC trial of vitamin supplementation to prevent neural tube defects has tended to draw attention away from the underlying problem of inadequate micronutrient intake in the diet. From a public health perspective a broader approach must be adopted if we wish to significantly reduce the incidence of neural tube defects in the population. The prescription of vitamins can only be considered as a short-term, partial solution, and the long-term goal must be the elimination of the primary causes of micronutrient deficiencies. Particular emphasis must be placed on the nutrient losses and imbalances that arise from current food production and processing techniques.

Nutritionally induced congenital defects

“…Finally, a more speculative issue is the more far-reaching question of apparent malnutrition figuring in a Western industrialized society. It has been suggested (St George, 1983) that although overt malnutrition has been eradicated, it has been replaced by a more subtle form of deprivation produced by modem methods of food production and food processing. The demand now is for food products, rather than food, which are clean and attractive, and the scientific farming and food processing involved in their production lead to the loss of micronutrients (Bender, 1978).…”