Folic Acid Fortification Case Study

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Read Case 12 The Folic Acid Fortification Decision: Before and After on pages 351-363 of your text. Once you have read the case, you are to address these questions. The word limit per response is 200 words. 1. Describe the authorizing environment for folic acid fortification in the United States.

Beginning the case study, we are introduced with the call from the British Medical Research Council (MRC) being informed of the significant results showing the benefits of folic acid and the reductions of NTS’s. The next step for the United States was to decide amongst the CDC and the FDA on the best way to implement these results to women of childbearing age. At that point in time, there were only a few ways to ingest folic acid, which brought …show more content…

Why would a decision based on strong British studies influence the U.S. decision to fortify cereal products but yield a delayed response in the U.K.? I find that the delayed response to fortify foods with folic acid was due to two factors including the potential adverse health effects as well as deciding what the best way would be to improving the folic acid levels in childbearing women. One example includes the animal studies showing that of high doses of folic acid resulted in conflicting results. Following this study resulted in controlled studies, evaluating the effects of the potential for a higher risk of cancer. However, following these studies, the SCAN reported with the statement,” the evidence for an association between folic acid and increased or reduced cancer risk is equivocal” (p. 360). In addition to the SCAN study on increase risk of cancer, there was also the concern of fortification of folic acid on the elderly population. Overall, I find that for a great period of time the concern of adverse effects caused further studies to be conducted and ultimately delaying the onset of the fortification of folic acid. Aside from adverse health effect, I find that the U.K also struggled to determine the best approach to implementing folic acid. With this, the U.K had narrowed down 4 options. Overall, the final decision was to implement a mandatory fortification of flour products in …show more content…

In the 1993 case of the CDC, they found that the number of cases avoided was estimated at 116 NTD- affected births per year. While the University of California study of 1995 estimated that, the number of cases avoided was estimated at 304 NTD per year. Furthermore, both cases found there to be a substantial economic benefit with the fortification of folic acid. The CDC included a benefit of $5 million per avoided case while the University of California estimated there to be a benefit of $342,500. On of the major differences between the two studies and their values includes the fact the University took into account the loss of productivity. Along with this, I find that the time in which the studies occurred played a role. I noticed that the University estimated there to be substantially more prevented cases than the CDC’s prediction. I find that the difference between the two studies could be due to the fact the University of California’s study come out after the FDA’s decision to mandate the fortification of folic acid in cereal products and that there may have been more accurate research or

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