叶酸:一个公共卫生挑战
Monika Eichholzer1, Otmar Tönz, Roland Zimmermann
1Institute of Social and Preventive Medicine, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland. eichholz@ifspm.unizh.ch
Lancet (London, England)
|April 25, 2006
概括
许多女性不服用叶酸补充剂,导致持续的神经管缺陷. 一些国家的强制性强化大大减少了缺陷,但需要更广泛的策略.
科学领域:
- 公共卫生 公共卫生
- 营养科学 营养科学
- 预防医学 预防医学
背景情况:
- 公共卫生运动建议补充叶酸以预防神经管缺陷 (NTDs).
- 许多妇女不遵守这些建议,而NTD仍然令人担忧.
- 低坚持与教育水平,年龄和意外怀孕有关.
研究的目的:
- 评估叶酸补充和强化对NTD率的有效性.
- 确定挑战,并提出改善叶酸状况的替代公共卫生战略.
主要方法:
- 全球公共卫生运动和强化政策的审查.
- 分析在有或没有强制强化的国家中NTD率.
- 评估人口的叶酸和同型半氨酸状态.
主要成果:
- 美国,加拿大和智利的强制性叶酸强化导致NTD显著减少 (31-78%).
- 许多欧洲国家没有显示NTD的下降,这表明对建议的遵守程度很低.
- 在非强化国家,一般人群的日常食物叶酸摄入量往往不足.
结论:
- 强制性叶酸强化是有效的减少NTDs和改善人口叶酸状况.
- 强制强化所面临的挑战包括未经证实的益处和对健康风险和选择的担忧.
- 创新的公共卫生方法是必要的,以改善叶酸状况,并在全球范围内预防NTD.
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