{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:07:41Z","timestamp":1791230861138,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T00:00:00Z","timestamp":1378080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Folic acid was proven in 1991 to prevent most cases of spina bifida and anencephaly. In 2008, less than 10% of folic acid\u2013preventable spina bifida and anencephaly (FAPSBA) was prevented through folic acid fortification programs. This study updates the global estimates of the proportion of FAPSBA prevented with various types of folic acid fortification as of 2012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>For each country, we estimated the annual birth prevalence of FAPSBA and the daily amount of folic acid consumed from mandatory folic acid fortification programs. Assuming in Model I (our original Bell and Oakley model) that it required 400 \u03bcg, and in Model II (a new model), 200 \u03bcg of folic acid daily for total prevention of FAPSBA, we estimated the percentage of FAPSBA being prevented in each country by fortification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Using the original model, we estimate that 15% of FAPSBA is being prevented in 2012, compared with 2006 (6.8%) and 2008 (9.1%). We estimate in our new model that 25% of FAPSBA is being prevented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      We estimate an increasing prevention of FAPSBA in the world through folic acid fortification, yet the pace is slow. Our new model estimates that only 25% prevention and reminds us that there remains a lot of work to do in countries that do not implement mandatory fortification, which is key to achieving global and total prevention. If we are to prevent all FAPSBA, there is an urgent need to build the global political will to find sufficient resources to aid in this effort.\n                      <jats:italic>Birth Defects Research (Part A) 97:658\u2013663, 2013<\/jats:italic>\n                      . \u00a9 2013 Wiley Periodicals, Inc.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bdra.23166","type":"journal-article","created":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T08:18:44Z","timestamp":1378109924000},"page":"658-663","source":"Crossref","is-referenced-by-count":65,"title":["2012 Update on global prevention of folic acid\u2013preventable spina bifida and anencephaly"],"prefix":"10.1002","volume":"97","author":[{"given":"Monica E.","family":"Youngblood","sequence":"first","affiliation":[{"name":"Department of Behavioral Science and Health Education Rollins School of Public Health of Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health of Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen N.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health of Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Johnson","sequence":"additional","affiliation":[{"name":"Training and Technical Support Group Flour Fortification Initiative Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Kancherla","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health of Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Godfrey P.","family":"Oakley","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Rollins School of Public Health of Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,9,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3182227887"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20304"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20504"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1093\/ajcn\/86.1.265","article-title":"Cognitive impairment in older Americans in the age of folic acid fortification","volume":"86","author":"Berry RJ","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911113412001"},{"key":"e_1_2_6_7_1","first-page":"1","article-title":"Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects","volume":"41","author":"Centers for Disease Control and Prevention","year":"1992","journal-title":"MMWR Recomm Rep"},{"key":"e_1_2_6_8_1","volume-title":"March of Dimes global report on birth defects: the hidden toll of dying and disabled children","author":"Christianson A","year":"2006"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530210052030"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)07247-4"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2005.10719474"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.10.3166"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn331"},{"key":"e_1_2_6_14_1","unstructured":"United Nations Children's Fund.2012.UN Data. 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