In addition, all women of child-bearing age should increase their intake of folic acid by eating foods which are rich in this B vitamin, Dr Kenneth Calman said. Such foods include broccoli, brussels sprouts, green vegetables, bananas, orange juice, rice, spaghetti cereals and wholemeal bread.
Dr Calman said it was vital that women are made aware of this development in dietary advice, which follows a report from an Expert Advisory Group set up by the Department of Health last year.
'Women planning a pregnancy should take 0.4mg folic acid supplement from the start of trying to conceive until the twelfth week of pregnancy,' he said. Tablets are available over the counter but may be hard to find. 'It is entirely acceptable to use a multi-vitamin preparation containing this dose of folic acid in the short term.'
Each year 200 babies in England are born with spina bifida, a condition in which one or more of the vertebrae fail to develop completely, leaving part of the spinal cord exposed. Affected children suffer a range of disabilities.
The new recommendations build on advice issued last year to women who had already given birth to a child with spina bifida. Such women are 10 times more likely to have another affected child.
A study by the Medical Research Council showed that the risk was reduced by 50 to 70 per cent if the women's diet was supplemented with a dose of 4mg to 5mg daily until the twelfth week of any subsequent pregnancy. Tablets at this strength are available on prescription, and doctors are strongly recommended to prescribe them.
The expert group, chaired by Dame June Lloyd, Professor of Child Health at the Institute of Child Health, was set up to see if the advice should be extended to all women. They concluded that a lower dose was sufficient to reduce the risk in women planning a first pregnancy, or those who had no known risk factors.
Supplements were necessary because the average folic intake is only 0.2mg, and it is impractical to expect women to boost their intake through dietary measures alone, Dame June said. She added that an increased range of bread and cereals fortified with folic acid should be made available, and labels should show levels of the vitamin.
Folic Acid and the Prevention of Neural Tube Defects, Health Publications Unit, Heywood Stores, No. 2 Site, Manchester Road, Heywood, Lancashire OL10 2PZ.Reuse content