title: Folate and folic acid in the periconceptional period: recommendations from official health organizations in thirty-six countries worldwide and WHO.
abstract: OBJECTIVE
  To summarize the recommendations on folate intake and folic acid supplementation and fortification in the periconceptional period, aimed at prevention of neural tube defects (NTD), provided by official health organizations in different countries worldwide and WHO.
  
  
  METHODS
  Information on recommendations for folate and folic acid intake in the periconceptional period was gathered from the websites of official national health organizations of several countries worldwide and from the WHO website.
  
  
  METHODS
  WHO, selected developed countries and emerging economies, totalling thirty-six countries worldwide (some European, BRICS, G8, Asian Tiger/Asian Dragon and Australia).
  
  
  RESULTS
  Recommendations differ between countries, although the majority (69·4 %) recommend a healthy diet plus a folic acid supplement of 400 µg/d from preconception (4-12 weeks) until the end of the first trimester of pregnancy (8-12 weeks). The same recommendation is issued by the WHO. Dosages for women at high risk of NTD are up to 4-5 mg/d (for 41·7 % of studied countries). The recommended intake for folate is in the range of 300-400 µg/d for women of childbearing age and 500-600 µg/d for pregnant women in different countries and WHO. Five countries emphasize the importance of a healthy diet rendering supplementation needless. By contrast, five others advise a healthy diet and supplementation plus mandatory fortification. Only one mentions the importance of ensuring an adequate folate status and refers to checking with a health-care provider on the need for supplements.
  
  
  CONCLUSIONS
  Different recommendations regarding folate and folic acid, seeking NTD prevention, are available worldwide; however, most countries and WHO focus on a healthy diet and folic acid supplementation of 400 µg/d periconceptionally.
authors: 1Institute of Public Health of the University of Porto (ISPUP),Porto,Portugal.
authors: Sandra
authors: S
authors: Gomes
authors: 1Institute of Public Health of the University of Porto (ISPUP),Porto,Portugal.
authors: Carla
authors: C
authors: Lopes
authors: 2Department of Clinical Epidemiology,Predictive Medicine and Public Health,University of Porto Medical School (FMUP),Porto,Portugal.
authors: Elisabete
authors: E
authors: Pinto
mesh_terms: D001315:Australia; D004032:Diet; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005247:Feeding Behavior; D005260:Female; D005306:Fertilization / Q000187:drug effects*; D005492:Folic Acid / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007391:International Cooperation; D009436:Neural Tube Defects / Q000517:prevention & control; D011247:Pregnancy; D064167:Recommended Dietary Allowances; D014944:World Health Organization
chemical_list: D005492:Folic Acid
keywords: Folate; Folic acid; Neural tube defects; Official health organizations’ recommendations; Periconceptional period