Folic acid prophylaxis:: not only against neural tube defects

The value of primary prophylaxis against neural tube defects is undisputed. However, it is rather difficult to put it into practice. Individual prevention through daily intake of vitamin supplements which targets all women "who want to or could become pregnant" is affected by incomplete compliance on the mothers-to-be (and many physicians!). On the other hand, an epidemiological approach to general prophylaxis through addition of folic acid to bread flour is currently difficult to realise with regard to the reservations by marked-oriented forces and even not feasible in the EU-states because of nutrition laws. The fact that a high intake of folic acid not only reduces the incidence of neural tube defects but also prevents other malformations and could offer health benefits to everybody (e.g. decreased risk of coronary heart disease and stroke, reduced incidence of certain types of cancer), should lead to efforts to change legislation and decrease consumer-oriented reservations.