Micronutrients are essential elements of our diet for health and well-being. For more information see the Linus Pauling Institute's Micronutrient Information Center. According to the 2016 Scaling Up Nutrition (SUN) Annual Report, micronutrient deficiencies are still common around the world. 30% of women are anemic from a lack of iron. 38% lack iodine and are at risk for goiters and neurologically impaired infants. Folic acid deficiency is also likely to be common.
There is no question that neural tube birth defects are devastating malformations and that these birth defects are caused in large part by a deficiency of folic acid in the first month of pregnancy. Fortunately they are rare and preventable. North America has chosen to address this by fortifying flour with folic acid.
Folic acid is found naturally in meats, eggs, green vegetables, brown rice and citrus fruits. Some methods of cooking, such as boiling, result in loss of folic acid. Dietary deficiency of folic acid is suspected when these components are limited or missing. For example, in rural regions of Nepal a typical diet consists of boiled lentils and white rice (dal-bhat) with supplemental boiled greens when available. This supplies the essential amino acids and calories for an adult, but is deficient in the folic acid needed for a healthy pregnancy.
Improving nutrition is possible through better education. Changing traditional cooking and eating habits can improve the content of folic acid in the diet. Supplementation is another alternative.
GNE and other organizations are trying to address this problem. SUN is advocating for governments to adopt better nutrition policies. WHO is advocating for supplements for all women of childbearing age. GNE has chosen to address the need with education and supplements in specific regions where women are undernourished one village at a time, but the message is global.
If you would like to learn more about undernutrition and folic acid supplementation, here are some suggested resources and reading: