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Canadian law has insisted on the folic acid fortification of all types of white flour, enriched pasta and cornmeal since November 1998. Now data from seven Canadian provinces for 1993–2002 (New England Journal of Medicine 2007;357:135–42) have shown that the prevalence of neural tube defects fell from 1.58 per 1000 births before fortification to 0.86 per 1000 after full fortification. The reduction was 46% for all neural tube defects, 53% for spina bifida, 38% for anencephaly and 31% for encephalocoel. It was greater in provinces with higher prefortification rates and the differences between provinces were virtually eliminated.

There is evidence that air pollution may be associated with adverse pregnancy outcomes and increased infant mortality. Now a study in 10 cities in England (J Epidemiol Community Health 2007;61;719–22) has shown no association between levels of carbon monoxide, nitric oxide, nitrogen dioxide, ozone or particulate matter (PM10) and infant mortality. A 10 μg/m3 increase in air concentration of sulphur dioxide was associated with a significant 2% increase in infant mortality. The increase was seen for both neonatal and postneonatal deaths and was greater in the summer months. It is concluded that continuing reductions in atmospheric sulphur dioxide levels may provide benefits for infant health.

Eating plenty of fruit and …

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