The National Academy of Science and Technology, Philippines (NAST PHL) held the Roundtable Discussion on Folic Acid on June 23, 2015 at Hotel Jen Manila. The activity was organized by the Health Sciences Division (HSD) of NAST PHL.

The roundtable discussion focused on the importance of taking enough folic acid by all women of reproductive age, more importantly, pregnant and lactating women. Folic acid is a B-vitamin that is critical to the development of a baby’s brain and spine. The RTD acknowledged the role of different sectors in the drafting of the policy on Folic Acid supplementation and food fortification.

Dr. Marissa B. Lukban, child neurologist of the Philippine General Hospital (PGH) and professor of College of Medicine, University of the Philippines Manila (UPM), discussed the burden of neural tube defects (NTDs). NTDs are the failure in closing of the neural tube during a baby’s brain development.

Dr. Lukban enumerated various consequences of NTDs and advised taking folic acid supplements to avoid NTDs. She presented several studies showing that folic acid can reduce the risk of NTD-affected pregnancies. She said that all women of reproductive age need 400 micrograms per day (μg/day), while high-risk or pregnant women need 4000 μg/day.

Dr. Karen Codling, executive officer for Asia of the Food Fortification Initiative, talked about the global progress of fortification efforts and regional activities. She discussed the need for enough folic acid intake in women. According to her, folic acid intake should start even before conception, because global data show that around 50% of pregnancies are unplanned. Supplementation during pregnancy is already too late, since the baby’s neural tube develops during the first 28 days of conception — a period when most mothers are still unaware of their pregnancies.

Dr. Codling said that supplementation and food fortification is vital. Getting enough daily requirement of folic acid from food alone is extremely difficult, because a huge amount of food is needed to have the required amount of folic acid daily. According to her, despite various educational campaigns, the awareness and practice of folic acid supplementation are relatively low.
Dr. Codling said that there is no clear evidence that folic acid causes harm to those who take it. When it comes to review of safety, it is important to distinguish the difference between supplementation and fortification.

Ms. Maria Lourdes A. Vega, chief of Nutrition Policy and Planning Division, National Nutrition Council, discussed the successes and challenges of fortification efforts in the Philippines. Ms. Vega presented the data on the trends in the prevalence of anemia and vitamin A deficiency in the Philippines. They showed a decline in the number of cases since the full implementation of mandatory food fortification (RA 8976) in 2004. RA 8976 requires staples and encourages processed foods to be fortified with micronutrients iron and vitamin A.

Despite the law already being in place, there are several challenges faced by its implementation like compliance of products to standards, availability of unfortified staples in the market, and imported and smuggled goods, among others.

Academician Carmencita D. Padilla, focal person of the RTD, presented the highlights of the proposed legislation on folic acid, ”An Act Establishing a Comprehensive Policy on Achieving Adequate Intake of Folic Acid through Fortification and Supplementation”.
Acd. Padilla asked the audience from the different sectors of science and technology, education, health, nutrition, public and private, and media, to give their inputs to and support the bill for a higher chance to be passed on the Congress and the Senate.
Acd. Padilla said that they have gathered data on NTDs from the Philippine General Hospital (PGH) for the last decade and prospectively looked at 81 hospitals in the country for other cases. She said that the data show the need to address folic acid deficiency. According to her, there are already many efforts addressing folic acid deficiency that only require coordination and support of policy.
Acd. Padilla’s proposed bill aims to move forward folic acid supplementation and fortification in the country and to come up with a law that is comprehensive, but with room for future changes for expansion. She said that it is uncertain when the bill will be passed and there are other challenges in implementing and monitoring it, but according to her, it is important to already start crafting it.
Dr. Luz B. Tagunicar, supervising health program officer of Child Health Division, Department of Health (DOH) and Dr. Leah A. Perlas, supervising science research specialist of the Food and Nutrition Research Council (DOST-FNRI), served as the reactors of the RTD.
Dr. Tagunicar committed the support of the DOH to the bill that will be comprehensive and integrative to the health program that already exists in the DOH.
Dr. Perlas talked about FNRI’s national nutrition survey in 2003 which showed  37.5% of pregnant women with folate deficiency on a national scale. She discussed their research on the fortification of rice kernels with folic acid similar to iron fortification on pilot scale. The FNRI is also planning to determine the folate content of Filipino foods to monitor the folate intake of Filipinos.
Dr. Eva Cutiongco-De La Paz, UP Manila vice chancellor for research, and executive director of National Institutes of Health-UPM, provided the highlights of the presentations and the discussions. She emphasized the important role of academe in conducting research that can be used to support policy-making and ended the roundtable discussion with the statement —“We need folic acid.”