Folic acid, as a water-soluble B-vitamin, is very important for women of childbearing age because of its key-role in many metabolic processes, particularly in cell growth and cell regeneration. A folic acid deficiency in the early stages of pregnancy could lead to defects of the spinal column, so-called neural tube defects. In contrast to adolescents and adults, who normally need about 400 microgram folate equivalents a day, pregnant and breastfeeding women are in need of 600 microgram. German-speaking countries document about 1 neural tube defect per 1000 births. In the case of recurrence, the risk is about 3% and after a second occurrence about 10%. On average, between 300.000 and 400.000 children are affected by these defects world-wide. In Austria the frequency ranges from 60 to 64 cases per year. Recent studies have shown that the prevalence of neural tube defects can be reduced by the administration of folic acid before conception.

The aim of the project is to describe the recent evidence on benefits and risks, as well as efficacy and safety of potential flour enrichment with folic acid. Efficacy was analysed with regard to the decrease of neural tube defects and other birth deformities, the risk of aborts and twin births, the prevalence of cardiovascular diseases, breast cancer, colorectal carcinoma, and also the safety regarding masking of a vitamin B 12-deficiency and anti-epileptic drug therapy.