In this episode of Milestones in Maternal Nutrition, Professor Andrew Prentice speaks with Professor Helene McNulty about the landmark evidence linking periconceptional folic acid supplementation to the prevention of neural tube defects (NTDs). Professor McNulty traces the science from early observational findings to the pivotal 1991 MRC trial demonstrating a 72% protective effect against NTD recurrence, and a subsequent Hungarian trial showing 100% protection against first occurrence. The discussion examines why dietary folate alone is insufficient, how mandatory fortification programmes in the US and Canada have safely reduced NTD prevalence over three decades, and why the standard 400 microgram dose remains appropriate for most women — with higher doses reserved only for those at established clinical risk.

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Nestlé Nutrition Institute