Two papers in this issue particularly caught my attention. The first is a paper based on the WHO vitamin and mineral information system, identifying prevalence figures for anaemia; the second, a paper looking at the cost-effectiveness of folic acid fortification in the USA.
McLean et al. provide an interesting background for those of us dealing with anaemia on the population level in their paper on the worldwide prevalence of anaemia(Reference McLean, Cogswell, Egli, Wojdyla and de Benoist1). The authors use data reported in the WHO Vitamin and Mineral Nutrition Information System, 1993–2005, to give a global estimate of the problem. In this important work, the authors conclude that one-quarter of the world’s population is affected, especially pre-school children and women.
Bentley et al. report on a cost-effectiveness analysis of folate fortification in the USA(Reference Bentley, Weinstein, Willett and Kuntz2). The paper states an impressive gain in quality-adjusted life years (QALY), with the highest benefit stemming from the prevention of myocardial infarctions, followed by colon cancer and NTD. Only a small number of additional vitamin B12 deficiency cases are predicted, thus leading to the conclusion that the health and economic gains far outweigh the losses. The authors suggest a higher fortification level in order to maximize health gains.
Going back to the commentary on the Women’s Health Initiative (WHI) published in this journal previously(Reference Lissner, Serra Majem and de Almeida3), should these dramatic effects of folic acid fortification not have been taken into account when evaluating the effects of the WHI intervention?
