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Global health notes - Prakhar Agarwal Global Health Work...

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Prakhar Agarwal 3/5/2008 Global Health Work Folic Acid fortification as a means to reduce neural tube defect affected pregnancies Why fortify fords? -only when a nutrient deficiency (widespread) is tied to a specific disease - first mandated program was folic acid in 1998 - other countries have followed - controversial in US and worldwide >1 billion people exposed to folate fortified foods Neural tube defects -Spina bifiida- spinal cord not fully formed -Encephalocete- part of brain forms outside of skull - Anencephaly- absence of brain Neural tube forms in the first month of pregnancy, when most women do not know that they are pregnant CDC recommends 8.4 mg/day of women of childbearing age -Women largely didn't get the message - CDC pushes FDA for fortification - FDA changed definition of enriched grains to include folic acid Unintended consequences of folate fortification Improvement in stroke mortality Unmetabolized folic acid in blood decreased natural killer activity-may be cancer promoter antifolates used to treat cancer enhance effects of inadequate B12 status Lecture 3/12/08 Complex Emergencies What is a humanitarian emergency? An urgent situation in which there is clear evidence that there is human suffering Complex emergency: crisis where there is considerable breakdown of authority. Requires international
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