Director, Center for Spina Bifida Prevention at Emory University, Atlanta, GA, USA
24 October 2017
FFI: How did you become interested in nutrition?
Oakley: I am a birth defects prevention epidemiologist. When folic acid was proven to prevent two of the most common and severe birth defects-anencephaly and spina bifida - I knew that mass fortification of the food supply with folic acid, like vitamin D in milk, would improve the lives of thousands of families each year by preventing these birth defects.
FFI: What inspired you to become involved with food fortification?
Oakley: The power of fortification to totally prevent folic acid preventable spina bifida and anencephaly.
FFI: How is your country prioritizing fortification?
Oakley: We have mandatory folic acid fortification of all “enriched” cereal grains. This fortification has prevented almost all, if not all, of folic acid preventable spina bifida and anencephaly and saved our country, in health care cost alone, $10 billion since 1998. In addition, the fortification has eliminated folate deficiency, and folate deficiency anemia and may well have prevented some first ischemic strokes.
FFI: What are the main components to a successful fortification program where you live?
Oakley: It is mandatory, so no behavior has to change to get the prevention done.
FFI: What are the greatest challenges you have encountered in planning or implementing fortification programs? And how did you address those challenges?
Oakley: The biggest challenge is that some gate keepers in regulatory, academic, and nutrition communities do not value fortification and actively try to keep it from happening. It took nearly five years to get the US Food and Drug Administration to require fortification when we had randomized controlled trial proof that folic acid would prevent these serious birth defects. We need to find a way to be as timely and successful as the vaccine people are at getting all children vaccinated with a new vaccine is available.
FFI: Would you like to share anything else?
Oakley: I think it is important for those who want to prevent child mortality to know that fortifying with folic acid and consequently preventing these birth defects makes a substantial contribution to helping the world reach its Sustainable Development Goals by 2030. This is a very much under-appreciated fact.