The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines include recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or interferes with healthy behaviors. Community efforts are essential to create a social environment that promotes healthy food choices and physical activity. Therefore, this committee presents one key recommendation for community action to accompany the four recommendations for individual choices to reduce cancer risk. This recommendation for community action recognizes that a supportive social environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the Department of Health and Human Services' 2005 Dietary Guidelines for Americans.

http://www.iacld.ir/DL/elm/ajcguidelinesonnutritionandphysicalactivityforcancerprevention.pdf

American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer with Healthy Food Choices and Physical Activity

Food and Agricultural Organization of the United Nations PA N I S F I A T G u id e in e s o n fo o d fo r tific atio n w th m ic r o n u tr ie n ts Interest in micronutrient malnutrition has increased greatly over the last few years. One of the main reasons is the realization that micronutrient malnutrition contributes substantially to the global burden of disease. Furthermore, although micronutrient malnutrition is more frequent and severe in the developing world and among disadvantaged populations, it also represents a public health problem in some industrialized countries. Measures to correct micronutrient deficiencies aim at ensuring consumption of a balanced diet that is adequate in every nutrient. Unfortunately, this is far from being achieved everywhere since it requires universal access to adequate food and appropriate dietary habits. Food fortification has the dual advantage of being able to deliver nutrients to large segments of the population without requiring radical changes in food consumption patterns.

Guidelines on food fortification with micronutrients

The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and, ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published approximately every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and they reflect the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines focus on recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or creates barriers to healthy behaviors. Therefore, this committee presents recommendations for community action to accompany the 4 recommendations for individual choices to reduce cancer risk. These recommendations for community action recognize that a supportive social and physical environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the 2010 Dietary Guidelines for Americans and the 2008 Physical Activity Guidelines for Americans. CA Cancer J Clin 2012. © 2012 American Cancer Society.

https://acsjournals.onlinelibrary.wiley.com/doi/epdf/10.3322/caac.20140

American Cancer Society guidelines on nutrition and physical activity for cancer prevention

Background: Measurement of plasma total homocysteine has become common as new methods have been introduced. A wide range of disorders are associated with increased concentrations of total homocysteine. The purpose of this review is to provide an international expert opinion on the practical aspects of total homocysteine determinations in clinical practice and in the research setting and on the relevance of total homocysteine measurements as diagnostic or screening tests in several target populations. Methods: Published data available on Medline were used as the basis for the recommendations. Drafts of the recommendations were critically discussed at meetings over a period of 3 years. Outcome: This review is divided into two sections: (a) determination of homocysteine (methods and their performance, sample collection and handling, biological determinants, reference intervals, within-person variability, and methionine loading test); and (b) risk assessment and disease diagnosis (homocystinuria, folate and cobalamin deficiencies, cardiovascular disease, renal failure, psychiatric disorders and cognitive impairment, pregnancy complications and birth defects, and screening of elderly and newborns). Each of these subsections concludes with a separate series of recommendations to assist the clinician and the research scientist in making informed decisions. The review concludes with a list of unresolved questions.

/pdf/facts-and-recommendations-about-total-homocysteine-23jbkelsns.pdf

Facts and Recommendations about Total Homocysteine Determinations: An Expert Opinion

Epidemiology of mucopolysaccharidoses

ContextDaily consumption of 400 µg of folic acid before conception and
during early pregnancy dramatically reduces the occurrence of neural tube
defects (NTDs). Before food fortification, however, only an estimated 29%
of US reproductive-aged women were taking a supplement containing 400 µg
of folic acid daily. The US Food and Drug Administration authorized addition
of folic acid to enriched grain products in March 1996, with compliance mandatory
by January 1998.ObjectiveTo evaluate the impact of food fortification with folic acid on NTD
birth prevalence.Design, Setting, and PopulationNational study of birth certificate data for live births to women in
45 US states and Washington, DC, between January 1990 and December 1999.Main Outcome MeasureBirth certificate reports of spina bifida and anencephaly before fortification
(October 1995 through December 1996) compared with after mandatory fortification
(October 1998 through December 1999).ResultsThe birth prevalence of NTDs reported on birth certificates decreased
from 37.8 per 100 000 live births before fortification to 30.5 per 100 000
live births conceived after mandatory folic acid fortification, representing
a 19% decline (prevalence ratio [PR], 0.81; 95% confidence interval [CI],
0.75-0.87). During the same period, NTD birth prevalence declined from 53.4
per 100 000 to 46.5 per 100 000 (PR, 0.87; 95% CI, 0.64-1.18) for
women who received only third-trimester or no prenatal care.ConclusionsA 19% reduction in NTD birth prevalence occurred following folic acid
fortification of the US food supply. However, factors other than fortification
may have contributed to this decline.

/pdf/impact-of-folic-acid-fortification-of-the-us-food-supply-on-5gjpyz41i7.pdf

Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Defects

Background The objective is to study racial differences in infant mortality attributable to birth defects (IMBD) in the United States. Methods We analyzed 1989-1991 and 1995-2002 linked birth/death files for trends and racial differences in IMBD by selected categories of birth defects for infants of non-Hispanic white, non-Hispanic black, and Hispanic mothers. Results In 1989-2002, the IMBD rates declined. However, the decline in postneonatal mortality attributable to birth defects (PMBD) rate was significantly slower than that of overall postneonatal mortality. The adjusted rate ratio for non-Hispanic black and Hispanic versus non-Hispanic white for neonatal mortality attributable to birth defects (NMBD) remained unchanged from 1989-1991 through 2000-2002. For PMBD, it increased from 0.97 (95% confidence interval [CI], 0.90-1.13) in 1989-1991 to 1.12 (95% CI, 1.04-1.21) in 2001-2002 and from 1.08 (95% CI, 1.00-1.16) to 1.18 (95% CI, 1.10-1.27) for non-Hispanic black and Hispanic, respectively. Infant mortality due to cardiovascular and central nervous system defects were the main contributors to the increased racial disparities in PMBD rates. Conclusions The disparity in PMBD between infants of non-Hispanic black and Hispanic mothers and infants of non-Hispanic white mothers increased significantly from 1989-1991 to 2000-2002. Further studies are needed to assess the extent to which delays in care or lack of access to care for infants with birth defects might be contributing to the disparity in IMBD.

Racial differences in infant mortality attributable to birth defects in the United States, 1989-2002.

Spina bifida and anencephaly are serious birth defects. To reduce the occurrence of these birth defects, the Food and Drug Administration authorized the fortification of all enriched cereal grain products with folic acid in March 1996, with compliance mandatory by January 1998. This report reviews data reported to CDC's National Center for Health Statistics (NCHS) regarding spina bifida and anencephaly prevalence for live births in the United States during 1991-2001. Since 1989, NCHS has compiled birth defect data from checkboxes that appear on birth certificates. For consistency in trends, this report uses data for 1991-2001 from all U.S. reporting areas except Maryland, New Mexico, and New York. Data for 2001 are preliminary. During 1996-2001, a 23% decline occurred in neural tube defects (spina bifida and anencephaly combined). Spina bifida declined 24% during this period, and anencephaly declined 21%. The United States has experienced declines in spina bifida and anencephaly cases since folic acid fortification of all enriched cereal grain products. The observed declines have translated into approximately 920 infants being born without these serious defects each year. Continued monitoring of the occurrence of spina bifida and anencephaly will be necessary to evaluate the effectiveness of folic acid fortification.

T. J. Mathews

Papers

Impact of Folic Acid Fortification of the US Food Supply on the Occurrence of Neural Tube Defects

Racial differences in infant mortality attributable to birth defects in the United States, 1989-2002.

Spina bifida and anencephaly prevalence--United States, 1991-2001.

Impact of Folic Acid Fortification of the U.S. Food Supply on the Occurrence of Neural Tube Defects