爱尔兰的经济对叶酸强化和NTDs的流行产生了巨大的影响。在凯尔特之虎的鼎盛时期，人们可以买到各种各样的食物，这些食物都是自愿添加的。公司经常这样做，作为一种营销策略，以提高价格，这表明在爱尔兰的NTDs水平下降。然而，当经济崩溃时，人们再也买不起这些强化品牌的谷物，大多数人避免购买更昂贵的强化谷物，或开始在Lidl和Aldi等更便宜的商店购物。这些公司没有加强他们的谷物，因为这将提高产品的价格给消费者。这些自有品牌的食品更便宜，也更受欢迎。一个人的首要任务是把食物放在餐桌上，他们不关心他们购买的产品的叶酸含量。华盛顿特区的一个研究小组的研究发现，随着购物趋势的改变和强化食品供应的减少，人群中ntd的数量也在增加。调查发现，当时一家主流超市有多达100种强化食品，而Lidl只有1种。FSAI于2015年发布报告称，面包/面粉中强制添加叶酸是降低爱尔兰出生缺陷率最有效的方法。尽管有专家的建议，卫生部长仍然只建议公司自愿加强其产品，妇女每天服用推荐的叶酸补充剂。社会经济背景较低的女性更有可能不遵循当前的指导方针，因此她们的孩子患新td的风险仍然较高。然而，人们可以理解爱尔兰强制性强化的延迟，因为人们担心向那些不需要叶酸的人(如老年人)提供过多的叶酸。FSAI公共卫生营养首席专家玛丽·弗林教授表示，自愿加强食物营养确实有助于减少受NTDs影响的怀孕率。“据估计,被忽略的风险约为11 - 14%低结果主动强化食品的消费,如即食早餐麦片,造成额外的平均每日摄入50 - 63µg育龄妇女叶酸”(FSAI, 2016)。根据nan,育龄妇女归入(18-50)平均每日摄入总叶酸260µg /天,叶酸189µg /天,叶酸强化食品和补品的52µg /天。然而，在这类女性中，78%的人食用强化食品，只有16%的人食用叶酸补充剂。吃补充剂和强化食品的人有明显的区别。在爱尔兰，通过强化食品可以显著降低罹患NTDs的风险。
加拿大护理学作业代写 叶酸强化和NTDs
The economy in Ireland has had a massive impact on folic acid fortification & the prevalence of NTDs. During the height of the Celtic tiger, people could buy a wide range of foods of which were fortified voluntarily. Companies often did this as a marketing ploy in order to increase prices, this showed a drop in the level of NTDs in Ireland. However, when the economy crashed people could no longer afford these fortified branded cereals and most avoided the more expensive fortified cereals or began to shop in cheaper shops such as Lidl and Aldi. These companies did not fortify their cereals, as it would have raised the price of the product for the consumer. These own brand foods were cheaper and became more popular. One’s priority was to put food on the table in these times, they were not concerned with the folic acid content of the products they were buying. A small team of researchers in D.C.U, found that there was a link between the increasing numbers of NTDs in the population with the change in shopping trends and the decreased availability of fortified foods. It was found that there were up to 100 fortified products in one mainstream supermarket at the time and only 1 in Lidl. The FSAI published in 2015, that the mandatory folic acid fortification of bread/flour is the most effective way of reducing Ireland’s rate of birth defects. Although despite this recommendation from the experts, the minister for health still only recommends that companies voluntarily fortify their products and women to take the recommended supplement of folic acid per day. Women from lower socioeconomic backgrounds are more likely not to follow current guidelines, therefore they are still left at a higher risk of their child developing an NTD. However, one can understand the delay in a mandatory fortification in Ireland as there are concerns with providing too much folic acid to those who don’t need it (e.g. elderly). Professor Mary Flynn, chief specialist in public health nutrition in the FSAI, stated that the voluntary fortification of foods does contribute to the reduction of pregnancies affected by NTDs. “It is estimated that the risk of NTDs is approximately 11-14% lower as a result of consumption of voluntarily fortified foods, e.g. ready-to-eat breakfast cereals, resulting from an additional average daily intake of 50-63 µg folic acid in women of childbearing age” (FSAI, 2016). According to NANS, women classed as a reproductive age (18-50) had median daily intakes of total folate of 260 µg/day, folate of 189 µg/day and folic acid from fortified foods and supplements of 52 µg/day. However, while 78% of women in this category consumed fortified foods, only 16% consumed folic acid supplements. There is a clear distinction between those who consume supplements and fortified foods. There is potential to significantly reduce the risk of NTDs in Ireland through the fortification of food.
