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Los niveles de ácido fólico en la población venezolana y su impacto en el área de salud pública
| Content Provider | Semantic Scholar |
|---|---|
| Author | Apitz-Castro, Rafael |
| Copyright Year | 2015 |
| Abstract | Los folatos, constituyen cofactores fundamentales para los procesos bioquimicos que conducen a la sintesis y eventual modificacion epigenetica de acidos nucleicos e histonas. Ademas, su metabolismo esta intimamente relacionado al metabolismo de la homocisteina. Se han descrito numerosas causas de mal funcionamiento del ciclo metabolico de folatos, la causa mas frecuente y quizas la mas relevante desde el punto de vista de salud publica es la deficiencia nutricional. El papel central del folato en la sintesis y posteriores modificaciones epigeneticas del material genetico, por una parte, asi como su relacion con la homeostasis de la homocisteina, lo han asociado a dos tipos de patologias de gran importancia en salud publica: a) Enfermedades cardiovasculares y b) Defectos del desarrollo embrionario. En la actualidad, su papel en el riesgo cardiovascular es sujeto de controversia ya que estudios clinicos poblacionales no lo respaldan, sin embargo, si existe evidencia clara de su papel en la aparicion de defectos del desarrollo embrionario, especificamente aquellos centrados en el tubo neural y el sistema cardio-circulatorio. Estas evidencias, llevaron a proponer diversos modelos programaticos en salud publica para prevenir y tratar a nivel poblacional el deficit nutricional de folatos. De los varios modelos ensayados, la fortificacion obligatoria de ciertos alimentos de consumo masivo ha demostrado ser el mas exitoso y es actualmente implementado en 54 paises a nivel mundial. En Venezuela, desde la decada del 2000 se ha demostrado experimentalmente una seria deficiencia nutricional de folato, que afecta a mas del 70% de la poblacion femenina en edad fertil. A pesar de los multiples llamados hechos a los responsables de las politicas de salud en el pais, Venezuela sigue siendo uno de los pocos paises en la region que no ha implementado un programa de fortificacion. Su implementacion no requiere de una fuerte inversion oficial, pero si debe ser acompanado de un programa eficiente de seguimiento que permita a) evaluar los beneficios y b) las posibles modificaciones en su implementacion. The folate cofactors are essential for the biochemical processes that lead to the eventual synthesis and epigenetic modification of histones and nucleic acids. In addition, their metabolism is closely related to homocysteine metabolism. While there have been described numerous causes malfunction folate metabolic cycle, the most common and perhaps the most important cause, from the point of view of public health, is nutritional deficiency. The central role of folate in the synthesis and subsequent epigenetic modifications of genetic material, on the one hand, and their relationship with the homeostasis of homocysteine, have been associated with two types of diseases of great public health importance: a) Cardiovascular Diseases b) Defects of embryonic development. Currently, its role in cardiovascular risk is the subject of controversy since this have not received support from population trials , however, there is clear evidence of their role in the onset of embryonic development defects, specifically those focused on the neural tube and the cardio-circulatory system. This evidence, led to propose different program models in public health, at the population level, to attack the nutritional deficit of folates. Of the several models tested, mandatory fortification of certain foods for mass consumption has proved the most successful and is currently implemented in 54 countries worldwide. In Venezuela, since the 2000s it has been shown, experimentally, a serious nutritional folate deficiency, which affects over 70% of the female population of childbearing age. Despite numerous appeals made to those responsible for health policies in the country, Venezuela remains one of the few countries in the region that has not implemented a program of fortification. Its implementation does not requires a strong government investment, but must also be accompanied by an effective monitoring program that allows a) evaluation of the potential benefits and b) support rational implementation of any necessary changes. |
| Starting Page | 21 |
| Ending Page | 27 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| Volume Number | 28 |
| Alternate Webpage(s) | http://www.scielo.org.ve/pdf/avn/v28n1/art04.pdf |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
