RML MAINS 2025
Applied Nutrition & Dietetics
Easy
To prevent Neural Tube Defects (NTDs), which fortified food is given as part of national nutrition programs?
Appeared in: RML MAINS 2025
Explanation
- Folic acid (Vitamin B9) is critical for the synthesis of DNA and other essential biochemical reactions required for the proper closure of the neural tube in the first few weeks of fetal development.
- A deficiency in maternal folic acid levels before and during early pregnancy is strongly correlated with an increased incidence of Neural Tube Defects (NTDs), such as spina bifida and anencephaly.
- To ensure adequate intake for women of childbearing age, national public health programs mandate the fortification of staple cereal grains, including rice, flour, and pasta, with folic acid.
Why Other Options Were Wrong
- Option B: Iodine is essential for thyroid hormone synthesis. Fortifying salt with iodine is a strategy to prevent Iodine Deficiency Disorders (IDD), which include goiter and cretinism (impaired neurological function), not NTDs.
- Option C: Calcium is vital for bone and teeth formation and mineralization. It does not have a direct role in the closure of the neural tube.
- Option D: Vitamin A is crucial for vision, immune function, and cell growth. Fortification of foods like oil and milk with Vitamin A is done to prevent Vitamin A Deficiency (VAD), which can cause night blindness and increase susceptibility to infections.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Nutritional Fortification for Disease Prevention as background academic context rather than a clinical decision trigger.
- Nurses have a key responsibility to provide pre-conceptional counseling to all women of childbearing age about the importance of adequate folic acid intake (at least 400 mcg daily) to prevent NTDs.
- This education is a cornerstone of primary prevention, as the neural tube closes very early in pregnancy, often before a woman is aware she is pregnant.
- What if? If a woman has a personal or family history of a pregnancy affected by an NTD, the standard recommendation changes. She should be advised to take a much higher dose of folic acid (e.g., 4 mg daily) starting at least one month before conception and continuing through the first trimester, under medical supervision.
How to Approach the Question
- First, identify the core concept of the question, which is the prevention of a specific condition: 'Neural Tube Defects (NTDs)'.
- Recall the specific micronutrient that is scientifically proven to prevent this condition. The link between folic acid deficiency and NTDs is a fundamental topic in maternal and child health.
- Analyze the options provided. Each option pairs a nutrient with a fortified food.
- Select the option that correctly pairs the nutrient (folic acid) with a common food vehicle used in national fortification programs (rice/cereal grains).
- Eliminate the other options by recalling the primary purpose of their respective fortifications (Iodine for goiter, Calcium for bones, Vitamin A for vision).
Concept Tested & Keywords
- Concept Tested: Nutritional Fortification for Disease Prevention
- Stem keywords: Neural Tube Defects (NTDs), prevent, fortified food, national nutrition programs
- Lead-in keywords: which
- Negative lead-in flag: false
Question ID
q1Lpk04AROcXla-Sjkr2K
Reference Book
E6 Pharmacology Katzung 16e p. 935-937
E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1367-1369
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1036-1038
Practise the full RML MAINS 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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