Chancellor’s Professor and Professor of Medicine Aśok C. Antony, MD, MACP, has been awarded a prestigious Fulbright-Nehru Distinguished Scholar Fellowship to continue his work on preventing neural tube defects in newborns in India. Antony, who is a member of the Division of Hematology/Oncology and the IU Simon Cancer Center, aims to do this by fortifying tea with two key vitamins that play a role in fetal development of the brain and spinal cord.
During a previous Fulbright Fellowship in India in 2001, Antony and his team discovered a very high incidence of neural tube defects among babies born in India—as many as 300 a day. These severe malformations of the brain and spinal cord occur within the first month of development in the womb. Many babies with neural tube defects do not survive long past birth; those who do are severely disabled.
Images of babies with neural tube defects
**Please note that these images may be disturbing.**
Fortunately, about seventy-five percent of the time, neural tube defects can be prevented by ensuring that women have adequate folate and vitamin B12 in their diets before they become pregnant. In the US and 80 other countries, this is achieved by fortifying centrally processed flour with folic acid, resulting in a dramatic reduction of the incidence of neural tube defects in babies.
“This is one of the great success stories in preventive medicine,” said Antony.
In India, however, this strategy doesn’t work.
According to Antony, seventy percent of the Indian population live in small villages where grain is grown and produced locally, bypassing any need for centrally processed fortified flour. This means that an alternative food source is needed for fortification, he said.
“Such a food vehicle needed to be widely acceptable, and one that could accommodate the marked dietary differences among Indians of every geographic, social, economic, and cultural diversity, and where there are widely distinct, ethnically-based food preferences,” he said.
That vehicle, Antony said, is the most popular beverage in India: tea.
As a Fulbright-Nehru Distinguished Scholar, Antony will build upon recent work in which he and his team demonstrated that Indian women with borderline or low folate and B12 stores who consumed a single cup of tea fortified with water-soluble vitamins eliminated their deficiencies (and reduced their rates of anemia) within just two months.
“Our plan is to standardize and scale up the fortification of loose tea with folate and vitamin B12” at factories in the states of Maharashtra and Assam, he said. Then, they will research whether this has an impact on the incidence of babies born with neural tube defects among underprivileged tea plantation workers. He and his team will also communicate with the Indian Ministry of Health, the Tea Board of India, and other key stakeholders to make them aware of their goals to make vitamin-fortified tea widely available throughout the country.
This realization of this ambitious plan has been long-awaited by Antony and admiring colleagues.
“I have had the privilege to observe Dr. Antony’s passion and persistence for the past 20 years on this important project,” said Rakesh Mehta, MD, Vice Chair for Education in the Department of Medicine. “I have greatly enjoyed hearing how he first identified this shockingly high incidence of neural tube defects in India, and then developed an innovative, yet simple and feasible, solution that should markedly reduce the number of these tragic events.”
