According to an editorial, one of the challenges to implementing compulsory fortification is choosing a level that will prevent NTDs without exposing population to excessive doses. The commentators note that current levels of fortification in US (140 µg folic acid/100 g enriched cereal grain) provide on average 163 µg/day to women of childbearing age, which has been highly successful in preventing folate related NTDs. As the current data indicate that the EU’s current strategy is failing to prevent many NTDs and mandatory fortification has been shown to work in many countries, with no important adverse effects identified to date, the commentators hope this study will prompt the relevant authorities in the EU to take a further look at the compulsory fortification option.