Fortification of enriched cereal grains such as bread and pasta with folic acid was mandated by the Food & Drug Administration (FDA) beginning in 1998. Since then, the rate of birth defects of the brain and spine known as neural tube defects (NTDs), which include spina bifida and anencephaly, has decreased by nearly one-third.
However, despite this success, about 3,000 pregnancies in the United States still are affected by NTDs annually and Hispanics have the highest rate when compared to other race or ethnic groups.
"Fortification of cereal grains with folic acid in 1998 is a public health success story. Adding this B vitamin to corn masa flour will build on that initiative and begin to address the disparities in these birth defects," said Alan R. Fleischman, MD, March of Dimes medical director and lead author of the commentary. "Despite the fact that fortification has given thousands of babies a healthy start in life, it is imperative we address this serious health problem in the Hispanic community. Public health officials and businesses must work together to expand the success of folic acid fortification to corn masa and to the Hispanic community in the US. "
Corn masa flour is made from specially treated corn and used to make products common in Latin American diets such as corn tortillas and tamales. Dr. Fleischman writes that by targeting traditional Hispanic food made with corn masa for folic acid fortification, it would be possible to lower the rate of NTDs among Hispanics, particularly Mexican-Americans. Studies have shown that folic acid works if taken before conception and during early pregnancy.
Hispanic women are about 20 percent more likely to have a child with an NTD than non-Hispanic white women, according to the National Birth Defects Prevention Network. Although the reasons for the disparity is not well understood, Hispanic women have been found to have lower intake of folic acid overall compared to non-Hispanic white women.
In order for corn masa flour products to be fortified with folic acid, approval of the Food and Drug Administration is needed. Many countries in Latin America interested in public health measures known to prevent neural tube defects already fortify their food products with folic acid, including Chile, Costa Rica, and Mexico. This safe and effective public health intervention can successfully decrease birth defects.
The commentary "Fortification of Corn Masa Flour with Folic Acid in the U.S." was published online today by the American Journal of Public Health