Health In Focus
  • Folic acid intake during pregnancy prevents birth defects of the brain and spine in an unborn baby.
  • The diet of Hispanic mothers does not contain sufficient amounts of folic acid.
  • FDA recommends adding folic acid in corn masa flour which is used to make staple food for Mexicans to prevent neural tube defects.
Folic acid is believed to prevent neural tube defects like anencephaly and spina bifida and is added to cereal grains for fortification. According to Center for Disease Control (CDC), Hispanics still produce babies with these birth defects. The main cause of this may be that the staple diet of these women is based on foodstuffs made out of corn masa flour. Therefore, Food and Drug Authority (FDA) has approved the addition of folic acid to this flour, also known as masa, Spanish for dough.

Folic Acid and Pregnancy

Folic acid is a vitamin of the B-complex series. It helps the body in the production of red blood cells, and the synthesis and repair of DNA. When taken during pregnancy, it helps in the cell growth of the placenta as well the developing baby in the womb.
FDA Approves Addition of Folic Acid to Corn Masa Flour to Prevent Birth Defects in Hispanic Population
FDA Approves Addition of Folic Acid to Corn Masa Flour to Prevent Birth Defects in Hispanic Population

Folic acid is also required for the proper closure of the neural tube in the unborn baby as DNA biosynthesis and methylation reactions which are required for this process are dependent on folic acid. An insufficiency of the same therefore leads to neural tube defects which manifest as anencephaly (neural tube fails to close at the head end, resulting in the absence of scalp and some part of the brain) or spina bifida (neural tube fails to close at the tail end, resulting in underdeveloped spinal cord and backbone).

These birth defects occur between 20-28 days of conception and women usually do not even know by that time that they are expecting. The CDC, thus, recommends that women must start taking folic acid at least a month before they are planning to conceive and all through the first trimester. This reduces the incidence of these birth defects by up to 70%.

Many pregnancies are unplanned. Keeping this in mind, CDC recommends all women of the child-bearing age to ensure an intake of 400 mcg of folic acid daily. It may be taken through a multivitamin supplement prescribed by a doctor or through diet.

Folic acid is also known to lower the incidence of other birth defects like cleft lip, cleft palate, and defects of the heart.

In 1998, FDA recommended the addition of folic acid to enriched cereal grains (rice and flour) and enriched cereal grain products (bread and macaroni). Many of the cereal grain products now contain the whole Recommended Daily Allowance (RDA) in a single serving. The rationale behind it was that cereal grains and cereal grain products are routinely consumed by the majority of the population, including pregnant women. This would ensure intake of folic acid in pregnancy. This actually resulted in a significant lowering of the incidence of birth defects in most populations.

The Need to Add Folic Acid in Corn Masa

Hispanic women are 20% more likely to give birth to babies with neural tube defects than non-Hispanic women. "Many Hispanic women don't benefit from the folic acid in cereal grain products because those products are not a mainstay of their regular diets - which often are corn masa-based," said Jonca Bull, Director of the FDA Office of Minority Health.

The staple food of Mexican and Central and South American diets consists of tortillas, tacos, and tamales. These items are made up of corn masa flour which is prepared by cooking corn in alkali and then grinding it into a powder.

The AAP (American Academy of Pediatrics), Spina Bifida Association, National Council of La Raza, March of Dimes Foundation, Royal DSM N.V., and the Gruma Corporation petitioned to the FDA for the addition of folic acid to corn masa flour. FDA ensured the safety of the vitamin for pregnant women as well as the rest of the population by conducting a scientific review. It also verified the stability of the compound during the production process. Once it was completed, FDA approved the addition of folic acid to fortify corn masa flour in a quantity up to 0.7 mg per pound of masa flour.

Though there is not much data available from other countries who have fortified corn masa flour with folic acid regarding the incidence of birth defects, yet the significant reduction in the incidence of neural tube defects in the USA after enriching cereal grains/products, it sounds rational that this step may have a similar result.

The five organizations that filed a petition for the addition of folic acid in masa flour are thrilled at the announcement and believe that it shall address and remove the ethnic disparity and offer a healthy life to Hispanic mothers and babies.

References :
  1. Adding Folic Acid to Corn Masa Flour May Prevent Birth Defects
  2. Cereals that Contain 100% of the Daily Value (DV) of Folic Acid
  3. Coalition Petitions FDA to Fortify Corn Masa Flour With Folic Acid
  4. Fortification of Corn Masa Flour With Folic Acid in the United States
Source: Medindia

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