Physicians and child health advocacy organizations, including the March of Dimes, Spinal Bifida Association, the National Council of La Raza and the American Academy of Pediatrics mark a victory in the fight against birth defects with the April 14 FDA decision to get corn masa harina flour fortified with folic acid to help prevent serious birth defects.
“Fortifying grains with folic acid has been a tremendously successful intervention in promoting healthier pregnancies and preventing birth defects, leading to a one-third decline in neural tube defects,” said American Academy of Pediatrics President Benard Dreyer, MD, FAAP. Because of the FDA’s action, he said mothers and young children will be healthier and safer as a result.
Dr. Stephen Braddock, director of the division of Medical Genetics at Saint Louis University School of Medicine, said earlier studies have shown that providing additional folic acid/folate decreased the recurrence rate of spina bifida/neural tube defects by dramatic amounts.
“In 1992 the US Public Health Service recommended that all women who could potentially become pregnant should consume 400 micrograms of folic acid daily to prevent birth defects,” Braddock said.
Folate, or Vitamin B9, is an essential vitamin not produced by the body. Folate in its natural form is found in foods, whereas folic acid is the synthetic supplement for folate.
“By fortifying our flour/grains, one can assure that women of reproductive age will at least receive a minimum amount of folic acid,” Dr. Braddock explained. “As half of all pregnancies are unplanned and many women do not realize that they are pregnant until well after the neural tube closes (by 28 days post conception = 14 days post missed period). Fortification is necessary so that all children have the full benefit rather than relying on all of these women to take a daily supplement.”
For most U.S. residents of Mexican and Hispanic descent, corn tortillas are a staple food. Groups have been petitioning and commissioning new research to get fortification of corn masa flour products.
March of Dimes President Dr. Jennifer L. Howse said the decision represents a major victory for maternal and child health, especially in Hispanic communities.
“The FDA’s decision will prevent numerous cases of devastating birth defects like Spina Bifida,” Howse stated. “The March of Dimes and our partners applaud the FDA for moving forward with this vital public health effort.”
In addition to reducing the incident of neural tube defects, reducing folic acid deficiency may have other health benefits.
“It is now believed that folic acid supplementation decreases the incidence of cleft lip and palate, congenital heart defects, and possibly premature delivery (and thus the many medical morbidities associated with prematurity),” added Dr. Braddock, a pediatrician at Cardinal Glennon Children’s Hospital. “However, the data on these latter examples is still not as strong as that for neural tube defects.”
Gruma Corporation is the world´s largest producer of corn masa flours and tortillas. When the National Council of La Raza reached out Gruma to support folic acid fortification aimed at reducing risks of neural tube defects within Mexican and Hispanic populations living in the USA, the company immediately responded favorably.
“Latinos are disproportionately affected by Spina Bifida and other neural tube defects. The scientific evidence that the major cause of this disparity is the absence of fortification of corn flour products is convincing,” stated Charles Kamasaki, senior cabinet advisor at NCLR.
Rates of neural tube defects vary by racial and ethnic background. For example, Spina Bifida affects 2.73 per 10,000 live births among non-Hispanic blacks or African-Americans, 3.09 per 10,000 live births among whites, and 3.80 per 10,000 live births among Hispanics.
In many other nations where corn masa flour is a major part of the diet, governments have encouraged and endorsed fortification with folic acid to reduce neural tube defects.
