Folic acid has long been linked to a lower risk of spina bifida and
anencephaly, birth defects of the brain and spinal cord that can
develop early in pregnancy, often before women know they have
conceived. In 1996, the U.S. Food and Drug Administration (FDA)
required all enriched cereal grains - but not corn masa flour - to
be fortified with folic acid. Fortification of corn masa flour
became permissible but not mandatory in 2016.
In December 2017, researchers analyzed corn masa and corn tortilla
products in 11 grocery stores in northeast Atlanta that cater to
Hispanic residents. Only two of 20 corn masa flour products, and
none of the 21 soft corn tortilla products, were labeled as
containing folic acid, the researchers report in JAMA.
"If what we found in the Atlanta market is true nationwide - and we
think it is, because we tested national brands - this means folic
acid is not reaching the intended population - that being many
Hispanic people who consume foods made with corn masa flour," said
senior study author Dr. Godfrey Oakley Jr., director of the Center
for Spina Bifida Prevention at the Emory University Rollins School
of Public Health in Atlanta.
"This is needed to reduce the two-fold increase in occurrence of
neural tube defects, such as anencephaly and spina bifida, in babies
born to Hispanic mothers compared to other racial and ethnic groups
in the U.S.," Oakley said by email.
The best way for women to prevent these birth defects is to only buy
grain products that contain folic acid, and to also take prenatal
vitamins containing at least 400 micrograms of folic acid daily,
whether or not they are planning pregnancy, Oakley advised.
"Taking prenatal vitamins after the pregnancy test comes out
positive is too late to prevent neural tube defects," Oakley said.
"One has to have folic acid before pregnancy and in the first four
weeks of pregnancy for preventing neural tube defects."
[to top of second column] |
Hispanic women are less likely than other women to take prenatal
vitamins, and also less likely to consume enriched cereals that must
contain folic acid, Oakley and colleagues note.
The study results suggest that voluntary regulations allowing
fortification of corn masa flour and tortillas may not be having the
desired impact of reducing birth defects, the study authors
conclude.
The study wasn't a controlled experiment designed to prove whether
or how enriching corn masa flour and tortillas might directly alter
the amount of folic acid women consume or impact their risk of
having babies with birth defects. It's also possible that products
in Atlanta grocery stores might not reflect what shoppers would find
in other parts of the country.
Still, the benefits of folic acid are clear, said Alina Flores, a
scientist with the National Center on Birth Defects and
Developmental Disabilities at the U.S. Centers for Disease Control
and Prevention.
"Getting the recommended daily amount of folic acid can help reduce
a woman's risk of having a baby born with a neural tube defect,"
Flores, who wasn't involved in the study, said by email.
"Hispanic women remain at higher risk for having a neural tube
defect-affected birth than non-Hispanic white or black women,"
Flores added. "Adding folic acid to corn masa flour will provide an
additional avenue by which Hispanic women can get the recommended
400 micrograms of folic acid."
SOURCE: http://bit.ly/2OxEKnC JAMA, online October 16, 2018.
[© 2018 Thomson Reuters. All rights
reserved.] Copyright 2018 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content.
|