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Fortifying cereal, flour and other foods with folic acid prevents about 1,300 babies from being born with defects such as spina bifida each year, state and federal health officials said Thursday.
But there’s room to save many more, especially babies born to Hispanic women, they said in a report issued by the Centers for Disease Control and Prevention.
Folic acid is a B vitamin found in leafy green vegetables, beans and fruit. It helps cells grow and if a pregnant woman doesn’t have enough folic acid, her baby can be born with severe birth defects such as spina bifida, when the spinal column doesn’t form correctly, or anencephaly, which means the baby doesn’t have a fully formed brain.
They’re referred to as neural tube defects, because the damage is done early in pregnancy, when the brain and spine are still forming.
So since 1998, the Food and Drug Administration has required that folic acid be added to most enriched bread flours, cornmeal, pasta, rice, and other grain products in the U.S. and Canada. It’s raised average folic acid intakes by about 100 micrograms a day and cut the number of children born with a neural tube defect by 25 to 50 percent.
It may have protected other people, too. Studies suggest folic acid also helps protect against stroke and heart disease.
CDC and state health officials wanted to update the numbers to see if there’s room for improvement, so they looked at data from 19 state programs going up to 2011. They compared this to the total number of new births, which is just around 4 million a year.
“The number of births occurring annually without neural tube defects that would otherwise have been affected is approximately 1,326,” the state-federal team wrote in the CDC’s weekly report on death and disease.
“Fortification led to a decrease in the prevalence of serum folate deficiency from 30 percent to less than 1 percent.”
“Folate deficiency in the United States effectively disappeared,” Sarah Tinker, an expert on birth defects at the CDC, told TODAY.
There’s room for improvement. Nearly 22 percent of U.S. women of childbearing age still don’t have enough folate in their blood to prevent neural tube birth defects. Women need to get their levels up even if they are not actively trying to get pregnant, because the most important time of development is within the first few weeks after conception, when a woman might not realize she is pregnant.
Rates of these preventable birth defects went down among all ethnic groups, but Hispanics lagged. There may be a couple of reasons for this. “They tend to eat fewer enriched cereal products that have folic acid,” said CDC birth defect expert Jennifer Williams.
Hispanic people also may carry a genetic change that makes it harder for the body to use folic acid.
A second study looked at women who had babies with a neural tube defect. Some had healthy babies the second time, while others were unlucky enough to have a second baby with a neural tube birth defect. Eighty percent of the moms who had a healthy baby the second time were taking supplements while pregnant, compared to just 35 percent of the mothers with a second affected baby.
It’s not clear why, Tinker said. Many women may not be getting good health care, because any doctor taking care of a pregnant woman should be advising her to take a special supplement.
Women who have had one baby with a neural tube defect should be taking a super-strong folic acid supplement — one containing 4 milligrams a day, or 10 times the recommended daily intake, Tinker said.
Health officials are considering a policy that would add folic acid to masa, a type of corn flour used in Hispanic cooking. It’s used to make corn tortillas, tamales, pupusas and other popular Latin American staples.
“Implementation of corn masa flour fortification would likely prevent an additional 40 cases of neural tube defects annually,” the researchers said.
CDC recommends getting 400 micrograms of folic acid a day. Foods naturally rich in folic acid include lentils, spinach, black beans, broccoli and orange juice.