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October 2005 Folic acid fortification of grain foods has produced a one-third decline in serious birth defects of the brain and spine, according to a study, but the March of Dimes urged federal officials to require higher levels of the B vitamin to spare even more babies. A team of researchers led by Laura J. Williams, MPH, of the National Center on Birth Defects and Developmental Disabilities at the CDC, reported that folic acid fortification accounted for a 36% decline in neural-tube defects (NTD) in the Hispanic population and a 34% drop among the white, non-Hispanic population between 1995 and 2002. The prevalence of NTD in the black, non-Hispanic population did not decrease significantly, the CDC researchers said. In an accompanying editorial, Robert L. Brent, MD, PhD, and Godfrey P. Oakley Jr., MD, MSPM, called on the FDA to at least double the amount of folic acid required in enriched grain foods (currently set at 140 µg of folic acid per 100 grams of grain). They also urged the FDA to require grain suppliers to add vitamin B12 to enriched products to optimize health effects from fortification. The researchers also urged the manufacturers of corn flour to make all their products enriched with folic acid to prevent more NTD among Hispanic babies. The March of Dimes restated its longtime position in response to two articles published recently in Pediatrics. “It’s so rare that we get the opportunity to save thousands of babies from being born with a disabling or fatal birth defect with such a simple, low-tech means as folic acid fortification,” Jennifer L. Howse, MD, president of the March of Dimes, said in a statement. “Studies have shown that adequate daily folic acid intake beginning before pregnancy can reduce the incidence of these tragic birth defects by up to 70%, and we should not settle for anything less than maximum prevention.” Since 1996, the March of Dimes has recommended that the FDA set the level of folic acid required in enriched grain foods at 350 µg per 100 grams of grain to prevent as many NTD as possible, according to Howse. Before fortification, NTD affects about 4,000 pregnancies annually, some of which result in miscarriage or stillbirth. Currently, about 1,000 fewer babies annually develop one of these devastating conditions in which the neural tube fails to close properly before birth. To help prevent NTD, March of Dimes officials noted, all women capable of becoming pregnant should consume a multivitamin with at least 400 µg of folic acid every day starting before pregnancy, as part of a healthy diet containing foods fortified with folic acid and foods that naturally contain folic acid, such as leafy green vegetables and beans. Daily consumption is crucial because NTD occur in the early weeks following conception, often before a woman knows she is pregnant. For more information: |
