Folic acid fortification of grain foods has produced a one-third decline in serious birth defects of the brain and spine, but the March of Dimes urged federal officials to help spare a greater number of babies from these devastating conditions by requiring higher levels of the B vitamin.
The March of Dimes restated its longtime position in response to two articles published today 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," says Dr. Jennifer L. Howse, president of the March of Dimes. "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 percent, and we should not settle for anything less than maximum prevention."
Since 1996, the March of Dimes has recommended that the U.S. Food and Drug Administration set the level of folic acid required in enriched grain foods at 350 micrograms per 100 grams of grain to prevent as many neural tube defects (NTDs) as possible, said Dr. Howse.
A team of researchers led by Laura J. Williams, M.P.H., of the National Center on Birth Defects and Developmental Disabilities at the U.S. Centers for Disease Control and Prevention (CDC) reported that folic acid fortification accounted for a 36 percent decline in NTDs in the Hispanic population and a 34 percent drop among the white, non-Hispanic population between 1995 and 2002. The prevalence of NTDs in the black, non-Hispanic population did not decrease significantly, the CDC researchers said.
In an accompanying editorial, Robert L. Brent, M.D., Ph.D., and Godfrey P. Oakley, Jr., M.D., MSPM, call on FDA to at least double the amount of folic acid required in enriched grain foods (currently set at 140 micrograms of folic acid per 100 grams of grain). They also urged FDA to require grain suppliers to add vitamin B12 to enriched products to optimize health effects from fortification. The authors also urged the manufacturers of corn flour to make all their products enriched with folic acid, in order to prevent more NTDs among Hispanic babies.
Dr. Howse said the March of Dimes also supports the idea of enriching corn flour with folic acid to help prevent more NTDs among Hispanics and other populations for whom corn products are a dietary staple.