Fortifying corn flour with folic acid could cut Hispanic birth defects

Corn masa flour is made from specially treated corn and used to make products common in Latin American diets such as corn tortillas and tamales.

Fortification of enriched cereal grains, such as bread and pasta, with folic acid was has been mandatory for 13 years. Since it was mandated by the Food & Drug Administration (FDA), the rate of birth defects of the brain and spine known as neural tube defects (NTDs), which include spina bifida and anencephaly, has fallen by nearly one-third.

But about 3,000 pregnancies in the US still are affected by NTDs each year. Women of Hispanic origin are about 20 percent more likely to have a child with an NTD than non-Hispanic white women, according to the National Birth Defects Prevention Network.

The reasons for this are poorly understood but Hispanic women have been found to have lower intake of folic acid overall compared with non-Hispanic white women.

Success story​

Alan Fleischman, lead author of the commentary, said: “Fortification of cereal grains with folic acid in 1998 is a public health success story. Adding this B vitamin to corn masa flour will build on that initiative and begin to address the disparities in these birth defects.​

“Despite the fact that fortification has given thousands of babies a healthy start in life, it is imperative we address this serious health problem in the Hispanic community. Public health officials and businesses must work together to expand the success of folic acid fortification to corn masa and to the Hispanic community in the US​.”

Targeting traditional Hispanic food made with corn masa for folic acid fortification, would lower the rate of NTDs among Hispanics, particularly Mexican-Americans, said Fleischman.

Folic acid taken before conception and during early pregnancy has been shown to reduce the rate of NTDs.

FDA approval is needed in order for corn masa flour products to be fortified with folic acid.

A number of Latin American countries, such as Chile, Costa Rica, and Mexico already fortify their food products with folic acid.

Infant mortality​

The commentary, entitled Fortification of Corn Masa Flour with Folic Acid in the U.S​, was submitted on behalf of the March of Dimes; a nonprofit organization for pregnancy and baby health. The organization works to improve the health of babies by preventing birth defects, premature birth and infant mortality.

Fleischman is medical director for March of Dimes.

Meanwhile, in 2009 the US Census Bureau estimated the US Hispanic population at 48.4m, making it the nation's largest ethnic minority.

Hispanics constituted 16 percent of the nation's total population.

By 2050, the Hispanic population is forecast to reach 132.8m or about 30% of the nation's total population.

Nearly half (47 per cent) of the US Hispanic population lived in either California (13.7m) or Texas (9.1m).