The Food and Drug Administration is considering a petition that could benefit Hispanic women by allowing the addition of folic acid, or folate, to the corn flour — a staple in many Latino foods — to help reduce birth defects.
Pregnant Hispanic women are more likely to have children with neural tube defects than other women, new research suggests
“Most of the Hispanic women … don’t eat the wheat flour products that the more acculturated Hispanic women and the non-Hispanic white women are prone to eat,” said Dr. Alan Fleischman, a pediatrics professor at the Albert Einstein College of Medicine.
Instead, they eat foods made from masa corn flour, the main ingredient in tortillas and tamales.
The March of Dimes and other groups recently petitioned the FDA to let manufacturers add folate to masa. The petition asks only for the FDA to allow, rather than require, the fortification.
Immigrant women aren’t benefiting from the 15-year-old regulation that’s widely credited with reducing neural tube defects like spina bifida, according to Dr. Mary Gamble at Columbia University's Mailman School of Public Health.
“Folate deficiency is a well-established risk factor for neural tube defects,” Gamble said, “and we do know that fortification of the food supply in the U.S. has virtually eliminated folate deficiency.”
Since the FDA began requiring companies to add folate to most grain products, this group of birth defects has declined by about a third – from 4,500 cases a year in the U.S. to 3,000.
Pregnant women could also get folate from vitamins — but many women don't know they're pregnant for several weeks after conception, and by then taking supplements probably won't reduce the risk of spina bifida and other defects, because by then the neural tube is already closed.
“Some people think, 'When I get pregnant, I'll change all my behaviors — I'll stop drinking, I'll stop smoking, I'll start taking my vitamin,'” said Dr. Siobhan Dolan, an obstetrician and geneticist at Montefiore Hospital in the Bronx.
“ The truth is that those interventions are most effective, if they're undertaken before you get pregnant, so we need to keep backing up the messages for women.”
Americans have been fortifying milk with Vitamin D for about a century, Dr. Fleischman said, which has all but eliminated the disease rickets, which is caused by a deficiency of the vitamin.