A study has found that ever since grains and cereals in the United States were fortified with folic acid from 1998 onwards, the rate of spina bifida and anencephaly birth defects have gone down by one-third.
The study, a joint effort by the Centers for Disease Control and Prevention (CDC) and the University of Alabama, reviewed birth patterns in 21 states between 1995 and 2002 and saw that there was ‘significant decreases in the prevalence of spina bifida and anencephaly’ after the foods were fortified. While spina bifida leads to spine damage in the newborn, anencephaly results in a child having a malformed brain. Both are caused when an embryo’s neural tube, which later forms brain, skull and spine, does not close properly during the first weeks of conception.
The study, which took into account more than 11 million births, found 4,468 cases of spina bifida and 2,625 cases of anencephaly. However, after cereals and grains were fortified with folic acid, spina bifida went down by 36 per cent in Latino children and by 34 per cent in non-Latino white births. Similar results were noted for anencephaly.
However, not much change was noted in the rate of the two neural disorders in children born to African American women. “Educational efforts regarding the importance of consumption of folic acid-containing supplements and food high in folic acid and natural folate among women of all racial and ethnic groups should be continued,” the study’s authors wrote in the latest issue of
Pediatrics.
Following the study, health experts urged the Food and Drug Administration (FDA) to increase the levels of folic acid added to foods to further decrease the instances of birth defects. “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. We're not at maximum prevention. We would like the FDA to reconsider this matter, hold hearings and act as soon as they can,” said Dr Jennifer L Howse, president, March of Dimes, a group working towards the prevention of birth defects and infant mortality.
“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 per cent, and we should not settle for anything less than maximum prevention,” she added.
Her sentiments were echoed by Dr Godfrey P Oakley Jr of Emory University's Rollins School of Public Health, who is lobbying for the level of folic acid to be increased in grains. “It's time to light a fire under this (increase in folic acid content in foods),” he said, adding that studies have shown that folic acid decreases levels of homocysteine, an amino acid involved with cardiac disorders, in the blood. Presently, the folic acid content is 140 mg per 100 gm of grain. In nature, folic acid occurs in vegetables like leafy vegetables and beans and fruits like oranges.
However, not everyone is convinced that increase in folic acid content in fortified grains is a good idea. Some feel that folic acid can hide the symptoms of vitamin B-12 deficiency that afflicts senior citizens and leads to neurological disorders in them. Many also doubt that additional folic acid would lead to further drop in birth defects.
