Adding Folic Acid to Corn Masa Flour May Prevent Birth Defects

Latina eating a corn mesa tortilla (600x400)

If you’re a Latina who’s expecting a baby, your diet may be missing a key ingredient believed to help prevent certain kinds of birth defects.

That ingredient? Folic acid, which has long been used to fortify, or strengthen, certain enriched grains.

However, as Jonca Bull, M.D., director of the U.S. Food and Drug Administration’s (FDA) Office of Minority Health notes, “Many Hispanic women don’t benefit from the folic acid in cereal grain products because those products are not a mainstay of their regular diets—which often are corn masa-based.”

This could be a reason why Latinas represent the highest percentage of U.S. women giving birth to children with neural tube defects (NTDs), according to the Centers for Disease Control and Prevention (CDC). NTDs are birth defects of the brain, spine and spinal cord, such as anencephaly and spina bifida.

The FDA has moved to help protect these women and their children by approving the addition of folic acid to corn masa flour, an ingredient in foods including tortillas, tacos, tortilla chips and tamales. Foods made from this flour are staple foods of Mexican and some Central and South American diets.

When consumed by pregnant women before and during pregnancy, folic acid—a B vitamin—may help to prevent neural tube defects.

Corn masa flour, sometimes called masa—Spanish for dough—is produced by cooking corn in alkali (a substance that has a bitter taste and then forms a salt when mixed with an acid), then grinding it.

An Important Preventive Step

In 1998, in response to a recommendation by CDC and the U.S. Public Health Service, FDA made it easier for many expectant mothers to consume folic acid. The agency required the addition of folic acid to standardized enriched cereal grains, such as enriched rice and flour, and standardized enriched cereal grain products, such as enriched bread and macaroni.

Refined grains are enriched when certain B vitamins are added back after processing. Standardized foods contain ingredients required by FDA and are produced in a specified way.

“The reasoning was that enough people—including expectant mothers—eat enriched grains as a matter of course. And that could make a difference in the number of neural tube defects,” says Dennis M. Keefe, Ph.D., director of FDA’s Office of Food Additive Safety. In fact, the number of NTDs in the U.S. for all populations has since declined.

However, the incidence of neural tube defects in some Hispanic American populations has not declined to the same extent as in the general population.

So, FDA reviewed and approved a food additive petition from five organizations—the March of Dimes Foundation, the American Academy of Pediatrics, the Spina Bifida Association, the National Council of La Raza, and Gruma Corporation—requesting that folic acid be added to corn masa flour. Manufacturers may now voluntarily add the amount of folic acid (up to 0.7 milligrams) per pound of corn masa flour that is consistent with the levels in the enriched cereal grains mandated in 1998.

“With this approval, FDA is taking a powerful, preventive public health action,” Bull says. “By adding folic acid to corn masa flour, we have the opportunity to impact a large segment of the U.S. population and protect parents and their children from the devastating birth defects that are linked to insufficient folic acid consumed by the mother before and during pregnancy.”

Safety First

Before FDA could provide an approval, the agency first had to determine whether adding folic acid to corn masa flour is safe—not just for Latina mothers and mothers-to-be, but for men, women and children of all ages, ethnicities, and demographics. FDA scientists conducted a thorough scientific review of the information provided in the petition and determined that adding this amount of folic acid to the food supply would be safe for the general population.

“In addition to reviewing the safety and projected consumption data, we had to verify that folic acid remained stable throughout the production process and didn’t break down into other harmful substances during manufacturing,” Keefe says.

After this intensive review, FDA was able to give the go-ahead to those manufacturers who want to add folic acid to their corn masa products.

Cynthia Pellegrini, senior vice president of public policy at the March of Dimes, says, “FDA worked closely with us to design a study that garnered the information needed to establish the safety of this action. We’re thrilled at the outcome and feel confident that it will address the disparities we’ve seen in the Latina community and will give even more babies a healthy start in life.”

If You’re Pregnant or Thinking of Becoming Pregnant

CDC recommends that for folic acid to help prevent some major birth defects, a woman should start consuming 400 mcg a day at least one month before she becomes pregnant and the entire time while she is pregnant. For masa, cereals and grain products, read the ingredient statement to see if the food has been enriched with folic acid.

Some easy ways to make sure to get enough folic acid are to:

Eat a bowl of an enriched breakfast cereal that has 100% of the Daily Value of folic acid.
Eat other enriched cereal grain products mandated to contain folic acid.
Take a vitamin or multivitamin supplement that contains folic acid each day.

Talk to your health care provider about what’s best for you.

June 13, 2016