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Hispanic women are the one group of moms with the highest rate of pregnancies affected by neural tube defects and some think they know why—and how to fix the problem.
According to data from the March of Dimes, Latinas are about 20 percent more likely to give birth to babies with a neural tube defect than their white peers due to a lack of folic acid.
Neural tube defects cause serious birth defects of the brain and spine, such as anencephaly (when a baby is born without parts of its brain and skull) and spina bifida as well as other possible medical conditions. According to the Centers for Disease Control and Prevention, the number of U.S. babies born with neural tube defects has dropped about 35 percent since the U.S. Food and Drug Administration began requiring cereal, bread, pasta and many other products made with enriched flour be fortified with folic acid in 1998.
Although research shows that women who have an intake of at least 400 micrograms of folic acid per day can avoid birthing babies with this birth defect, folic acid only protects a fetus when it's consumed by the mother in the early weeks of pregnancy.
Because Hispanic women tend to consume fewer food products made with enriched flour fortified with folic acid, they receive less of it in their diet overall than their white peers—and possibly during the most crucial time in early pregnancy—because they're consuming corn flour masa instead of wheat flour products due to cultural and dietary differences.
A 2014 study suggested that adding folic acid to corn masa, used to make tortillas, could prevent between 40 to 120 cases of neural tube defects per year in babies born to Hispanic mothers.
So why don't tortillas come with added folic acid? Because of the way corn is processed by soaking in an alkaline solution to soften it, the FDA is concerned that this ancient Mesoamerican method of preparation—known as nixtamalization—could potentially affect the breakdown of folic acid and yield a harmful substance, raising concern about the safety, according to a statement from the agency.
Due to current FDA regulations, tortillas, corn chips and other foods made with corn masa flour cannot be fortified with folic acid.
"There is no question that Hispanic women are having babies with spina bifida and anencephaly because the FDA isn't putting folic acid in the flour," Dr. Godfrey Oakley, a former director of the birth-defects division at the CDC told the Seattle Times.
The March of Dimes, National Council of La Raza and other organizations have been petitioning the FDA to allow folic acid to be added to corn flour masa since 2012. However, FDA officials have voiced concern over whether folic acid would remain stable in corn masa flour—that is, if the addition of folic acid would remain effective and present over the time of the product's shelf life. The FDA asked petitioners to study folic acid's stability and report back.
Michael Dunn, a Brigham Young University food scientist, led the study and submitted the results to the FDA in October. Although petitioners have not commented publicly about the study results while they're under review by the FDA, the Seattle Times reported in July 2015 that early results indicated no loss of folic acid over a three-month storage period.
The FDA is expected to respond to the study results soon, although they may ask for more information before they'll deliver a final ruling.