Colorado State University Extension
SafeFood Rapid Response Network


SAFEFOOD NEWS - Winter 1998 - Vol 2 / No. 2

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Folic Acid Fortification Underway

The U.S. Government's plan to fortify grains with the vitamin folic acid is likely to reduce the risk of most neural tube defects (NTDs), according to an early study by researchers in Ireland and at the National Institute of Child Health and Human Development (NICHD). Some researchers had feared that the amount of folate that will be added to grains -- kept low so as not to jeopardize the health of those who may not need extra folate -- is not enough to prevent the birth defects.

Briefly, the study treated a group women of childbearing age with different doses of folic acid (0, 100, 200, or 400 micrograms) for 6 months to determine how much was needed to raise their blood folate to a level known to protect against most NTDs. The researchers found women receiving 100 micrograms reached a level that would prevent 22 percent of NTDs. The women receiving 200 micrograms did even better; they reached a level that would prevent 41 percent of NTDs.

Neural tube defects (NTDs) are a class of birth defects affecting the brain or spinal cord. They occur in about one per thousand pregnancies in the U.S. each year. Among the most common NTDs are spina bifida, in which a piece of the spinal cord protrudes from the spinal column, causing paralysis below the protrusion, and anencephaly, a fatal condition in which the brain fails to develop normally.

Experts believe that around 50 percent of NTDs can be prevented by folic acid and that 200 micrograms a day is a highly effective dose. Previous studies have found that women who take folic acid shortly before and just after they conceive a child are less likely to give birth to a child with an NTD, according to a member of the research team, James L. Mills, MD, Chief of the NICHD's Pediatric Epidemiology Section.

In addition, the United State Public Health Service currently recommends that all women of childbearing age take a 400 microgram folic acid supplement each day; however, this recommendation is not widely followed. (Folic acid is the form found in vitamin pills; folate is the natural form found in foods.)

Because women are not getting the recommended supplements, the FDA has instituted a program to fortify food with folic acid. By January 1, 1998, 140 micrograms of folic acid will be added to every 100 grams of enriched flour and other enriched grain products. This dose should assure an increase of 100 micrograms in the diet of the average woman of childbearing age. Note that if a grain product is not enriched to begin with, it is not required to be fortified with folic acid. Consumers will need to check the label to make sure a product is enriched and therefore also fortified with folic acid.

Source: NIH Release, December 4, 1997.

Updated Monday, August 29, 2011