Let’s Talk About Folic Acid

 
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Folate is a water-soluble B vitamin that can be found naturally in many foods such as legumes and dark leafy greens. Folic acid fortification of enriched cereal grain products like breakfast cereal, crackers, bread, and pasta was first authorized in 1996 and fully implemented in 1998. Why? To reduce the incidence of neural tube defects in newborns. Neural tube defects are defects in the brain, spine, or spinal cord that occur during the first month of pregnancy. One example a neural tube defect is spina bifida, when the spinal cord doesn’t close early in embryonic development. That can cause a range of problems including paralysis.

The Centers for Disease Control encourage all women of childbearing age to consume at least 400 mcg of folic acid every day to help prevent neural tube defects. There are three ways to consume the recommended amount of folic acid:

  1. Take a multivitamin that contains 400 mcg folic acid every day.
  2. Eat one serving of breakfast cereal with 100% of the daily value of folic acid every day.
  3. Choose a variety of grains fortified with folic acid, as well as foods that are naturally rich in folate including legumes, leafy greens (spinach, asparagus, and Brussels sprouts), fruit and fruit juices, dairy products, poultry, meat, eggs, and seafood.

Like many other types of vitamins, it is possible to consume too much folic acid from supplements or fortified foods. The upper limit for folic acid ranges from 300 mcg for children age 1-3 years to 1000 mcg for adults age 19 years and older.

FDA rules require mandatory folic acid fortification of enriched cereal grain foods, and allow voluntary fortification in foods such as energy bars and drinks. Check the food label to see the percentage of the Daily Value of folic acid present in fortified foods. The percent daily value for folic acid is 400 mcg, which means that if the label states one serving contains 50% of the percent daily value, then it contains 200 mcg of folic acid.

Fortifying foods with folic acid is considered one of the most successful public health programs in the United States, resulting in a 35% decrease in neural tube defects. However, Hispanic women continue to have a higher risk of having a baby with neural tube defects, perhaps because they typically consume fewer foods enriched with folic acid.

Corn masa flour is a staple food for many Latin Americans, used to make tortillas and tamales. Corn masa flour was not required to be fortified with folic acid, which led The March of Dimes Foundation, the American Academy of Pediatrics, and other groups to petition the FDA to allow voluntary fortification of corn masa flour with folic acid to protect this group. As of April 15, 2016, the FDA now allows folic acid fortification of corn masa flour. When purchasing corn masa flour, or foods made with corn masa flour, check the list of ingredients for folic acid.

Expanding the types of foods that may be fortified with folic acid may help to continue to decrease the incidence of neural tube defects.

By Lynn Grieger RDN, CDE, CPT, CWC

References:

U.S. Food and Drug Administration News Release. FDA approves folic acid fortification of corn masa flour. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm496104.htm 4-14-2016. Accessed 4-20-2016.

Centers for Disease Control and Prevention. Folic Acid. Key findings:  Folic acid fortification continues to prevent neural tube defect. http://www.cdc.gov/ncbddd/folicacid/features/folicacid-prevents-ntds.html Last updated 1-15-15. Accessed 4-20-16.

National Institutes of Health. Office of Dietary Supplements. Folate. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/ updated 4-20-16. Accessed 4-28-16.

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