Rosie Mestel, "Study: Fortified grain lowers birth defects", Seattle
Times, September 6, 2005,
Link:
http://seattletimes.nwsource.com/html/nationworld/2002474587_folic06.html

The rate of spina bifida and anencephaly birth defects has fallen by
more than one-third since the addition of folic acid to the nation's
enriched flours, rice and pastas in 1998, according to a study released
today.

The study, published in the journal Pediatrics, prompted a renewed call
from some scientists and health advocates for the Food and Drug
Administration (FDA) to double the required fortification levels to
further reduce the rate of the birth defects.

"We're not at maximum prevention," said Jennifer Howse, president of
the March of Dimes. "We would like the FDA to reconsider this matter,
hold hearings and act as soon as they can."

Other scientists, however, said not enough is known about the
consequences of enriching food with folic acid and cautioned that even
rare side effects could affect a significant number of people when the
entire population is receiving the vitamin through food.

"No one's really looked," said Barry Shane, professor of nutrition at
the University of California, Berkeley.

For instance, folic acid can mask the symptoms of vitamin B-12
deficiencies, which are common in the elderly and can lead to
neurological problems.

Spina bifida and anencephaly, known as neural-tube defects, arise when
the spinal column of a developing embryo does not properly close during
the first weeks of pregnancy.

The defect causes paralysis in spina bifida and fatal brain deformation
in anencephaly.

In 1991, scientists demonstrated that the risk of the birth defects
could be significantly reduced by giving expectant mothers a synthetic
version of folic acid.

The natural form of the vitamin is found in green leafy vegetables,
whole grains and citrus fruits, although it is less easily absorbed by
the body.

The government recommendation is for women of childbearing age to take
400 micrograms of folic acid each day.

Because the vitamin is needed so early in pregnancy, by the time many
women discover they are pregnant it is too late for a folic-acid
supplement to help prevent the defects.

After much debate among health researchers, the FDA mandated that
starting in 1998, 140 micrograms of the vitamin be added to each 100
grams of grains that are labeled as "enriched."

A higher level was eventually added to flour.

In 2001, the federal Centers for Disease Control and Prevention (CDC)
reported that U.S. rates of spina bifida and anencephaly had fallen by
almost 20 percent.

The new study, also conducted by the CDC, examined birth-defect records
from 20 states and Puerto Rico from 1995 to 2002.

The database, which covered more than 11 million births, turned up
4,468 cases of spina bifida and 2,625 cases of anencephaly.

Dr. Godfrey Oakley, a research professor at Emory University's Rollins
School of Public Health and one of the main advocates of folic-acid
fortification, said the findings showed that the FDA should require a
higher dose.

Other research has suggested that as much as 75 percent of all
neural-tube defects could be prevented by a higher level of folic-acid
fortification, he said.

But other scientists said they were uncertain whether the move would
lower the birth-defect rate much more.

Dr. Sonja Rasmussen, a CDC clinical geneticist and a co-author of the
paper, said women of childbearing age can ensure they are getting 400
micrograms of folic acid each day by taking multivitamins, folic acid
supplements or fortified breakfast cereals.