Study supports folic acid fortified tortillas to boost intakes

Fortification of corn masa flour with folic acid could produce enriched tortilla chips and corn chips, and serve as a new vehicle for the B vitamin, says new research.

According to new findings published in the American Journal of Clinical Nutrition, folic acid intake could increase by about 20 per cent for some sections of the population like Mexican-Americans, where corn masa flour products constitute a large portion of the diet.

The study was performed by the Centers for Disease Control and Prevention (CDC) and has particular implications in the US where Mexican-Americans are reportedly at a 30-40 per cent higher risk for a number of severe brain and spinal birth defects.

“The increased consumption of folic acid through corn masa flour fortification could provide an added level of protection for Mexican-American women,” said Alina Flores, health education specialist at the CDC’s National Center on Birth Defects and Developmental Disabilities and co-author of the study. “But we still need more research to understand why Hispanics have higher prevalence rates of NTDs.”

Folate is found in foods such as green leafy vegetables, chick peas and lentils, and an overwhelming body of evidence has linked folate deficiency in early pregnancy to increased risk of neural tube defects (NTD) - most commonly spina bifida and anencephaly - in infants.

This connection led to the 1998 introduction of public health measures in the US and Canada, where all grain products are fortified with folic acid - the synthetic, bioavailable form of folate.

While preliminary evidence indicates that the measure is having an effect with a reported 15 to 50 per cent reduction in NTD incidence, parallel measures in European countries, including the UK and Ireland, are still on the table.

Study details

A recent CDC study reported that only 21 per cent of Hispanic women are consuming the recommended amount of folic acid, compared with over 40 percent of white women. In order to consider if fortification of corn masa flour (which falls outside of the mandatory fortification) could redress the balance, the researchers developed a model.

The model included identifying corn masa flour-containing foods, measuring how much corn masa flour is used in each food item, and then estimating how folic acid fortification at a level of 140 micrograms per 100 grams of flour could boost intake.

According to the model results, the researchers estimated that corn masa flour fortification with folic acid would boost intake of the B vitamin by 19.9 per cent in Mexican American women, and by 4.2 per cent in non-Hispanics.

“Analyses suggest that corn masa flour fortification would have effectively targeted Mexican Americans, specifically, Mexican American women, without substantially increasing folic acid intake among other segments of the population,” wrote the authors, led by Heather Hammer.

“Such increases could reduce the disparity in total folic acid intake between Mexican American and non-Hispanic white women of childbearing age and implies that an additional NTD preventive benefit would be observed for Mexican American women.”

Source: American Journal of Clinical NutritionJanuary 2009, Volume 89, Number 1, Pages 305-315“Predicted contribution of folic acid fortification of corn masa flour to the usual folic acid intake for the US population: National Health and Nutrition Examination Survey 20012004”Authors: H.C. Hamner, J. Mulinare, M.E. Cogswell, A.L. Flores, C.A. Boyle, C.E. Prue, C.-Y. Wang, A.L. Carriquiry, O. Devine