#FindFolicAcid Didn't Find Much Folic Acid
Photo: A sample of corn masa flour photos submitted for the #FindFolicAcid social media campaign.
By Scott J. Montgomery
FFI Director
In preparation for World Birth Defects Day on March 3, we celebrate the 50,270 brain or spine birth defects prevented in one year because flour is fortified with folic acid. As a US citizen, I’m proud that my country is part of this global achievement, but recent research points to the need for improvement.
Adding folic acid to foods prevents about 1,300 brain and spine birth defects in the US every year. However, federal regulations for this do not apply to corn masa flour used to make tortillas for tacos, tamales, and pupusas favored among people of Mexican and Central American descent. The lack of folic acid in this special type of maize flour is likely why US Hispanics are 21% more likely than non-Hispanics to have a baby with a brain or spine birth defect.
We thought this was solved in April 2016 when the US Food and Drug Administration (FDA) allowed folic acid to be added to corn masa flour. Yet recent research makes it appear that this is another example that voluntary fortification does not lead to nationwide coverage.
Emory University researchers wanted to see if corn masa flour and products made with corn masa flour included folic acid. They bought products in stores near Atlanta, Georgia, USA, and found two of 20 corn masa flour products and no corn tortillas included folic acid. Their work was published in October 2018 in the Journal of the American Medical Association.
To see if this was the case across the country, we led a #FindFolicAcid social media campaign in January 2019. Consumers in 28 states from Hawaii to Vermont contributed photos of 43 unique products. The photos showed folic acid in three corn masa flour products and no corn tortillas made with fortified corn masa flour (see table).
The Emory researchers analyzed the Atlanta products in a commercial lab and found that the folic acid content matched what was on the label, which was no folic acid in most cases. Consequently, we assume that labels pictured in #FindFolicAcid accurately reflect the products’ nutritional content.
Gruma Corporation is the largest corn masa flour producer in the United States. It says its Maseca brand of instant white corn masa flour sold in 4.4-pound bags is its most widely selling corn masa flour product. That product included folic acid in both the Emory research and the #FindFolicAcid photos.
Yet Maseca instant white corn masa flour in other size packages is not fortified. Yellow Maseca corn masa flour and another Maseca brand used for tamales is not fortified. In addition, Gruma Corporation makes Mission and Guerrero brands of tortillas. Neither brand of tortilla is made with fortified corn masa flour, according to #FindFolicAcid photos.
As someone who spent 30 years in the grain industry, I understand why millers are not voluntarily adding this essential nutrient to corn masa flour. They are simply meeting their customers’ requests, and food producers are not asking for fortified corn masa flour.
Our next step is to appeal to major retail grocers and the manufacturers of foods made with corn masa flour to specify that the products they purchase or produce are enriched with folic acid. This a minuscule expense with enormous benefits. If successful, this appeal could make fortified corn masa flour and fortified corn tortillas as common in the US as enriched wheat flour. This in turn will likely lower the birth defect prevalence for everyone who enjoys corn tortillas, tamales, and pupusas.
Note: The recommended 400 micrograms of folic acid (vitamin B9) daily before conception and within 28 days after conception prevents most brain and spine birth defects such as anencephaly and spina bifida. These are also called neural tube defects. It is very difficult to get the recommended amount of folic acid from unfortified foods alone.