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Devastating Birth Defects Decreasing With Food Fortification

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June 19, 2001 -- It works! Folic acid fortification is helping decrease the number of birth defects in this country.

Since the FDA authorized adding folic acid to breads, pastas, rice, flour, cereal, and other grain products, the nation has witnessed a 19% drop in devastating birth defects called neural tube defects, according to one of the first studies to look at the impact of the folic acid program.

Neural tube defects, which include spina bifida and anencephaly, affect 4,000 pregnancies each year and result in 2,500-3,000 U.S. births annually. Spina bifida, or open spine, occurs when the backbone never closes completely and is a leading cause of childhood paralysis. Anencephaly is marked by a severely underdeveloped brain and skull.

The findings are published in the June 20 issue of Journal of the American Medical Association.

Increasing folic acid consumption before becoming pregnant and during the first trimester of pregnancy is known to reduce risk for such birth defects. But just 29% of U.S. women were consuming the recommended 400 mcg of folic acid daily. That's why, in 1998, the FDA required that all enriched grain products be fortified with folic acid, providing most people with an added 100 mcg of folic acid daily.

To evaluate the program's success, researchers reviewed birth certificate data for live births in 45 states and Washington, D.C., from January 1990 through December 1999. Before the fortification program began, 37.8 neural tube defects were reported for every 100,000 live births, compared with 30.5 defects for every 100,000 live births after mandatory folic acid fortification began.

"We are viewing the findings as good news," says study author Margaret A. Honein, PhD, MPH, an epidemiologist at the National Center on Birth Defects and Developmental Disabilities at the CDC in Atlanta.

She's not the only one. James L. Mills, MD, and Lucinda England, MD, of the National Institute of Child Health and Human Development in Bethesda, Md., co-wrote an editorial that accompanied the new study.

"This exciting news clearly validates the U.S. government's decision to intervene on a massive scale to prevent these devastating birth defects," they write.

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