Folic acid levels should be double to provide maximum protection during pregnancy

Reports say that the U.S. government decision to add folic acid to enriched grain products has reduced the incidence of two devastating birth defects, but more needs to be done.

In a review of births in 21 states from 1995, a year before the fortification was authorized, to 2002, it was found there were significant decreases in the incidences of spina bifida and anencephaly, two neural tube defects that result in spine and brain damage.

But the study from the U.S. Centers for Disease Control and Prevention and the University of Alabama, also found that there was a racial disparity, with children born to black women less likely to be protected, possibly because of genetic differences, or less education.

The study has recommended that programs which aim to educate about the importance of taking folic acid supplements and eating food high in folic acid and natural folate among women of all racial/ethnic groups should be continued.

Folic acid, a B vitamin is found in such foods as leafy green vegetables, beans and orange juice.

It is also in enriched grain products including breads and pasta.

Women have been advised for many for years, to eat such foods and also take supplements during pregnancy to avoid neural tube defects.

Every year in the U.S. 2,000 children are born with defects that could be prevented if the fortification levels were higher.

If grain products in general were more enriched, as many as 200,000 such children born around the world yearly could have escaped the problems.

Many experts say the current fortification level should be doubled.

Robert Brent of the A.I. duPont Hospital for Children in Wilmington, Delaware, and Godfrey Oakley of Emory University in Atlanta, say the current recommended 140 micrograms of folic acid per 100 grams of grain needs to be twice that.

The March of Dimes Birth Defects Foundation also agree that a higher level is warranted, issuing a statement saying studies have shown that adequate daily folic acid intake beginning before pregnancy can reduce the incidence of such defects by up to 70 percent and anything less than maximum prevention is unacceptable.

The study is published in the September issue of Pediatrics, the journal of the American Academy of Pediatrics.