A PHS 795 student wonders why it took almost twenty years for the FDA to approve folic acid supplementation for corn masa flour, a dietary staple of the US Hispanic population:
Professor Ehrenthal’s lecture on Determinants of Health Across the Lifecourse reminded me of something that I had looked into lately: folic acid. It is a widely known fact that folic acid reduces neural tube defects (NTDs) in newborn babies. Since approximately half of all pregnancies in the U.S. are unplanned, the FDA published relevant regulations in 1996. As of January 1, 1998, folic acid fortification required enriched cereal-grain products (bread, rolls, and buns; wheat flours; corn meals; farina; rice; and macaroni and noodle products) to add folic acid. I understand that it has been a meaningful public health intervention here in the U.S. in promotion of fetal development and infant health, and of course health throughout one’s lifetime. And yet, there was an unintended loophole in the policy, missing out the corn masa – the regular diets of Hispanic Americans. Because the incidence of NTDs among Hispanic Americans did not decline as much as that of the general population, the FDA has approved a food additive petition this year, requesting that folic acid be added to corn masa flour! I found it quite fascinating how the U.S. government followed-up on its public health intervention and came up with a supplementary action in TWENTY YEARS! Here is the FDA website for you to take a look: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm504412.htm
The FDA’s website argues that the delay was in part due to the need to prove that folic acid supplementation of corn masa flour is safe… even though it was already mandated for enriched cereal-grain products). Strains credulity, in my opinion.