Fortified foods: One inadequate step in the right direction

This spring, the Centers for Disease Control and Prevention (CDC) announced that 500 serious birth defects arc prevented each year thanks to a 1998 government rule requiring manufacturers to fortify cereal grain products with folic acid. Although about one-third fewer babies are now born with serious defects of the spine (spina bifida) or the brain (anencephaly) — from 2,000 to 1,500 — the CDC researchers aren't completely satisfied. They're calling on health care practitioners working with reproductive age women to recommend either vitamins or special cereals with extra doses of folic acid.

NWHN believes there are better means to this end than through fortified foods. We agree that adequate amounts of folic acid are necessary for a health) pregnancy, and that women who might become pregnant should consume at least 400 micrograms a day, even if they're not planning to have a baby any time soon. But we think that the best way to get the needed amount of folic acid is through a diet rich in vegetables, fruits and legumes — foods that many Americans don't eat enough of. Each serving of fortified bread or cereal now provides part, but not all, of daily requirements.

In the January/February 1994 issue of our newsletter, we featured two articles with contrasting views. One emphasized the many health benefits of folic acid, the other raised questions about the effectiveness of fortification for the specific purpose of reducing birth defects. Both authors emphasized food as the best approach, and we gave readers a list of foods high in folic acid, including dark green leafy vegetables, kidney beans, lentils, citrus fruits and juice, peanut butter, broccoli, cauliflower and corn.

While we're delighted that some babies lives have been dramatically improved through fortification, imagine how many more lives would be improved if more of us were able to eat a healthier diet. These are habits learned in childhood, and pilot projects in various school districts have shown that kids will eat these foods if they're presented in an attractive manner and are affordable. Maybe the next frontier in reducing birth defects (not to mention lowering the risk of heart disease, diabetes and high blood pressure) should be in school cafeterias—not doctors' offices.