Spina bifida and neural tube defects are a devastating condition that affect 1 in 800 births. They represent the failure of the spinal column and overlying tissues to close in utero during the first trimester of pregnancy, leaving the spinal cord, and sometimes the brain, exposed. It is attributable in large part to dietary lack of folate, a B vitamin.
If pregnant mothers obtain 400 mcg per day of folate, the incidence of spina bifida is slashed by 72%–not eliminated, but markedly reduced (since there are causes outside of lack of dietary folate). Given the severity of this condition, it is an incredibly small effort for a potentially marvelous gain.
Because many Americans have chosen to adopt a diet based on fast foods and junk foods, many women of childbearing age develop deficiency in this ordinarily ubiquitous nutrient. For this reason, in 1998, the FDA passed a regulation requiring bread makers to add 40 mcg of folic acid per 100 grams (3.5 ounces or approximately four slices of white bread, medium thickness) of enriched (processed) bread; the requirement does not apply to whole grain breads. A typical two-slice white bread serving as, say, a sandwich, adds 20 mcg of folic acid.
The Wheat Lobby is trying to paint themselves as the champions in the fight against spina bifida with this press release via their Six Servings. Among young people and others unschooled or uncaring in nutrition, folic acid fortification of white flour products has indeed exerted a positive effect: Fortification of white bread products has indeed been associated with a reduction in spina bifida and neural tube defects. (Or perhaps it was the heightened awareness of folic acid and the need for prenatal vitamins that discussions of fortification encouraged, but we’ll concede the point.)
But it definitely does NOT mean that fortified white flour products SHOULD be the solution to these conditions. After all, the folic acid is added and, of course, added to foods that have plenty of problems associated with their consumption.
Here’s a partial list of how you SHOULD obtain folates/folic acid:
Asparagus, boiled, 8 spears 178 mcg
Avocado, raw, sliced, 1 cup 118 mcg
Beef liver (6 ounces) 430 mcg
Broccoli, chopped, cooked, 1 cup 104 mcg
Brussels sprouts, 1 cup 156 mcg
Egg, whole, hard-boiled, 3 large 66 mcg
Peanuts, dry roasted, 4 ounces 164 mcg
Spinach, raw, 2 cups 116 mcg
You can see that there are many natural sources of folate/folic acid that far exceed the paltry 20 mcg from two slices of white bread.
There are many other lesser natural sources of folic acid and folates, too, all of which generally add another 40-200 mcg or more per day. If you take a multivitamin or B-complex, you usually add another 200-400 mcg of folic acid per day. You can also purchase 400 mcg tablets of folic acid for something like $3 for 100 tablets (400 mcg per tablet, non-prescription). Because of the potential benefits of folic acid in the first trimester of pregnancy, all prenatal vitamins contain 400 mcg or more folic acid.
Obtaining a healthy quantity of folic acid is therefore quite easy given its presence in food and the ease of supplementation. Just adding 40 mcg of folic acid to 3.5 ounces of white bread does NOT somehow make white bread a good thing.