Research

The need for nutritional help is real.

Maternal deficiencies in basic nutrients such as folic acid, iodine, and vitamin A currently impact over 56 million people and threaten over 38 million pregnancies. The emotional suffering for the most severe cases is heart-wrenching, but the drag on global human capital and thus quality of life for the families involved is also immense. Even more shocking, however, is how easily this problem can be remedied on a national and global scale.

Folic acid deficiency is the cause of most neural tube disorders (NTDs), a common birth defect. NTDs occur when an opening in the spinal cord or brain does not close completely. The affected children, if they survive birth, live with severe, lifelong disabilities.

In the United States, there are only 1,300 cases of NTDs annually because most grains are enriched. A common NTD such as spina bifida creates a lifetime cost of $791,900 per child. Often, the burden is placed upon families from low socioeconomic backgrounds and ultimately absorbed by taxpayers. Hispanics are the largest ethnic group in the country and Hispanic women are 20% more likely to have a baby with NTDs. It is unclear if genetic predisposition, diet, or a combination is the root cause. Last year, the FDA finally permitted folic acid to be added to corn masa flour, the main ingredient in corn tortillas, a staple food item in Hispanic families. But more work is needed. The recommended daily folic acid intake for a pregnant woman is between 600-800 mcg, but an expectant mother with a family history of NTDs needs 4,000 mcg. An enriched tortilla only contains 48-64 mcg of folate. Furthermore, enrichment of flour and corn masa is voluntary; thus, consumers need to be educated on which brands contain the vital nutrient.

Globally, less than a third of all countries in the world have mandatory grain fortification. Enrichment of rice is difficult and voluntary in China and India. Thus, only 9% of all preventable NTDs are averted. Maternal deficiencies in nutrients we take for granted, such as iodine, placed 40 million infants at risk of intellectual, motor, and auditory disabilities as of 1990. The World Bank estimates that 26% of the world is still iodine deficient.

We need a two-pronged approach: policy reformation and triage. Until research and legislation catch up, we need to provide prenatal vitamins.