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Research Letter
October 16, 2018

Availability of Corn Masa Flour and Tortillas Fortified With Folic Acid in Atlanta After National Regulations Allowing Voluntary Fortification

Author Affiliations
  • 1Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
JAMA. 2018;320(15):1600-1601. doi:10.1001/jama.2018.11939

In 1996, the US Food and Drug Administration (FDA) required all enriched cereal grains to be fortified with folic acid at a concentration of 1.40 µg/g.1 Since then, there has been a significant reduction in the prevalence of spina bifida and anencephaly.2 The regulation did not include fortification of corn masa flour, a staple food for many Hispanic people.3 Hispanic women of reproductive age are less likely to take prenatal folic acid supplements, have lower blood folate concentrations, and have a higher prevalence of spina bifida and anencephaly than non-Hispanic women.4,5 To address this disparity, the FDA published regulations allowing voluntary fortification of corn masa flour and tortillas in April 2016.1,6 Our objective was to determine the availability of folic acid–fortified corn masa flour and tortilla products in Atlanta, Georgia, 20 months after the FDA permitted voluntary fortification.