Fortifying Grains Prevents Birth Defects of the Brain and Spine

In 2015, an estimated 35,500 birth defects of the brain and spine were prevented in 58 countries which implement mandatory programs to fortify flour with folic acid.

That is an average of 97 healthier babies every day!

Unfortunately, the total only represents 13% of all birth defects that might be prevented with enough folic acid.  Arth, Annelise, et al. A 2015 global update on folic acid-preventable spina bifida and anencephaly. Birth Defects Research (Part A): Clinical and Molecular Teratology. July 2016.



Birth defects of the brain and spine are neural tube defects. They include spina bifida, anencephaly, and encephalocele.

In spina bifida, the baby’s spine does not form correctly. Severe cases include paralysis and varying degrees of loss of bowel and bladder control. These children will undergo a lifetime of surgeries and face many health issues.

Anencephaly is when the brain does not form properly. Affected pregnancies are often miscarried; babies born with anencephaly die shortly after birth.

Encephalocele is a rare neural tube defect in which part of the brain protrudes through the skull.

To prevent these birth defects, public health officials recommend consuming 400 micrograms of folic acid before conception and during early pregnancy. Folic acid is vitamin B9. Everyone needs it to help cells reproduce. A growing amount of evidence links increased folic acid intake with reduced risk of cardiovascular disease and certain types of stroke.

Among the challenges for ensuring adequate folic acid intake are:

  • People often forget to take supplements
  • Women who are not planning a pregnancy are not likely to be taking prenatal vitamins
  • Women may not know the importance of folic acid, such as this mother in Kenya.
  • Vitamin B9 in food naturally is hard for the body to absorb. Consequently, it is very difficult to get the equivalent of 400 micrograms of folic acid a day from unfortified food alone.
  • Vitamin B9 is water soluble. The body cannot store it, and people need a daily supply.


One proven way to increase folic acid intake is to fortify commonly consumed foods such as wheat flour, maize flour, and rice.

Fortifying food is a cost-effective strategy for increasing people’s folic acid intake and preventing most birth defects of the brain and spine. It does not require consumers to change their behavior; they simply continue eating foods they already enjoy.

See more at the Food Fortification Initiative’s website.

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