California has become the first state to require food manufacturers to add folic acid to corn masa flour, a key ingredient in tortillas and other traditional foods. This move aims to address disproportionately high rates of serious birth defects among Hispanic infants.

Addressing a Public Health Disparity

For nearly 30 years, folic acid has been added to enriched wheat and white breads, cereals, and pastas in the U.S., significantly reducing rates of neural tube defects like spina bifida and anencephaly. However, corn masa flour was initially excluded, leading to persistently higher rates of these conditions within the Latino community.

A Mother's Story

Andrea Lopez, a lawyer from Bakersfield, experienced the devastating loss of her son, Gabriel, to anencephaly 15 years ago. She expressed relief that other Latina mothers may be spared the same heartache. “It’s such a small effort for such a tremendous impact,” Lopez stated. “There is very little that I wouldn’t do to spare anybody this heartache.”

Expanding Fortification Efforts

A similar law will take effect in Alabama in June. Legislation is also being considered in Florida, Georgia, Oklahoma, and Oregon. According to the Food Fortification Initiative, Texas, Delaware, New Jersey, and Pennsylvania have expressed “active interest” in the issue. Scott Montgomery, the group’s director, emphasized, “All women and children in the United States should have access to folic acid and have healthy babies.”

Industry Response and Adoption

Gruma Corp., the parent company of Mission Foods and Azteca Milling, has been involved in folic acid fortification since 2016. As of this year, 97% of the company’s U.S. retail sales include folic acid, with full fortification expected by July. Mission Foods began adding folic acid to all its corn tortillas in 2024. The Tortilla Industry Association initially had concerns about flavor and labeling costs, but now anticipates broader adoption of fortified products.

The Science Behind Folic Acid

Public health experts highlight the proven benefits of folic acid fortification. Vijaya Kancherla, an Emory University epidemiology professor, stated, “The science is clear: Folic acid fortification works. It’s safe. It’s proven. And it’s cost-effective.” Neural tube defects occur in the early weeks of pregnancy, often before a woman knows she is pregnant, impacting approximately 2,000 babies annually in the U.S.

Addressing Misinformation

Despite the scientific consensus, some critics have raised concerns about government overreach and the safety of folic acid. However, experts like Eva Greenthal of the Center for Science in the Public Interest refute these claims, emphasizing that folic acid has never been shown to harm individuals or populations. The U.S. Centers for Disease Control and Prevention also confirms that individuals with the MTHFR gene variant can process folic acid effectively.

California's Leadership and Future Impact

California Assemblymember Joaquin Arambula, who sponsored the legislation passed in 2024, believes the state’s large buying power will encourage nationwide adoption. He stated, “You have to be the first oftentimes to get the ball rolling. So, I’m glad other states have taken up that mantle.” Andrea Lopez hopes this law will prevent other families from experiencing the pain she endured, stating, “Trust me, you don’t want to go through this.”