In 1998, the Food and Drug Administration (FDA) added folic acid to the list of vitamins and minerals added to the nation's food supply. The intent was to prevent devastating neural tube birth defects, which previously afflicted as many as 1 in 1,000 newborns.

The Role of Folic Acid in Fetal Development

Studies from the Centers for Disease Control and Prevention established that 50% to 70% of neural tube abnormalities, which produce profound and sometimes fatal neurologic defects, can be prevented by ensuring that pregnant women get enough folic acid daily. Women who are planning to become pregnant should start taking a supplement containing 400 to 800 micrograms of folic acid every day. Women should start taking it at least 1 month before conception and continue it for the first 3 months of pregnancy. Without supplementation, most women would fall short of the mark.

Public health officials reasoned that if the vitamin were added to grain products, such as flour, pasta, bread and breakfast cereals, women would get more of the folic acid they need, when they need it. But there was much debate about how much folic acid could be safely added to food.

In a compromise, the FDA decided to limit the amount of folic acid added to food. A bowl of breakfast cereal, for instance, provides only about 0.1 milligram. Most women of childbearing age do not consume enough folic acid to prevent neural tube defects. All women of childbearing age should take a vitamin containing at least 0.4 milligrams of folic acid.

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