A study released today in the Journal of Nutrition shows that efforts to reduce the incidence of neural tube defects in infants by fortifying grain products with folic acid are paying off -- and the dividends are even greater than expected.

Folic acid is the synthetic form of a family of compounds referred to as folates, which are found primarily in legumes, vegetables, and fruits. For nearly a decade, medical professionals have recommended that all women of childbearing age consume 400 mg of folic acid per day to decrease the risk of a neural tube defect (NTD)-affected pregnancy. Since January 1998, all enriched flour, rice, pasta, cornmeal, and other cereal grain products in the United States have been fortified with folic acid to help reduce the incidence of NTDs.

As a result of this government-mandated fortification, most Americans now consume increased amounts of folic acid in common foods such as pasta and bread. Researchers at Tufts University recently investigated the effects of folic acid fortification in adults participating in the Framingham Offspring Study. Their results show that the introduction of folic acid in common foods significantly improved red blood cell folate levels, the single best measure of long-term folate status, by more than expected in most middle aged and elderly Americans, regardless of whether they took additional vitamin supplements or not.

Says lead author Dr. Silvina F. Choumenkovitch, "Our results indicate a significant decrease in the number of individuals who are deficient in folate. This is potentially beneficial not only for women of childbearing age, but also for other sectors of the population."

Mild folate deficiency has been associated with increased concentrations of plasma homocysteine -- an independent risk factor for vascular disease. Numerous studies have shown that folate and other B vitamins lower homocysteine levels in the blood, thereby potentially reducing the risk of heart attacks, strokes, and peripheral vascular disease. Mild folate deficiency has also been associated with increased risk of memory loss or mild cognitive impairment in the elderly and increased risk of certain types of cancer.

Signs of folate deficiency may include headaches, forgetfulness, loss of appetite, diarrhea, weight loss, weakness, sore tongue, heart palpitations, and irritability. If you are pregnant or breastfeeding, consume alcoholic beverages, or take medications that interfere with the action of folate you may be at increased risk of folate deficiency.

Some good sources of folate, in addition to fortified grain products and breakfast cereals, are spinach, collard and turnip greens, asparagus, brussels sprouts, romaine lettuce, broccoli, beans, black-eyed peas, cantaloupe, orange juice, and liver and other organ meats.