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A normal diet for women of childbearing age may not provide enough folate to prevent neural tube defects in their children, says a new study. According to researchers at the University of Minnesota's School of Public Health, in Minneapolis-St. Paul, the Food and Drug Administration's (FDA) ruling that requires manufacturers to fortify grains and cereals by January 1, 1998, may not be enough to help prevent birth defects.

Previous research shows that women can reduce the incidence of neural tube defects by 72 percent if they take folate supplements. Folate is a salt of folic acid and is found in fruits and vegetables. The two most common neural tube defects are spina bifida (exposed spinal cord) and anencephaly (absence of the brain's cortex). (For more information, see NSN June 1996, p. 12.)

The study, led by UMSPH's Judith Brown, Ph.D., tested red cell folate levels of 189 women between the ages of 22 and 35 who were intending to become pregnant during the study period. The researchers found that one in eight women had red cell folate levels (a marker of folate intake and tissue stores) below 200 nanograms per milliliter (ng/mL). Nearly half (44 percent) had red cell folate levels less than 300 ng/mL. Only one in four had red cell folate levels that were higher than the recommended 400 ng/mL levels, and these women took supplements.

It is estimated that adding folate-fortified refined cereal and grains to women's diets at the required FDA levels will increase their folate levels by 80 mcg per day. The mean folate intake for U.S. women is 286 mcg per day, so even fortified levels will fall far short of the preventative 400 mcg per day.

Researchers also say education efforts stressing the importance of folic acid supplements and folate-rich diets must be updated to compensate for FDA's underestimation of the amount of folate needed to protect children.