“Large scale manufacturers should be permitted to have one sub brand that does not include folic acid, so that … there would be an option for those who cannot or do not want folic acid in their corn masa products,” reads an opposition letter by AVFCA.
Last month, California lawmakers in Sacramento approved Assembly Bill 1830 (AB-1830), a new law requiring most manufacturers of corn masa flour and wet masa products to add folic acid to their food. Supporters argued the mandate would help reduce neural tube birth defects by increasing folic acid intake among Latinas, a demographic the bill identifies as having lower consumption rates.
But embedded in that justification is an uncomfortable assumption that the state government’s job is to observe what people eat—and what people lack—based on ethnicity and use the heavy hand of government to correct them.
“Latino communities face a disproportionately higher risk of neural tube defects (NTDs),” states the text of the bill. “While the American diet often relies heavily on wheat, many Central and South American cuisines depend on corn masa as a staple… The higher rate of NTDs in Latino communities is a symptom in the broader disease of health inequity.”
The bill’s author, Democrat Assemblyman Joaquin Arambul, thanked Governor Gavin Newsom for signing the bill into law and claimed “this legislation will provide a culturally appropriate way to address disparities to help prevent birth defects across our state.”
The bill received bipartisan support. And yet, lawmakers never really grappled with the proverbial elephant in the room: the question of whether or not it is the role of government to analyze the dietary habits of specific demographic groups and then mandate changes to the food supply? Of course, it would be a different matter entirely if corn tortillas were unsafe to eat. That would fall under the jurisdiction of the Food and Drug Administration. But no one is making that argument. Under this framework, the state identifies that “X group isn’t getting enough Y,” and the solution becomes a blanket requirement imposed on manufacturers and, by extension, consumers.
That approach ignores the obvious reality that many people who consume corn masa flour and tortillas are not female, not pregnant, not Latina, and not at risk of neural tube defects at all.
It’s also a remarkably bold assumption that making changes to the composition of tortillas is going to make a tangible difference in the reproductive health of Hispanic women.
Of course, not all Latinas eat masa. This rationale is cloaked in the bigotry of low expectations.
While healthy intake of folates is positive for some and neutral to others, it’s a far less important consideration for fetal health than factors like weight; physical activity; preexisting health conditions or propensity for diabetes, cardiovascular disease, hypertension, etc;. lipid reduction, whether or not one smokes, and so forth. Each of those—some being active lifestyle choices and others being a circumstance of one’s birth—will completely override or undermine the marginal benefits one gains from moderate increases in folic acid.
Indeed, research suggests that certain genetic differences make it more difficult for some individuals to convert folates into the active form their bodies actually use. This is especially true for individuals with histories of vascular disease, according to a study which looked at nearly 17 thousand participants. This data suggested that “folic acid supplements do not decrease heart disease or stroke risk” with the aforementioned population.
“This study may be another case where the epidemiologic findings on diet are not supported in studies where a single defined supplement is used,” reads the CABI Digital Library summary of the study. “It is possible that the relation between folate and lowered heart disease risk is more complicated than previously thought.”
In other words, people who consume folate-rich diets tend to have lower heart disease risk. But when one isolates folic acid as a single supplement and tests it in controlled trials, that benefit does not reliably appear.
But this is far from a condemnation of the nutrient folate. To that point, there is little doubt that folate deficiency is bad for developing fetuses. But the same can be said for folate in excess—and that’s the part that’s rarely talked about.
Studies suggest that new mothers with very high levels of folate right after giving birth see that “the risk that her child will develop an autism spectrum disorder doubles.” Very high B12 levels similarly triples this threat. Combined, the risk of developing autism increases a jaw-dropping 17.6 times.
“This research suggests that this could be the case of too much of a good thing,” said the study’s lead author, Ramkripa Raghavan, MPH, MSc. “We tell women to be sure to get folate early in pregnancy. What we need to figure out now is whether there should be additional recommendations about just what an optimal dose is throughout pregnancy.”
If the science is nuanced and the risks are individualized, why is the policy not?
Clearly, there are legitimate reasons someone may want to limit or avoid additional folic acid intake altogether. This is why consumer choice matters. Whether one agrees with the logic of AB-1830 or not, the new law removes that choice by default.
The health rights organization A Voice for Choice Advocacy asked legislators to instead consider changing AB-1830 to “an educational bill” which incentivizes—rather than requires— manufacturers to add “it in the same way as the enrichment of flour is incentivized.”
“Large scale manufacturers should be permitted to have one sub brand that does not include folic acid, so that … there would be an option for those who cannot or do not want folic acid in their corn masa products,” their letter reads.
Policy experts and public health advocates can debate endlessly whether mandatory folic acid fortification is neutral, beneficial, or potentially harmful and autism-inducing. But while that debate plays out, everyday Californians are largely left wondering why this even matters.
“I really was in shock because we grow with these kinds of tortillas since generations, and we never have any problems,” Dora Sanz, owner of Tres Hermanas restaurant in Sacramento told Newsweek. “We have healthy kids. So like, do we really need to put these in the tortillas?”
If the goal was awareness—informing women about folate, pregnancy timing, and individualized risk—an educational campaign would have sufficed. Evidently, lawmakers would rather go for the broad mandate and then pat themselves on the back in self-aggrandizing press releases which boldly insinuate other states must follow suit and adopt policies before knowing whether or not they even work.
“We expect to see the rest of our nation pay attention and follow suit,” said Assemblyman Arambul.
Perhaps other legislators will wait to see some clear results first.
Add Comment