Revisiting Folic Acid

When the British researchers Richard Smithells and Elizabeth Hibbard first noticed that mothers of children with neural tube defects (NTDs) had lower levels of the B vitamin folate than did mothers of unaffected children, the Iron Curtain was still closed and FDA had only recently approved “the pill” (yes, that one).

Which is to say, it was a long time ago. In the intervening decades, considerable research has not only corroborated their observations, but shown that raising mothers’ folic acid levels via supplementation genuinely prevents neural tube defects. And the message of that finding has spread so thoroughly that prenatal folic acid supplementation is as much a matter of public awareness as it is of public health policy. Not for nothing has the U.S. mandated folic acid fortification of so basic a staple as flour.

And yet in an era of superfoods and short attention spans, a vitamin like folic acid can be something of a sleeper: easy to overlook, but impossible to dismiss. It may not be “the cutting-edge ingredient of the month,” says Douglas “Duffy” MacKay, ND, senior vice president, scientific and regulatory affairs, Council for Responsible Nutrition (CRN; Washington, DC), but it challenges critics who question supplementation’s benefits for a population.

“What’s nice about the folic acid story,” says MacKay, “is that you can usually stop someone in their tracks just by reminding them that the recommendations provide a very strong foundation for why supplements are valuable, and for why they have an important public health role.”

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