California moves to fortify corn masa flour with folic acid

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California became the first U.S. state to require manufacturers to add folic acid to corn masa flour used to make tortillas and other traditional foods, a policy designed to cut the incidence of severe birth defects linked to the vitamin. The requirement, which took effect for manufacturers in January, targets neural tube defects that occur very early in pregnancy—often before many people know they are expecting.

The push is tied to disparities documented in state and national data. Neural tube defects, including spina bifida and anencephaly, are among the most serious conditions affected by folic acid deficiency, and the article says rates for those defects have remained disproportionately high among Hispanic communities, where masa flour is a staple. It also cites California data showing that the rate among Hispanic mothers is double the rate among white or Black mothers.

Andrea Lopez, 44, of Bakersfield, said the law has personal meaning after losing her first baby, her son Gabriel Cude, about 10 days after he was born with a rare neural-tube defect. “Es un esfuerzo tan pequeño para un impacto tan enorme”, Lopez said, adding, “Hay muy poco que yo no haría para evitarle a alguien este dolor”. She is now an attorney and mother of two daughters.

State Assemblyman Joaquin Arambula, who sponsored the 2024 legislation, said the state’s role as an early mover matters. “A menudo hay que ser el primero para poner la pelota a rodar”, he said, and added that he was glad other states had taken up the responsibility.

A similar law is scheduled to take effect in Alabama in June, while additional proposals are pending or under consideration in Florida, Georgia, Oklahoma and Oregon, the article says. It also reports that four other states—Texas, Delaware, New Jersey and Pennsylvania—have expressed “interés activo” on the topic, according to the Food Fortification Initiative, a group focused on micronutrient shortfalls.

The article describes how the national folic acid requirement has long covered wheat and other enriched products. For nearly 30 years, the U.S. has required folic acid in enriched wheat products and certain other staples, and the policy is described as having reduced severe neural-tube defects by about 30%, preventing close to 1,300 cases per year. But the mandate excluded corn masa flour at the start, leaving a gap for communities that rely heavily on corn-based foods.

Regulators in 2016 allowed—rather than required—fortification of folic acid in masa flour products. The article says that by 2023, only about 1 in 7 masa flour products and no corn tortillas contained folic acid, based on an analysis. It adds that national adoption accelerated as companies moved voluntarily: Gruma’s Azteca Milling began selling some fortified Maseca varieties in 2016, and the article says that 97% of the company’s retail U.S. sales already include folic acid, with remaining products expected to be fortified before July.

The article also says Mission Foods began fortifying in 2024 and now adds folic acid to all of its corn tortillas in the U.S., including both its own brands and private-label products. A recent report by the Center for Science in the Public Interest is cited as indicating that large producers’ actions have helped make it easier for smaller manufacturers to follow.

While the policy gains support from public health advocates, it has drawn criticism online. The article says CSPI principal policy scientist Eva Greenthal responded to concerns circulating on social media by arguing that the nation’s health official was spreading false claims and scaring people away from a nutrient that has prevented birth defects. The article cites a key dispute in the U.S. government’s messaging: Robert F. Kennedy Jr., the article says, called fortifying corn masa flour “una locura” in a post on X and accused California of “una guerra contra sus niños” aimed at poor and communities of color, according to the article.

A spokesperson for Kennedy declined to explain the comments, the article says. CSPI and other medical experts, by contrast, argue that folic acid fortification is both effective and safe. The article quotes Emory University epidemiology professor Vijaya Kancherla, who said, “La ciencia es clara: la fortificación con ácido fólico funciona”, and added that it is “segura. Está comprobada. Y es rentable”. It also cites a pediatric neurosurgeon, Dr. Jeffery Blount of the University of Alabama at Birmingham, who said folic acid in fortification doses “nunca ha demostrado causar daño a individuos o poblaciones”.

The article addresses a common genetic claim in the debate around folic acid: that people with certain variants of the MTHFR gene cannot process the vitamin. The article says the U.S. Centers for Disease Control and Prevention emphasized that people with the MTHFR variant can process all types of folate, including folic acid. It also notes that federal dietary guidance Kennedy supported calls for women of childbearing age to eat folate-rich foods and says folic acid from fortified foods or supplements is “crítico” before conception and during early pregnancy to prevent neural tube defects.

In the timeline of pregnancy, the policy is framed as targeting a critical window. Neural tube defects occur in the first weeks after conception, the article says, and a lack of planning can leave many people without a chance to start prenatal vitamins in time. It reports that more than 40% of pregnancies in the U.S. are unplanned, and that even with rapid action after pregnancy is suspected, the timeline may already be too late. Dr. Kimberly BeDell of a Long Beach rehabilitation clinic is cited saying, “Incluso con el mejor esfuerzo de las mujeres de ir de inmediato al obstetra y empezar a tomar vitaminas prenatales, ya es demasiado tarde”.

Lopez said she supports California’s law and called it “increíble” that it took so long to apply. Speaking about her son, she said, “Créame, no quiere pasar por esto”, and described Gabriel as the “primogénito” and “único hijo”, adding that she and her family now include two younger daughters who survived.

Even with fortification already underway in parts of the market, the article depicts California’s mandate as a policy lever meant to broaden adoption nationwide by standardizing the nutrient’s availability in a food that many families regularly eat.