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Our Review Summary

iStock_000041935272_SmallIn this story, the FDA is weighing a request to add folic acid to corn flour in order to possibly prevent neural tube defects during pregnancy. Hispanic women are at higher risk of giving birth to babies with these issues. Corn flour is often consumed more than white or wheat flours in some diets. Folic acid is already added to white and wheat flours. The story does a good job of explaining the logic of adding folic acid to corn flour and what benefits it might yield. A bit more attention to the costs of such a program and the alternatives to it (e.g. vitamin pills) would have been welcome.


Why This Matters

Prevention gets short shrift in most health stories, so it is great to read this one about how some prevention (adding folic acid to corn flour) might decrease the number of babies born with neural tube defects. We would have liked the story to discuss alternative ways to get high-risk women to consume folic acid.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not talk about any costs. There are a few places where cost might have been valuable. The story could have discussed whether refining corn flour by a different method would cost more than the existing method. The story might have included whether fortified corn flour would be equal or higher in price for consumers than unfortified.

We also would have welcomed some comment on the cost of caring for a baby born with a neural tube defect.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story gives the reader an idea of how many neural defects could be prevented by adding folic acid to corn flour. “And studies suggest that fortifying corn masa with folic acid could prevent an additional 40 to 120 cases of neural tube defects among babies born to Hispanic mothers each year.”

Does the story adequately explain/quantify the harms of the intervention?


The story discusses the FDA’s worry that a chemical used on corn flour could interact with the corn masa flour. It quotes the FDA which says: “The FDA is concerned that the breakdown of folic acid in corn masa flour could yield a substance that raises concerns about safety.” It would have been nice for the story to explain more clearly what concerns are raised — this seems pretty vague — but we’ll give the benefit of the doubt.

Does the story seem to grasp the quality of the evidence?


The story mentions a study about the potential impact of fortifying corn flour on Hispanic women at higher risk. The study is a high-quality one.

We wish the story had talked more explicitly about the quality of the evidence.

Does the story commit disease-mongering?


There was no disease mongering.

Does the story use independent sources and identify conflicts of interest?


The story quotes independent sources.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story never really discusses the alternative of taking vitamin supplements.

Standard preventive advice for women of childbearing age who are considering pregnancy is to take a multivitamin in order to have enough folic acid for any future pregnancy. But this advice may be unheeded, vitamins may be too expensive, or pregnancy may be unintended.

Does the story establish the availability of the treatment/test/product/procedure?


The story explains that extra folic acid is already widely available in other flours. It notes that there is debate about adding it to corn flour. Concerns about the technical difficulty of adding folic acid that remains in usable effective form is a central point.

Does the story establish the true novelty of the approach?


There is nothing novel about the suggestion (made in 2012) that folic acid be added to corn flour, and the story explains why this issue is newsworthy now.

Does the story appear to rely solely or largely on a news release?


The story quotes multiple sources and does not rely on a news release.

Total Score: 7 of 10 Satisfactory


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