Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, July 28, 1993                   TAG: 9307280167
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-5   EDITION: METRO 
SOURCE: Associated Press
DATELINE: BAR HARBOR, MAINE                                LENGTH: Medium

FOOD ADDITIVE URGED DOCTORS FORECAST BIRTH-DEFECT DROP

Many women are not getting enough of the vitamin to prevent birth defects even with well-balanced diets, and fortifying the food supply is the surest way of getting it to them, the researchers said.

"This is the most important medical finding of the latter part of the 20th century," said Dr. Godfrey Oakley, director of the birth-defects division at the U.S. Centers for Disease Control and Prevention.

"It's like the Salk vaccine - it's that magnitude of importance."

"It really works and it's simple," said Dr. Judith Hall, a specialist on birth defects at the University of British Columbia.

Yet concerns about possible harm from folic acid are slowing government efforts to require the addition of the vitamin to grains.

Hall and Oakley say those concerns can easily be met. "The risk you'll do good so far outweighs the harm," Hall said at a meeting of geneticists at The Jackson Laboratory in Bar Harbor.

Folic acid - found in fruits, liver, peas, milk and leafy green vegetables such as spinach - isn't harmful, even in large doses, Hall said.

One concern is that folic acid can make it difficult to detect an uncommon blood disorder called pernicious anemia, a condition caused by a deficiency of Vitamin B-12 that can lead to irreversible nerve and brain damage.

Hall and Oakley said that problem can be dealt with and shouldn't delay the addition of folic acid to food.

In November, the U.S. Food and Drug Administration said it was examining the question of grain fortification with folic acid. After several meetings, it is now considering how much to require in grain.

Oakley is concerned that the FDA will set the level too low.

"If you don't put enough in, most women will not get the recommended level," Oakley said.

If the level of fortification is set correctly, 90 percent of American women could receive enough of the vitamin to lower their risk of having children with birth defects, he said.

The cost will be scarcely noticeable. "It will come for free. The price of a loaf of bread won't change," he said.

Recommending that women take folic acid pills - in lieu of grain fortification - would cost more and would be less effective in reaching women with less education and inadequate medical care, Hall said.

Research in recent years has shown convincingly that folic acid given in the first few weeks of pregnancy can prevent disorders known as neural tube defects.

These disorders occur at 20 to 24 days after conception when tissues fail to close into the tube that gives rise to the brain and spinal cord. One such defect is spina bifida, in which part of the spinal cord remains outside the body at birth.

More recent findings, including some reported last month, show that folic acid also cuts the rate of other birth defects.