Fifteen years after losing her first baby to a devastating birth defect, Andrea Lopez finds comfort in knowing that other Latina mothers may be spared similar grief. In January, California became the first US state to require food makers to add folic acid to corn masa flour, a staple in tortillas and other traditional Latino foods. The law aims to reduce the disproportionately high rates of neural tube defects among Hispanic infants, which claimed Lopez's son, Gabriel Cude, when he was 10 days old.
“It’s such a small effort for such a tremendous impact,” said Lopez, 44, a lawyer and mother of two from Bakersfield. “There is very little that I wouldn’t do to spare anybody this heartache.” A similar law takes effect in Alabama in June, and legislation is pending or under consideration in Florida, Georgia, Oklahoma and Oregon. Texas, Delaware, New Jersey and Pennsylvania have expressed “active interest,” according to the Food Fortification Initiative.
For nearly 30 years, folic acid has been required in enriched wheat and white breads, cereals and pastas, cutting rates of spina bifida and anencephaly by about 30% and preventing around 1,300 cases annually. However, corn masa flour was excluded from the original 1998 mandate, leaving Hispanic communities with persistently high rates of these defects. In California, the rate among Hispanic mothers is twice that of white or Black women.
In 2016, federal regulators allowed, but did not require, folic acid in corn masa products. By 2023, only about one in seven corn masa flour products and no corn tortillas contained the vitamin. California's law, sponsored by Assemblymember Joaquin Arambula, passed in 2024 and leverages the state's huge buying power to encourage nationwide adoption. “You have to be the first oftentimes to get the ball rolling,” he said.
Major producers have already responded. Gruma Corp., parent of Mission Foods and Azteca Milling, now sells 97% of its US retail corn masa flour with folic acid, with the rest expected by July. Mission Foods began fortifying all its corn tortillas in 2024. Smaller manufacturers are expected to follow, said Jim Kabbani of the Tortilla Industry Association. “The train has left the station,” he said.
“The science is clear: Folic acid fortification works,” said Vijaya Kancherla, an Emory University epidemiology professor. “It’s safe, proven and cost-effective.” Critics, including Health Secretary Robert F. Kennedy Jr., have labelled the mandate as government overreach. Kennedy posted on X: “This is insanity. California is waging war against her children.”
