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Nearly every bite of bread, cereal, pasta, or delicious chocolate croissant you eat comes with a tiny dose of folic acid, also known as vitamin B9. Adding folic acid to enriched flour—mandatory in the US since 1998—has protected about 1,300 babies a year from neural birth defects. That’s the big picture. But drill down and the picture looks less rosy. One particular group has been left behind: Hispanic women eating tortillas instead of bread.

The Food and Drug Administration currently doesn’t even allow—let alone mandate—folic acid in corn masa flour, which is used to make tortillas, tamales, corn chips, and more. Three years ago, a coalition of groups including the March of Dimes Foundation petitioned the FDA to allow folic acid as a food additive in corn masa flour. The FDA asked for more tests, the last of which food scientists at Brigham Young University are completing right now. The agency has long touted folic acid fortification in wheat flour as “true victory” for public health—and it might finally extend the same logic to corn masa flour.

Hispanic women have the highest rates of giving birth to babies whose brain or spinal cords are not fully formed, 30 to 40 percent higher than average. Folic acid—a synthetic form of the folate that occurs naturally in lentils, leafy greens, and other vegetables—taken early in pregnancy can prevent anencephaly, which is fatal, and spina bifida, which is debilitating. Since the FDA mandated folic acid in enriched flour, neural tube defect rates have fallen 36 percent in the US. And folic acid fortification of corn masa flour is standard in Latin American countries such as Mexico and El Salvador.

“This is the staple of the Latino diet,” says Edward McCabe, chief medical officer for the March of Dimes Foundation. “That population deserves to have the protection given their babies are at the highest risk.” McCabe notes that genetic factors seem to predispose children of Hispanic women to neural tube defects. The lack of folic acid in their diet is a double whammy.

Shelf Lives

Corn masa flour differs from simple cornmeal because of the addition of lime, or calcium oxide, a highly alkaline ingredient that gives tortillas their unique flavor and feel. That’s also what gave the FDA pause this time. After the 2012 petition, the FDA asked for a study confirming that folic acid could be stable in alkaline corn masa flour over several months. The study would have cost $600,000 to $800,000. “It threw a huge monkey wrench in the works,” says McCabe.

Eventually, Brigham Young University food scientist Michael Dunn got on board. Dunn had extensive experience working on fortifying tortillas in Mexico, and his involvement got the FDA to agree to scale down the tests to an affordable range.

This spring, he got 3,000 pounds of corn masa flour in his lab and mixed in milligrams of folic acid—no trivial matter. “The thing most people in the industry are not aware of is how hard it is actually mix minute amounts of powder into a large volume of something,” says Dunn. If the 3,000 pounds of flour plus folic acid aren’t perfectly evenly mixed, any comparison between samples is moot. Dunn had to get a special multidirectional mixer used by pharmacy companies to mix ingredients for pills.

About six months have passed since mixing day, and Dunn says the stability results so far are encouraging. Midway through the test, he and his students took over an industrial kitchen to make tortillas and corn chips from the fortified corn masa flour, checking to see how the folic acid fared. “The one thing that did surprise us is the tortilla chips,” he says. “That’s pretty harsh, with wet dough going into super hot frying oil. We thought we’d see a hefty loss and we didn’t.” They’re collecting the last of the data to submit to the FDA, but a final decision from the FDA will at the very least take months more.

The Golden Age of Wonder Bread

The corn masa flour in Dunn’s experiments was donated by Gruma, a multinational corn and tortilla company based in Mexico. Gruma is also one of the co-petitioners to the FDA. Despite their involvement with folic acid fortification, Dunn says the company was less interested in enriching corn masa flour with the other vitamins commonly added to wheat flour. The reason, likely, had to do with America’s evolving views about pure and natural foods. (Gruma did not respond to a request for comment before publication.)

American first came to enriched flour in World War II, not long after white fluffy bread was exposed as nutritionless loaves. The mandatory addition of B vitamins like thiamin and niacin to wheat flour wiped out vitamin deficiency diseases like beriberi and pellagra, unknown to subsequent generations. The FDA started mandating folic acid in 1998. More recently, though, food writers—foremost among them Michael Pollan—have pointed out the folly in stripping wheat of all its nutritious parts to make flour and then adding synthetic vitamins back in.

In the case of folic acid, the vitamin clearly has benefits for pregnant women—but for the rest of the population, the advantages are less clear. Why fortify food for everyone? The pro side argues that folic acid is important in the early weeks of pregnancy—often before a woman even knows she’s pregnant. Fortification in food means women don’t need to actively seek out vitamins. “It’s a very effective passive approach to public health,” says Cynthia Pellegrini, vice president of government affairs for the March of Dimes.

The petition to the FDA is to simply allow folic acid in corn masa flour. But herein lies the rub: Unless fortification is as widespread as if it were a requirement, it can’t really achieve its goal.