Glowing wheat field symbolizing folic acid fortification in Argentina.

Folic Acid Fortification: How Argentina Slashed Neural Tube Defects

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"Discover the remarkable impact of folic acid fortification in Argentina and how it significantly reduced the prevalence of neural tube defects, offering valuable insights for global public health strategies."

Neural tube defects (NTDs) are major structural congenital anomalies affecting the brain and spinal cord. These conditions arise very early in pregnancy when the neural tube doesn't close completely, potentially leading to significant disabilities or even death. The most common NTDs include anencephaly and spina bifida, both of which present substantial medical and emotional challenges for affected families.

Recognizing the critical role of folic acid in preventing NTDs, many countries have implemented fortification programs. Folic acid, a synthetic form of folate (vitamin B9), is essential for cell growth and development. Supplementing a woman's diet with folic acid before and during early pregnancy can significantly reduce the risk of NTDs. Argentina took a significant step in 2002 by passing National Act no. 25630, mandating the addition of folic acid to wheat flour.

This initiative set the concentration of folic acid at 2.2 mg per kilogram of flour, aligning with international standards. Folic acid fortification (FAF) was initiated in late 2003, with the first prenatally exposed newborns expected by the third quarter of 2004. By 2005, most newborns were exposed, setting the stage for evaluating the program's impact on NTD prevalence.

Argentina's Fortification Success: A Breakdown

Glowing wheat field symbolizing folic acid fortification in Argentina.

A recent study meticulously examined the impact of folic acid fortification in Argentina, comparing NTD prevalence before and after the implementation of the national program. This ecological, cross-sectional study utilized data from the National Registry of Congenital Anomalies (RENAC) and the Latin-American Collaborative Study of Congenital Malformations (ECLAMC).

Researchers analyzed data from November 2009 to December 2013, encompassing 703,325 births assessed by RENAC. This period followed the full implementation of folic acid fortification. The data revealed significant reductions in the prevalence of specific neural tube defects:

Anencephaly and Encephalocele: These defects showed a remarkable 66% decrease.
Spina Bifida: There was a notable 47% reduction in cases.

These findings underscore the effectiveness of folic acid fortification in preventing neural tube defects. When researchers compared the post-fortification period with pre-fortification data collected by ECLAMC (2002-2004), the results were statistically significant, confirming the substantial impact of the intervention.

The Path Forward: Sustaining Success and Expanding Impact

Argentina's success with folic acid fortification provides a compelling case study for other countries seeking to reduce the burden of neural tube defects. By maintaining and strengthening its fortification program, Argentina can continue to protect future generations. Further research and monitoring are essential to optimize the program and address any remaining challenges, ensuring that all women have access to this vital intervention.

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Everything You Need To Know

What are neural tube defects, and why are they significant?

Neural tube defects (NTDs) are structural congenital anomalies that affect the brain and spinal cord, occurring when the neural tube doesn't close completely during early pregnancy. The most common NTDs are anencephaly and spina bifida. These conditions present significant medical and emotional challenges for affected families. The article highlights that the early stages of pregnancy are crucial for preventing NTDs, emphasizing the importance of interventions like folic acid fortification.

What is folic acid, and why is it important?

Folic acid is a synthetic form of folate (vitamin B9) that is crucial for cell growth and development. Supplementing a woman's diet with folic acid before and during early pregnancy has been shown to significantly reduce the risk of neural tube defects (NTDs). Its importance lies in its ability to prevent the development of these severe congenital anomalies. The study's findings underscore the direct link between folic acid intake and the reduction in NTD prevalence.

What specific action did Argentina take regarding folic acid?

Argentina passed National Act no. 25630 in 2002, mandating the addition of folic acid to wheat flour. This initiative set the concentration of folic acid at 2.2 mg per kilogram of flour. This policy decision was a crucial step in implementing folic acid fortification (FAF) across the country, with the goal of reducing the prevalence of neural tube defects. This policy set the stage for the widespread impact that was later observed in the study.

What data sources were used to evaluate the impact of folic acid fortification?

The study utilized data from the National Registry of Congenital Anomalies (RENAC) and the Latin-American Collaborative Study of Congenital Malformations (ECLAMC). Researchers analyzed data from November 2009 to December 2013, which encompassed 703,325 births. The RENAC data provided information on the prevalence of NTDs after the implementation of folic acid fortification. ECLAMC was used to gather pre-fortification data. The data revealed a significant reduction in the prevalence of anencephaly, encephalocele, and spina bifida after folic acid fortification.

What were the key findings of the study regarding the effectiveness of folic acid fortification?

The study showed remarkable reductions in neural tube defects (NTDs) in Argentina after the implementation of folic acid fortification. Specifically, there was a 66% decrease in anencephaly and encephalocele, and a 47% reduction in spina bifida. This data confirms that this approach is highly effective in preventing the development of these birth defects. By sustaining and strengthening the folic acid fortification (FAF) program, Argentina can protect future generations. Further research and monitoring are essential to optimize the program and address any remaining challenges.