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Comments on a report on the survival and severity of neural tube defects during the period that the U.S. Food and Drug Administration mandated folic acid fortification of grains. Clinical impact of the research findings; Review of related literature; Appeal to the U.S. Congress to increase the budget of the Centers for Disease Control and Prevention.

This article proposes that the U.S. Food and Drug Administration must require the addition of more folic acid in enriched flour and other grains in 2005. In 1991 Wald and his colleagues first provided unambiguous evidence that synthetic folic acid in a pill would prevent most children from getting spina bifida and anencephaly. Sufficient folic acid fortification of food eaten by most women of reproductive age would prevent almost all folic acid-preventable spina and anencephaly. In this regard, the Centers for Disease Control and Prevention and in state health departments have tracked the continuing occurrence of spina bifida and anencephaly before and after folic acid fortification of enriched grains. Unfortunately, the agency estimates that 2000 cases of folic acid-preventable spina bifida and anencephaly pregnancies continue to occur yearly in the country.

A letter to the editor featuring the authors' acknowledgement of the contributions of the journal in educating its readers about the positive effects of folic acid dietary supplementation in preventing neural tube defects is presented.

Comments on a study about pregnant women who consume enough synthetic folic acid before and during the early weeks of pregnancy. Recommendations for increasing the pace for prevention of folic acid-preventable spina bifida and other folic acid-preventable diseases; Discussion on consumption of wheat and corn flour in the U.S.; Overview of the decision of the Food and Drug Administration to require folic acid-enriched grain products.

The article presents a response to a letter to the editor about the concentration of folic acid in food.