California folic acid rule reshapes tortillas — and birth defect risk

State of play: California's requirement took effect Jan. 1, but its impact is only now becoming clear as manufacturers standardize products and other states weigh similar moves.

• The law requires folic acid in corn masa flour used in tortillas and similar staples — closing a long-standing gap after decades of fortification in enriched breads and other grains.
• States including Alabama, Texas and Georgia are considering similar moves.

The big picture: Folic acid, a B vitamin, prevents serious birth defects of the brain and spine early in pregnancy.

• Since 1998, the FDA has required folic acid in enriched grain products like bread and pasta — helping reduce those defects significantly.
• Daily folic acid intake before pregnancy can reduce the risk of these defects by up to 80%.

Yes, but: Corn masa — a staple in many Latino diets — was left out of that mandate.

• Hispanic women have lower intake of folic acid and higher rates of neural tube defects — a gap that persists.

Zoom in: Large tortilla makers are already standardizing production across the U.S. rather than maintaining separate lines, said Jim Kabbani, CEO of the Tortilla Industry Association.

• "The cost of adding it versus the cost of maintaining two separate production lines is just ... a no-brainer," he told Axios.
• Consumers are likely already seeing fortified tortillas on shelves outside California.

Mission Foods told Axios it has transitioned 100% of its U.S. corn tortillas to include folic acid, after starting the process in 2024.

• Its parent company, Gruma, has pushed for folic acid fortification for years and worked with states including California and Alabama on legislation.
• "There are few issues more important to the health and well-being of Latino women, children and families than folic acid fortification," the company said in a statement to Axios.

The shift is drawing a divide within the tortilla industry:

• Large manufacturers can scale fortification nationwide, while smaller, artisanal makers are often exempt — and some have raised concerns about taste and tradition.
• But Kabbani said any taste difference is "not perceptible" for most consumers.

The intrigue: Supporters say fortification is a proven, low-cost way to prevent birth defects and address health disparities, while critics argue it could interfere with consumer choice and food traditions.

• The new law "addresses a health equity issue," said California Assemblymember Joaquin Arambula, who authored it.
• Health Secretary Robert F. Kennedy Jr. has called the mandate "insanity," writing that California is "targeting the poor and communities of color."
• A Health and Human Services spokesperson told Axios that while federal guidelines emphasize folate-rich whole foods, fortified foods and supplements remain "critical" for preventing birth defects.

What we're watching: Whether major tortilla makers standardize folic acid nationwide.

• How quickly grocery shelves shift outside California.
• If more states — or federal regulators — move to require fortification.

Contributing: Adriel Bettelheim