The Law Of Unintended Rabbinic-Created Consequences

The New Jersey Jewish News has a feature about Spina Bifida, a genetic disorder (birth defect) that disproportionately strikes Orthodox Jews and, among Orthodox Jews disproportionately strikes haredim:

Just why Orthodox communities show higher than usual incidences of spina bifida has not been established. [Renee] Krul said the causes may include a lack of leafy greens in their diet due in part to problems of washing such food according to the rules of kosher preparation, which is concerned about bug infestation.

In other words, what we have is the Rabbi Blumenkrantz Effect. Obsess about so-called bug infestations, make eating leafy greens next to impossible, get the kosher supervising organizations involved to complicate the issue further, and watch as Jewish children are born deformed and suffer a lifetime of pain and suffering as a result.

The Torah forbids eating bugs. The normal amount of bug forbidden to eat would be a kezayit, the size of a very large olive and, in practice today, about one ounce. But rabbis long ago cut that amount in half. And they did something else, something that has made keeping kosher all the more difficult – they created a category called baria. A baria is, in effect, a whole bug. A baria can never be negated (battel).

So one whole bug will render a food unkosher.

Conversely, even many pounds of non-kosher meat can be negated. The most famous case is three (large) pieces of meat found in a home. Two are known to be kosher and one is known to be non-kosher. The problem? No one knows which is which. The law is all pieces are ruled kosher and you must eat at least a kezayit from each piece to demonstrate that you accept the law.

Yet a tiny bug, even if now unseen, will make the stew cooked with those three pieces of meat non-kosher.

It used to be a thorough washing of the greens followed by a quick inspection done with the naked eye was enough to render greens edible. But Rabbi Blumenkrantz, may God rest his soul, and other rabbis entered into a competition of sorts to see who could be more restrictive. Soon it became necessary to have special training to check for bugs, special equipment was now "necessary," three bugs found in 100 pounds of lettuce became an "infestation." And leafy greens became rare in the haredi diet.

Now you see how salad became treife. And now you know why haredi babies are significantly more likely to be born with Spina Bifida.

[Hat Tip: Pushkina.]

NJJN Online New Jersey Feature
Activist promotes simple way to prevent a major birth defect
by Elaine Durbach
NJJN Bureau Chief/Central
07.19.07

Renee Krul has been seeing disturbing levels of spina bifida in the fervently Orthodox community.

Though population surveys don't define health statistics according to religious denomination, Krul has firsthand knowledge of the patterns in the community as Northern New Jersey nursing coordinator for the Spina Bifida Association of the Tri-State Region.

She suggests that the birth defect, characterized by a spinal cord that fails to close properly, is overrepresented in a community with dietary restrictions, early marriages, and large families.

"The people themselves have begun to perceive spina bifida as a Jewish genetic disease — which it isn't — because the incidence is so high," she says. "In other communities I see one child with spina bifida, if that. When you see five children under the age of five with it in one community — like in Lakewood — you know something is wrong."

She said she is also getting word of similar problems from Orthodox areas in New York, Canada, and Israel.

As a result, Krul, who lives in Elizabeth, is reaching out to Orthodox communities in New Jersey to raise awareness about the defect, its prevention, and its treatment. In the fall she plans to bring her presentation to the Jewish Educational Center's Bruriah High School for Girls in Elizabeth, and is hoping other schools around the state will follow that example.

She is also preparing mailings to pediatricians and other doctors, and sharing information and tactics with colleagues from all over the country.

One of her primary goals is to get Orthodox teenage girls and young wives into the habit of taking a daily dose of folic acid, either by itself or in a multivitamin pill. Studies show that about 70 percent of neural tube birth defects — of which spina bifida is the most common — can be prevented if fertile women consume adequate amounts of folic acid. It can be obtained in its natural form, folate, in leafy green vegetables and from fortified grain products, but research has shown that the most efficient method of delivery is with supplements.

This is not just talk from Krul. Her husband, pediatrician Geddy Krul, put her daughter Elana onto a multivitamin when she was a student at Bruriah. She is 24 now, still taking those pills, married and expecting her first baby.

Their son Steven, 25, and recently married, is engaged in rabbinic and social work studies at Yeshiva University in New York. Asked for his view of his mother's work, he cited the profound importance the Torah places on having children, and the belief that all healing comes from God. With that in mind, he said: "I think it's a beautiful and tremendous thing to look after the health of children, not just the wonderful ones who are in front of us, but also those who are not yet born. To me, given what a significant impact folic acid has, it's a holy act to take it."

Major endorsements

Just why Orthodox communities show higher than usual incidences of spina bifida has not been established. Krul said the causes may include a lack of leafy greens in their diet due in part to problems of washing such food according to the rules of kosher preparation, which is concerned about bug infestation. She also suggested that young women interested in a good match, or shidduch, can develop eating disorders that lead to malnutrition. Large family sizes can increase the chances of maternal metabolic deficiencies, she said.

The early age for marriage is also a major factor, she suggested. Krul says she encounters young wives who are ignorant about nutrition and more concerned with their appearance than their health. "Some of them are really just adolescents when they get married," she said.

Whatever the reasons, some notable Orthodox figures have endorsed Krul's efforts to provide young Orthodox women with information about spina bifida and nutritional supplements.

Chai Lifeline, the international Jewish nonprofit organization that provides support for seriously ill children and their families, has expressed support for her cause. This past March, Torah Umesorah, the organization that links and supports about 700 Orthodox Jewish day schools around the country, issued a letter on the subject, urging females of childbearing age to take folic acid. The letter, signed by Rabbi Joshua Fishman, executive director of the organization, cited a "leading Rosh HaYeshiva" (yeshiva head), and urged principals to convey the information to 12th-graders and seminary students.

In addition to brochures, she has also produced small prayer cards for young women. They carry a prayer with paraphrasing approved by Rabbi Simcha Bonim Cohen, senior Kollel fellow at Beth Medrash Govoha in Lakewood, to have children without struggle and free of defects. On the flip side of the card is information on spina bifida and how to avoid it. "It looks almost like a credit card," Krul said.

Krul has reached out to most of the fervently Orthodox girls' high schools in the state, but come the next school year, she hopes to continue her outreach to modern Orthodox schools as well. She said Chaya Newman, the principal of Bruriah, has invited to her to show her PowerPoint presentation to a science class there.

She has also been invited to come to Israel, where the same problems have been observed in the Orthodox population. She wants to reach the youth there, too.

"Teenagers' diets are usually lacking in nutrition, so taking a multivitamin is good anyway," she said. "The important thing is to make taking one a habit. They say it takes a year to form a habit but just a week to break one."

Spina bifida

Spina bifida, caused by the failure of the fetus' spine to close properly during the first month of pregnancy, occurs in about five in 10,000 births. Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying degrees of paralysis of the lower limbs. There may be improperly formed or missing vertebrae and accompanying nerve damage. In addition to physical and mobility difficulties, most individuals have some form of learning disability.

The United States Public Health Service recommends a daily dose of 400 micrograms of folic acid for women with no family history of neural tube defects. For those with an incidence in the family, the dose should be 10 times higher. Folic acid is water soluble and the body excretes whatever it does not use.

Comments

[Alex]

Spini Bifisa is merely a symptom of a larger disease - religious fundamentalism.

[Dave]

Isn't spinal bifida caused by marriage among close cousins, as well?

[Nachman]

Alex,
Shoteh, Rasha V'gas Ruach!
The disease you suffer from "EPIKORSUTH" is merely a symptom of a far larger disease - Sinas Yisrael. In other terms - self hate...

[Anon]

This whole article seems a bit fishy to me. While I'm not an expert on this issue, I understand that accepted medical view is that the folic acid contained in the average American's diet is generally considered too low (most of us eat to little greens) and not sufficient to make a meaningful dent in the number of spina bifida babies. The medical profession recommends that all women that may become pregenant supplement their folic acid intake with vitamins (spina bifida occurs early in the pregnancy so to begin taking those vitamins after a woman knows she is pregnant is probably too late). I suspect that the higher incidence of spina bifida has more to do with the lower percentage of jewish woman who make sure to take vitamins before they get pregnant. In any case, I'll wait for more scientific data before I jump to conclusions. But jumping to conclusions has never been an issue on this blog.

Are there any studies that show whether the percentage of spina bifida is higher among orthodox jews? All the article indicates is that the total number of five (under five years old) in one community is unusual. One would think that they factored in the fact that there are significantly more children under five in areas such Lakewood - but did they?

[Anon]

--Isn't spinal bifida caused by marriage among close cousins, as well?--

Never heard of that one. The exact cause of Spina Bifida is not known. Belief is that it is caused by genetic factors and environmental factors and can be controlled to some degree by proper intake of folic acid.

BTW, I looked up the general prevalence of spina bifida in the U.S. it is seven out of every 10,000 births but that varies among groups (e.g. much less than that among Blacks which means it is higher among Whites). Anyone know how many children under 5 there are in Lakewood?

[Shmarya]

I'd suggest you reread the article. It says clearly that other large centers of haredim have similarly high numbers of Spina Bifida.

As for the idea that this happens because haredim are less likely to take vitamins rather than the lack of leafy green vegetables in the haredi diet, I would point out that previous epidemiological studies have found that a lack of greens is the major culprit. I would also point out that this lack is documented (albeit for "religious" reasons) in the haredi community.

[Abe]

I'm not sure that lack of leafy vegetables is a cause of spina bifida among hareidim. I'd like to see the statistics regarding the occurance of this disease about 20 years ago, before kosher vegetables became the de rigeur among the obsessively frum.
I would speculate that the higher incidence with which this disease frequents itself among hareidim is due to inbreeding within the haredi community and self imposed pre -natal medical ignorance. Genetic fetal testing would detect spina bifida within the first trimester. Most married couples would terminate the pregnancy since this is a horrific disease that ususaly ends in miscarrriage or death of the child shortly after birth. However there are some children that survive to live painful unsatisfied lives. Haredim, unfortunately, will not consider abortion.
Such is the fate of omnipotently ignorant.

[Nigritude Ultramarine]

they created a category called baria.

Shmarya, can you us tell when that happened? Who came up with it?

[Shmarya]

Early rabbinic. J mentions it, I think, in complaining about beit shammai (although the 'mesora' there says Pharisee):

"You blind guides! You strain out a gnat but swallow a camel" (Matthew 23:23,24)

[Fleishike Kishke]

If over time this turns out to be correct Spina Bifida should be renamed Blumenkrantz's Disease, and let that be his legacy. My personal wish is that Yidden who don't eat vegetables for "Halakhik reasons" get whatever it takes to remove them from the gene pool. My prayer this Tisha B'ov is that those who promote this idiotic lifestyle, especially if for financial gain - boydek lettuce and whatnot - in their old age witness the dying out of their seed. In their ignorance/selfishness they don't appreciate that making vegetables "non-kosher" is invalidating the whole Torah in the eyes of many. Yimakh She`mom to the no-lettuce frummies. Yimakh she`mom to the no tap-water frummies.

[Nigritude Ultramarine]

Here's a quickie overview of the issue of "bugs" in lettuce: Peering Through the Insects: The Story of Bagged Lettuce.

[zdub]

And, of course, when it comes to maror many chareidim - especially chassidim - eschew the halachically preferable romaine lettuce for horseradish.

[Nigritude Ultramarine]

This video seems to suggest that the only way to check lettuce, is with a lightbox. What did people do before lightboxes?

[Alex]

OMFG another idiot Nachman, I do not hate myself moron, I just don't apreciate Judaism becoming like a clone of Afghanistan's Islam.

Shoteh, Rasha, V'gas Ruach

Thank you for your kind words >:-)

[Nigritude Ultramarine]

Thank you for your kind words >:-)

No doubt he learned his potty mouth ways from the "gedolim."

[malachhamovies]

Rabbi Blumenkrantz died at a young age due to his own chumras. Orthodox Judaism will be doomed when people start seeing themselves and their families getting all and any types of diseases and medical conditions (in their late 40's and early 50's) due to the lack of proper nutriton.

It is already happening.

P.S. The "big doctor" that the charedei oilam seems to worship receives only 3 hours of information about nutrition in medical school!! Everyone should do their own research !!

Trust me, there will be many almonus and yesomem in the coming years. Have rachmonus on yourself and your family and do the right thing.

[C-G]

I think the folic acid acid/ leafy vegetables connection is tenuous, at best. Other risk factors for spina bifida are maternal diabetes and obesity.

The most likely link, in my estimation, is genetic. A 1999 study by researchers in Texas and New York found that a group of Jews were nearly twice as likely to be carrying a mutant form of a gene believed to be linked to spina bifida as a group of non-Jewish Texans.

So you have a population that's more likely to be carrying a potentially disease-causing gene. Factor in hareidi intermarriage... No surprises here.

[Isa]

Regarding:"""But Rabbi Blumenkrantz, may God rest his soul, """
This was in the sixth paragraph or so, Who wrote this crap??
Someone who will cause untold disease and misery through the generations. Maybe he was a nice old man with good intentions but he will STILL cause misery.
A child molester will cause generations to be screwed up as the first generation of victims might just become abusers themselves and that gets passed on...

Hey Heredim pass up those vegies-that is just animal food-lots of bread and nice juicey Postville steaks-skip that lean stuff-no good for you, and when you burp maybe a moo will come out too! Put lots of sugar on everything! Just say some prayers that will protect from you harm.

[orthomom]

I can't believe my eyes on this one. The fact that you can say with such certainty "And now you know why haredi babies are significantly more likely to be born with Spina Bifida" is simply unbelievable. Let's take the fact that the article itself notes that folic acid is far more effecive in supplement form than in leafy greens. Or how about we consider that one cup of orange juice is as good a source of folic acid as a serving of leafy greens. Any good theories for why Charedi Rabbis shortsightedly prevent their communities from drinking OJ? Come on, I'm sure you can come up with a good one if you try hard enough...

And this:
As for the idea that this happens because haredim are less likely to take vitamins rather than the lack of leafy green vegetables in the haredi diet, I would point out that previous epidemiological studies have found that a lack of greens is the major culprit.
Where are these conclusive study results? Because I'm pretty well-read on these topics, and though there is pretty solid evidence that a diet that contains adequate folate can prevent Spina Bifida, I have never seen a lack of greens specifically pinpointed as "the major culprit". Perhaps poor nutrition is a factor - but there is plenty of folate to be found in citrus, whole grains, breakfast cereal, nuts, and chick peas.

It's clear that there are many of you who enjoy jumping on the anti-Charedi bandwagon - when justified. But this is just gratuitous, people. Sheesh. I like to shoot from the hip as much as the next blogger. But a little intellectual honesty would go a long way in terms of credibility and being taken seriously.

[Shmarya]

Renee Krul has been seeing disturbing levels of spina bifida in the fervently Orthodox community.

Though population surveys don't define health statistics according to religious denomination, Krul has firsthand knowledge of the patterns in the community as Northern New Jersey nursing coordinator for the Spina Bifida Association of the Tri-State Region.

She suggests that the birth defect, characterized by a spinal cord that fails to close properly, is overrepresented in a community with dietary restrictions, early marriages, and large families.…

Do Mormons and devout Catholics seem to have this problem? It does not appear so.

That leaves dietary restrictions and inbreeding. Take your pick.

[orthomom]

Hmm. It says here that foods Liver and beans are far better sources of folate than green leafy veggies. I seems that shabbos chopped liver and chulent would probably be better at preventing spina bifida than a green salad would be (bugs and all).

Go figure.

[Shmarya]

Now you are being foolish. The average woman would be lucky to eat more than one serving of beans (chulent) and far less than one serving of liver (chopped liver) per week. When coupled with the lack of leafy greens, one can see how a folate deficiency would happen.

[orthomom]

Do Mormons and devout Catholics seem to have this problem? It does not appear so.

That leaves dietary restrictions and inbreeding. Take your pick.

Actually, there are plenty of studies that show that show high rates among other populations such as Irish immigrants or Hispanics. Those studies DO suggest poor nutrition as a cause - which I am not disagreeing with. What I do take issue with is the attempt to connect the dots into some hazy picture that "proves" or attempts to prove that the lack of green leafy vegetables is the specific source that causes these higher rates of the birth defect in Charedim. And then to point to the virtual ban on those vegetables in the Charedi community due to infestation as the direct cause of these defects.

Especially hard to make that case when there are so many other sources of the vitamin.

Just because the person quoted in the article took what is clearly a wild stab at showing causation doesn't mean I expect you to perpetuate it.

[Shmarya]

And then, we have this from OSU:

Folate can be lost from foods during preparation, cooking, or storage. To retain folate:

* Serve fruits and vegetables raw whenever possible.
* Steam, boil, or simmer vegetables in a minimal amount of water.
* Store vegetables in the refrigerator.

So, let's see. If you cook those beans for 12 to 15 hours, what happens to the folate?

orthomom may have an argument with Renee Krul. But, even so, it is clear that haredim will get much less folate than average.

[orthomom]

Now you are being foolish. The average woman would be lucky to eat more than one serving of beans (chulent) and far less than one serving of liver (chopped liver) per week. When coupled with the lack of leafy greens, one can see how a folate deficiency would happen.

Am I, Shmarya? As a working mother of quite a few kids, I find it far easier to down a multivitamin with a glass of orange juice than a green salad on a daily basis. I suspect most of my ilk would agree. And that gets me far more folate than a cup of green leafies.

Not to mention the fact that flour and bread are now enriched with as much folate as naturally occurs in the same green veggies you worry are missing from the Charedi diet.

You want to make the case that Charedim should take their vitamins and eat varied diets - as should everyone else? Feel free. But the leafy green argument is dead in the water, in my opinion.

[Shmarya]

I'd also add that many of those "other good sources" rely on supplementation, either through vitamin pills or through so-called fortified cereals and breads.

I would wager most haredi bakeries, especially those that use only yoshan, do not use fortified flour.

Also, many if not most organic and so-called health food cereals are not fortified. And it is well-known that homeopothy, health fads and other natural and magic "cures" are very popular in the haredi community.

In other words, less folate.

[orthomom]

orthomom may have an argument with Renee Krul. But, even so, it is clear that haredim will get much less folate than average.

Who says? I think that the point here in this post is an attempt to point fingers at the Charedi leadership for making it difficult if not impossible for their followers to eat green leafy veggies due to their supposed infestation. And though you may well be 100% correct that Charedim eat far less in the way of green leafies than other populations, I think it should be clear that it's far from the slam-dunk cause for higher spina bifida rates that you perpetuate in this post.

I detest the twisting of facts to make a point - I don't care how valid you think your point may be.

[Shmarya]

And what of the non-enriched flour commonly used by haredi bakeries?

Remember, they only eat pas yisroel, and they do not usually eat regular OU and other packaged breads.

I think it's admirable that you want to defend haredim from misuse of facts. But, if you do so, you must deal with all the facts.

[Shmarya]

Including, I should add, the fact that lots mothers with large families and husbands learning need to work outside the home for many hours a week to pay bills. They have little time for baking. Which means the enriched flour they could buy in the store probably is little used.

[orthomom]

And what of the non-enriched flour commonly used by haredi bakeries?

Remember, they only eat pas yisroel, and they do not usually eat regular OU and other packaged breads.

I think it's admirable that you want to defend haredim from misuse of facts. But, if you do so, you must deal with all the facts.

You make me laugh. Two posts up you're "wagering" that Yoshon flour isn't held to the USDA enrichment standards. Then by the nest comment you write, it's already a "fact".

The bottom line is that you made a statement very clearly that Charedi Rabbis are to blame for high spina bifida rates because of the ban of leafy green veggies.

I think that statement was wildly irresponsible and unproven - and a far cry from your present position that Charedim just happen to have fewer sources of folate in their diets for various other reasons.

I maintain that position.

[orthomom]

Including, I should add, the fact that lots mothers with large families and husbands learning need to work outside the home for many hours a week to pay bills. They have little time for baking. Which means the enriched flour they could buy in the store probably is little used.

This is silly. You still haven't shown any proof that Charedi bakeries don't use enriched flour. Or that there is any particular reason that the best source of the vitamin, supplements, are used any less by Charedim. Or that if they do use fewer supplements, that it's in any way shape, or form the casue of their Rabbis.

I don't like this post. I didn't like the post of a few months back where you claim that Metzizah B'Peh is causative of the (very debatable) higher rates of ADD and other learning disabilities in Charedi children. I called you out on it then, I'll call you out now.

Shmarya, you are completely entitled to your agenda and I applaud it when it's responsibly pursued. But it irks me when the agenda seems to cloud your clear thinking.

Just my 2 cents.

[Shmarya]

You assume enrichment is flour mandatory. I'm not 100% sure on this but, a quick search of the USDA website finds this article:

http://search.usda.gov/search?q=cache:XcM8IdS9qpcJ:http://www.usda.gov/news/pubs/fbook99/sections/chapter1.pdf+flour+enrichment&access=p&output=xml_no_dtd&ie=UTF-8&client=usda&num=10&site=usda&proxystylesheet=OC

It mentions that 90% of all refined flour is now enriched. That means 10% is not.

Does this mean haredim are using non-enriched flour? No. But having some experience with the USDA and the haredi world, I'd bet there are many haredi bakeries using non-enriched flour. Remember, there are many haredi rabbis who demand kosher certification of vitamins, even though they are not edible as a stand alone product.

And, again, we have the yoshon issue as well.

[Shmarya]

I'm waiting for confirmation on this but it seems many smaller craft bakeries do not use enriched flour.

[Shmarya]

Note Breadsmith here:

http://www.breadsmith.com/ingredients.html

None of the flours say "enriched," which I believe is a USDA requirement in food labeling.

I'll check tomorrow to see if, in fact, enriched flour is used.

BTW, Breadsmith does a lot of Orthodox Jewish and haredi business, at least here in the Midwest

[Nigritude Ultramarine]

For what it's worth, I have read that Folic Acid can be introduced, with the same degree of effectiveness, through diet or supplements.

Here's a short video on the topic: Folic Acid: Simple Cure for Common Birth Defect (1:40).

/The mother interviewed says she was told to take 4,000 mg when she was pregnant.

[Nigritude Ultramarine]

More information about Folic Acid.

According to this source, women of childbearing age need 400mg a day. That's what the doctor at the beginning of the above video said.

[orthomom]

Again - you are now simply drawing the targets around the very accusatory dart you lobbed at Charedi leadership - one with very inadequate sourcing.

A little more clear-thinking on your part might have been exercised in dealing with what was merely raised as a possibility in the article you sourced. The possibility that you presented as a clear and proven fact.

[orthomom]

Nigritude:
Agreed. I was told to take a supplement when I was pregnant/trying to get pregnant. No one made a point of telling me to specifically up my leafy green intake, as it is not a realistic means of getting the high suggested daily intake for expectant mothers. I don't know many working mothers who manage to eat 3 or more servings of leafy greens, Charedi or not.

[orthomom]

Nigritude:
Agreed. I was told to take a supplement when I was pregnant/trying to get pregnant. No one made a point of telling me to specifically up my leafy green intake, as it is not a realistic means of getting the high suggested daily intake for expectant mothers. I don't know many working mothers who manage to eat 3 or more servings of leafy greens, Charedi or not.

[Nigritude Ultramarine]

Oops! That should be 400 mcg.

Oops again! The video is here.

[Shmarya]

In 1996, the United States Food and Drug Administration (FDA) published regulations requiring the addition of folic acid to enriched breads, cereals, flours, corn meals, pastas, rice, and other grain products…

Again, I'm waiting for confirmation from my USDA linked sources but note the term used: "enriched." If the bread does not say "enriched" or "fortified," it probably is not.

Indeed, again, I believe it must be so labeled by law.

[Shmarya]

Ooops! Source:
http://en.wikipedia.org/wiki/Folic_acid#Dietary_fortification_of_folic_acid

[Nigritude Ultramarine]

What is folic acid and where can I get it?

...

Convenient ways to make sure that you get enough folic acid:

* Take a multivitamin with 400 mcg of folic acid or take a single pill of 400 mcg of folic acid every day. (Folic acid pills are small and easy to swallow.) Both folic acid pills and multivitamins can be bought at grocery stores, pharmacies, or discount stores.
* Eat a bowl of a breakfast cereal containing 100 percent of the daily value of folic acid per serving. Total, Product 19, Cheerios Plus and Smart Start are some examples.
* Eat a healthy diet that contains lots of fruits, vegetables and foods fortified with folic acid. "Enriched" cereal grain products such as pasta, rice, bread, flour, and cereals have been fortified with certain amounts of folic acid. Foods containing folate include fruits; green, leafy vegetables; and dried beans and legumes.

[Shmarya]

Nigritue,

Can you check your local haredi store to see if breakfast cereals sold under haredi brands are 100% fortified?

Thanks!

[orthomom]

Indeed, again, I believe it must be so labeled by law

Indeed, again, I believe you are digressing from your original accusations. You know, the one where you blame Rav Blumenkrantz(z'tl) and his ilk for the high rate of spina bifida in the Charedi community? Because they created a "competition of sorts" over banning leafy greens? Yeah, that.

[Nigritude Ultramarine]

Can you check your local haredi store to see if breakfast cereals sold under haredi brands are 100% fortified?

Sure. I'll look into it Wednesday and post what I find under this thread.

[orthomom]

Nigritue,

Can you check your local haredi store to see if breakfast cereals sold under haredi brands are 100% fortified?

Thanks!

Oy. Shmarya, again. What's he point? You ignore the most important fact here. Everyone says that the most important source of Folate is a vitamin supplement. I haven't seen your theory where you place blame on Charedi leadership for banning vitamin supplements. Because there is no ban. Walk into any Charedi-owned or -frequented pharmacy. There are scads of vitamin supplements that carry heimishe hechsherim. Vitamins and supplements are actually very popular in Charedi circles.

[Shmarya]

http://www.cfsan.fda.gov/~dms/wh-folic.html

FDA also emphasizes that adequate levels of folic acid, in the form of folate, can be obtained by eating natural sources such as:

* Leafy dark green vegetables
* Legumes (dried beans and peas)
* Citrus fruits and juices
* Most berries

Haredim as a rule don't eat the leafy greens.

Haredim eat dried beans but overcook them to such an extent that the folate levels are reduced (see above a few comments for source).

Haredim do not eat most berries because of bug issues.

That leaves citrus fruit and citrus juice. But these are expensive, especially the juice, and I think it's safe to say most orange juice purchased by haredim is consumed by their children, not by adults.

[Shmarya]

Everyone says that the most important source of Folate is a vitamin supplement. I haven't seen your theory where you place blame on Charedi leadership for banning vitamin supplements. Because there is no ban. Walk into any Charedi-owned or -frequented pharmacy. There are scads of vitamin supplements that carry heimishe hechsherim. Vitamins and supplements are actually very popular in Charedi circles.

So called "heimishe" vitamins are much more expensive than Walmart's brand or Walgreens, etc.

Women tend NOT to take supplements, They do, however, tend to eat.

If you read the literature on folate use you'll note the big problem is getting women to, a) Take the pills and, b) eat the greens, etc.

That's why the enrichment program was started.

[Shmarya]

Indeed, again, I believe you are digressing from your original
accusations. You know, the one where you blame Rav Blumenkrantz(z'tl)
and his ilk for the high rate of spina bifida in the Charedi community?
Because they created a "competition of sorts" over banning leafy
greens? Yeah, that.

Not at all. It's just that more expensive vitamins, unenriched flour and other factors – all fostered by the Rabbi Blumenkrantz crowd just as the lack of leafy greens in the haredi diet is fostered by them – also contribute to the problem.