UK - Food agency may recommend folic acid in flour to cut birth defects
Support grows to boost bread for healthy babies
Food agency may recommend folic acid in flour to cut birth defects
Denis Campbell, health correspondent
Sunday May 6, 2007
The Observer
The prospect of folic acid being compulsorily added to bread has moved closer after research by the Food Standards Agency revealed that the controversial move is backed by 50 per cent of the population. Scientists say the additive would help reduce the number of seriously disabled babies conceived.
Next week the 12 members of the FSA's ruling board will decide whether to recommend to the Department of Health that it introduces folic acid as a mandatory additive.
Two sets of independent government advisers, the Scientific Advisory Committee on Nutrition and its predecessor, the Committee on Medical Aspects of Food and Nutrition Policy, have already told ministers that a positive decision would cut the number of babies with spina bifida.
But critics claim such a policy would lead to 'mass medication' by the government, denying citizens the right to choose what food they eat and endangering exports of cakes and cereals.
The Observer understands that the FSA is moving towards advising the Department of Health to introduce the mandatory fortification of white and brown flour, but to exempt wholemeal flour. FSA board members feel that by leaving wholemeal bread as an alternative, the agency would be able to counter criticism that consumers were being denied the freedom to choose: FSA chair Dame Deirdre Hutton is said to be keen that the agency is not seen to be pushing through a 'nanny state'-type edict.
There will be an educational campaign to alert people to the benefits of folate intake and also warn of the possible dangers of over-consumption, which some experts say include a greater risk of bowel cancer and a danger that it can mask the lack of vitamin B12 in some older people. Products such as bread, cakes, biscuits and sauces would have to undergo extensive relabelling if the move went ahead.
Folic acid is found in green leafy vegetables such as spinach and broccoli. Everyone needs to take it in order to make blood cells and to avoid becoming anaemic, especially women hoping to have children, who are advised to take supplements. An estimated 13 million Britons, including many elderly people, are believed to get too little dietary folic.
Many women who become pregnant also do not take nearly enough, helping produce a situation in which an estimated 700-900 pregnancies a year involve babies with neural tube defects (NTD). Those are spina bifida, which causes paralysis; hydrocephalus, which leads to learning difficulties and sight problems; and anencephaly, which causes a miscarriage or the baby's death soon after birth because its brain has failed to develop. The majority of such pregnancies end in a termination, but around 200 NTD-affected babies are born each year.
The FSA is alarmed at the poor diet of many young women who become pregnant, and that campaigns to encourage folic acid consumption have produced no improvement. It says that getting enough folic acid during pregnancy means a baby is 70 per cent less likely to suffer from a neural tube defect. Countries with mandatory fortification, including the US and Canada, have seen dramatic falls in the number of pregnancies involving a neural tube disorder.
Professor Nicholas Wald, a birth defects expert and the Academy of Medical Sciences's spokesman on folic acid, said: 'The FSA board should recommend the mandatory fortification of flour with folic acid. It would be safe, effective and cheap, and contribute to a reduction in spina bifida. There's a concern that if they do, people will say, 'it's the government interfering with the food supply again', as they did with fluoride. Public health is a greater priority than freedom of choice. There are no known health risks associated with doing this.'
The Food and Drink Federation, which represents major food manufacturers, prefers greater use of voluntary fortification, which already sees folic acid added to some spreads and breakfast cereals, backed by messages displayed in schools, supermarkets and GPs' surgeries urging young women to take more.
Folic acid: The facts
The United States became the first country in the world to introduce mandatory fortification of the food supply with folic acid in 1992, for the same health reasons that prompted the Food Standards Agency to consider adopting a similar approach. However, in America a wide range of products have to include set amounts of the vitamin - bread, corn meals, rice, noodles, macaroni and other grain products - rather than just flour, the proposal the FSA will debate on 17 May.
A total of 39 countries now add folic acid to flour, including Canada, Israel and Mexico. The Republic of Ireland, Australia and Canada are considering doing the same.
In Britain four ingredients have been added to bread by law since just after the Second World War: the vitamins niacin and thiamine, plus iron and calcium. In addition about five million people in parts of the UK drink water which has had fluoride added to prevent dental decay.
Food agency may recommend folic acid in flour to cut birth defects
Denis Campbell, health correspondent
Sunday May 6, 2007
The Observer
The prospect of folic acid being compulsorily added to bread has moved closer after research by the Food Standards Agency revealed that the controversial move is backed by 50 per cent of the population. Scientists say the additive would help reduce the number of seriously disabled babies conceived.
Next week the 12 members of the FSA's ruling board will decide whether to recommend to the Department of Health that it introduces folic acid as a mandatory additive.
Two sets of independent government advisers, the Scientific Advisory Committee on Nutrition and its predecessor, the Committee on Medical Aspects of Food and Nutrition Policy, have already told ministers that a positive decision would cut the number of babies with spina bifida.
But critics claim such a policy would lead to 'mass medication' by the government, denying citizens the right to choose what food they eat and endangering exports of cakes and cereals.
The Observer understands that the FSA is moving towards advising the Department of Health to introduce the mandatory fortification of white and brown flour, but to exempt wholemeal flour. FSA board members feel that by leaving wholemeal bread as an alternative, the agency would be able to counter criticism that consumers were being denied the freedom to choose: FSA chair Dame Deirdre Hutton is said to be keen that the agency is not seen to be pushing through a 'nanny state'-type edict.
There will be an educational campaign to alert people to the benefits of folate intake and also warn of the possible dangers of over-consumption, which some experts say include a greater risk of bowel cancer and a danger that it can mask the lack of vitamin B12 in some older people. Products such as bread, cakes, biscuits and sauces would have to undergo extensive relabelling if the move went ahead.
Folic acid is found in green leafy vegetables such as spinach and broccoli. Everyone needs to take it in order to make blood cells and to avoid becoming anaemic, especially women hoping to have children, who are advised to take supplements. An estimated 13 million Britons, including many elderly people, are believed to get too little dietary folic.
Many women who become pregnant also do not take nearly enough, helping produce a situation in which an estimated 700-900 pregnancies a year involve babies with neural tube defects (NTD). Those are spina bifida, which causes paralysis; hydrocephalus, which leads to learning difficulties and sight problems; and anencephaly, which causes a miscarriage or the baby's death soon after birth because its brain has failed to develop. The majority of such pregnancies end in a termination, but around 200 NTD-affected babies are born each year.
The FSA is alarmed at the poor diet of many young women who become pregnant, and that campaigns to encourage folic acid consumption have produced no improvement. It says that getting enough folic acid during pregnancy means a baby is 70 per cent less likely to suffer from a neural tube defect. Countries with mandatory fortification, including the US and Canada, have seen dramatic falls in the number of pregnancies involving a neural tube disorder.
Professor Nicholas Wald, a birth defects expert and the Academy of Medical Sciences's spokesman on folic acid, said: 'The FSA board should recommend the mandatory fortification of flour with folic acid. It would be safe, effective and cheap, and contribute to a reduction in spina bifida. There's a concern that if they do, people will say, 'it's the government interfering with the food supply again', as they did with fluoride. Public health is a greater priority than freedom of choice. There are no known health risks associated with doing this.'
The Food and Drink Federation, which represents major food manufacturers, prefers greater use of voluntary fortification, which already sees folic acid added to some spreads and breakfast cereals, backed by messages displayed in schools, supermarkets and GPs' surgeries urging young women to take more.
Folic acid: The facts
The United States became the first country in the world to introduce mandatory fortification of the food supply with folic acid in 1992, for the same health reasons that prompted the Food Standards Agency to consider adopting a similar approach. However, in America a wide range of products have to include set amounts of the vitamin - bread, corn meals, rice, noodles, macaroni and other grain products - rather than just flour, the proposal the FSA will debate on 17 May.
A total of 39 countries now add folic acid to flour, including Canada, Israel and Mexico. The Republic of Ireland, Australia and Canada are considering doing the same.
In Britain four ingredients have been added to bread by law since just after the Second World War: the vitamins niacin and thiamine, plus iron and calcium. In addition about five million people in parts of the UK drink water which has had fluoride added to prevent dental decay.
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