Plan to put folic acid in bread to be reviewed

The mandatory fortification of most breads with folic acid to reduce the incidence of certain birth defects is being re-examined…

The mandatory fortification of most breads with folic acid to reduce the incidence of certain birth defects is being re-examined following the emergence of new scientific information.

Folic acid is a B vitamin which, if taken before, and in the early stages of pregnancy, can reduce the risk of a baby developing a neural tube defect (NTD) such as spina bifida or anencephaly.

In 2006, the Minister for Health agreed with a recommendation from a national committee that most breads on sale here should be fortified with folic acid and she appointed a group to implement this.

However, in the course of the group's work it emerged that the folate status of the Irish population had improved when contrasted with previous surveys.

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A spokeswoman for the Department of Health said that it had emerged that the level of NTDs, at 0.8 per 1,000 births was lower than previously identified. The rate was previously estimated at 1 to 1.5 per 1,000 births.

She said the group was also examining research suggesting that high levels of folate were being linked with the development of colorectal cancers in certain people with a predisposition to such cancers.

Asked if this meant that the decision to fortify bread was now in doubt, she said "the proposal to fortify with folic acid was science led; it follows that, if new scientific evidence emerges, the proposal will be revisited. Indeed, it would be irresponsible not to consider new evidence.

"However, the department would not say that the fortification of flour is now in doubt. The evidence is being reviewed and we will have to await the outcome of this review."

The group's work is expected to be complete around the middle of this year.

The National Committee on Folic Acid Food Fortification had recommended that bread should be fortified with folic acid at a rate of 120mg per 100g bread and it estimated that up to a quarter of pregnancies affected of by NTDs would be prevented by this move. Some breads would not be fortified, in the interests of consumer choice, it recommended.

On average, Irish women of childbearing age only get about 30 micrograms of folic acid a day in their diet from foods such as green leafy vegetables. The optimal level to help reduce the risk of birth defects is 400 mg.

Because almost half of all pregnancies in this State are unplanned, many women are not taking folic acid in the key pre-conception stage.

The incidence of NTDs in parts of North America and Canada have reduced by up to 78 per cent since fortification of flour was introduced more than a decade ago. While folic acid is usually associated with reducing NTDs, it emerged in recent days that it could also reduce the incidence of premature births.

On Thursday, a University of Texas-led study reported that women who took folic acid supplements for at least a year before becoming pregnant could greatly reduce their risk of delivering a baby prematurely.

Alison Healy

Alison Healy

Alison Healy is a contributor to The Irish Times