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Folate fortification

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Anadama_bread_(1)Marilyn Head is NZNO’s senior policy analyst. In 2012 Marilyn wrote the NZNO submission to the Ministry for Primary Industries on the Future of Folic Acid Fortification of Bread in New Zealand. You can read that submission here.

Great to see the New Zealand Organisation for Rare Disorders’ hard hitting press release “Babies die as bakers fail miserably with bread fortification project“.  It could also have said each year at least 20 more will join those children and adults already living with lifelong pain, disability and surgery,  because of the government’s continued failure to implement mandatory fortification of flour with the essential vitamin B9 (folic acid)  to prevent neural  tube defects.  Estimates suggest that between 80 and 245 cases of neural  tube defects could be prevented each year if intake was boosted in the first weeks of pregnancy; since half of all pregnancies are unplanned, and it is difficult to get enough folic acid from food, fortified bread has proved a safe, effective means of ensuring that.

Former Minister Kate Wilkinson’s excuse for postponing and then cancelling mandatory fortification was that people needed ‘choice’. No-one chooses to have spina bifida.  But the breadmakers have certainly chosen to reduce their production of fortified bread. There is 25 percent less fortified sliced bread available now than there was in 2012, and it is in that form that the most vulnerable young mothers are protected in all other developed countries.

One would imagine that in this country where Captain Cook’s bold move to replace rum with lime juice to prevent scurvy, even though the protective mechanism (vitamin C) was not fully understood, is hailed, that there would be a willingness to act on evidence for the public good. As with other evidence based public health initiatives such as immunisation, fluoridation and iodised salt, folate fortification has come under the attack of a vociferous minority, supported, in this case, by an industry that is cruelly indifferent to the opportunity it has to prevent untold suffering.

Shame on them,  and shame on the government for its continued refusal to act on the expert advice and evidence  available, including that given by the Chief Science Adviser it appointed.   NZORD, NZNO and the medical community are to be congratulated for their persistent advocacy of evidenced public health initiatives, such as folate fortification, that reduce disease and health disparities.

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