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Thursday, 9 May, 2002, 14:34 GMT 15:34 UK
Caution urged over folic acid
bread
Folic acid could be added to flour
The Food Standards Agency has decided not to recommend that folic acid be added to flour to reduce the risk of babies being born with defects like spina bifida.

The watchdog decided at a meeting on Thursday that more research was needed into the possible side effects of the policy.


We hope the issue is given revised consideration very soon

Andrew Proctor
Members of the FSA board are particularly concerned that fortifying flour with folic acid may mask a deficiency of vitamin B12 in elderly people.

The FSA will consider the results of a study taking place in Chile, where the mandatory fortification of folic acid to flour began in 2000.

Cuts risk

Proponents of fortification argue that adding folic acid to flour would be an effective way to ensure that pregnant women receive a healthy dose.

The vitamin has been shown to reduce the risk of babies being born with neural tube defects such as spina bifida.

For folic acid to have a benefit, it must be taken during the very earliest stages of pregnancy. Therefore, women need to take it before they conceive.

However, it is thought that only a third of women take folic acid supplements while they are trying for a baby.

Those who back the fortification idea say the most effective way to ensure that most women do get enough is to introduce it into the national diet by adding it to flour.

Caution

The predecessor of the FSA, the Committee on Medical Aspects of Food and Nutrition Policy, recommended the addition of folic acid in 2000, saying it would prevent more than 70 children a year being born with defects.

However, the Department of Health decided more work was needed before it could proceed and announced a public consultation exercise.

This view was echoed by research published last year in the British Medical Journal.

Professors Brian Wharton and Ian Booth, from the Institutes of Child Health in London and Birmingham, warned that in people with vitamin B12 deficiency, consumption of folic acid may mask a condition called megaloblastic anaemia - which if not picked up can lead to degeneration of the spinal cord.

They also warned that folic acid interferes with some epilepsy drugs.

The FSA decision has been welcomed by the Consumers' Association which warned not enough was known about the risks for the body to recommend to ministers fortification of flour.

Sue Davies, principal policy officer for the Consumers' Association, said: "We welcome this decision.

"Now it's important that the Food Standards Agency and the Department of Health address the many issues that need to be researched before revisiting this subject.

"These include effective ways of monitoring of possible B12 deficiency if folic acid were added to flour; the possible long-term effects of high doses of folic acid for the whole population; and the issue of choice: consumers would need an alternative if they don't want to eat fortified products."

The Spina Bifida Association strongly backs the introduction of fortified foods.

The charity Action Research, which has funded research into the benefits of folic acid, said the FSA decision was surprising.

Andrew Proctor, the charity's head of communications said: "Babies deserve to be given the best chance in life, and improving the population's intake of folic acid through fortification is one way of helping to do this, especially in targeting the many unplanned pregnancies.

"We hope the issue is given revised consideration very soon."

See also:

23 Nov 01 | Health
Folic acid safety questioned
18 Nov 99 | Health
Benefits of folic acid reinforced
13 Jan 00 | Health
'Put folic acid in bread'
26 Jul 01 | Health
Folic acid 'doubles twin chance'
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