New Zealand pediatricians say delaying folic acid in bread will cost $10 million

From New Zealand Doctor:

Deferring the decision to introduce mandatory fortification of bread with folic acid for another three years is likely to cost the health system at least $10 million, Paediatric Society president Rosemary Marks says.

In an email to prime minister John Key, health minister Tony Ryall and food safety minister Kate Wilkinson, Dr Marks says Auckland University researchers estimated in 1997 the cost of healthcare for an individual with spina bifida over 20 years would be $355,060.

Even using this figure, which would be significantly higher in 2009, each year folic acid fortification is deferred results in a conservative cost to health services of at least $3.5 million over the ensuing 20 years, or at least $10 million with a three-year delay, she writes.

A consultation document due for release today proposes the mandatory fortification be deferred until May 2012. Submissions close 12 August.

This follows a week and a half of debate in the mainstream media between scientists, lobbyists, politicians and bakers over the risks and benefits of fortifying flour for bread making with folic acid.

Under an agreement made in 2007 with the trans-Tasman body Food Standards Australia New Zealand, folic acid was due to be added to flour for all bread making, except for organic products, from September 2009, increasing folic acid intake by about 135 micrograms per 100g of bread.

Folic acid is a more readily absorbable form of folate or vitamin B9.

“Folic acid is essential for the function of every human cell. It’s perfectly safe in the amounts that are being suggested and GPs can reassure their patients there are no health risks in taking it in these amounts,” Dr Marks says.

There’s evidence folic acid will reduce the number of neural tube defects, such as spina bifida, and early evidence showing it could reduce the incidence of congenital heart disease and have a protective effect against colorectal cancer in people who don’t have early lesions, she says.

But the bakers have been keeping an eye on the science as well, and say there is concern about folic acid interfering with the gene pool and increasing risks of cancer.

“We don’t want bread to be a vehicle for delivering pharmaceuticals,” Association of Bakers president Laurie Powell says.

The UK Government has put off introducing mandatory fortification and the association doesn’t believe the idea should be supported, Mr Powell says.

Liggins Institute director Peter Gluckman, who is Mr Key’s chief science advisor, points the finger at a lack of consensus from scientists as this confused the public and put politicians in a difficult position.

A distinguished professor of paediatric and perinatal biology, Professor Gluckman has no doubt folic acid is safe and beneficial, but supports the Government’s moves to defer flour fortification.