Currently No Need for Mandatory Fortification – Increased Folate Status Negates Mandatory Folic Acid Fortification at This Time
Wednesday, 11 March 2009
The Implementation Group on Folic Acid Fortification today presented its final report to the Department of Health and Children. The Implementation Group proposes that at this current time there would no benefits to public health to introduce mandatory folic acid fortification. This new advice follows scientific assessment and a number of factors which negate the need for a mandatory policy. These factors include the fact that women of childbearing age now receive 30% more folate in their diet as compared to three years ago, due to voluntary fortification across the food sector; a reduction in the incidence of neural tube defects (NTDs) to 0.93 per 1,000 births has occurred since 2005 and finally, preliminary and inconclusive data indicate some potential for adverse effects to excessive high levels of folic acid. The full report is available on www.fsai.ie
Mr Alan Reilly, Chairman of the Implementation Group on Folic Acid food Fortification and Deputy CEO of the Food Safety Authority of Ireland (FSAI) states that folic acid is a B vitamin that provides major health benefits to healthy people and at intake levels of 400 micrograms per day in women of childbearing age is proven to assist in the prevention of NTDs. NTDs, such as spina bifida, are a group of severe birth defects that can develop in babies during the first weeks of pregnancy. Folic acid is known to reduce the risk of NTDs by up to 70% if taken prior to conception and up to 12 weeks after conception.
The recommendation today follows extensive national monitoring of the folate status of the population and of levels of folic acid in foods on the Irish market by the Implementation Group. In 2005, in order to reduce the number of pregnancies affected by NTDs, the National Committee on Folic Acid Fortification (NCFAFF) recommended all bread on the market should be fortified with folic acid on a mandatory basis as the folate status in the Irish diet was low.
“Since 2005, the environment has changed significantly. In particular, the trend over recent years of the food industry to voluntarily add folic acid to a range of foods has led to a higher folate status of the Irish population. Whilst folic acid was only added to breakfast cereals for some years, now food manufacturers are adding folic acid to a large range of foodstuffs including dairy spreads, fruit juices, milk, yogurts, soups and cereal bars,” Mr Reilly says.
“This increase in folic acid in the Irish diet has had an effect. The national incidence of NTDs in 2005 and 2006 has reduced from 1-1.5 to 0.93 per 1,000 births. This is close to the lowest level that can be achieved through folic acid fortification of food, therefore any further steps in this area would not provide much additional protection and mandatory fortification is no longer necessary at this time. However, our advice for women of childbearing age who are sexually active remains the same – they should ensure they receive the recommended level of 400 micrograms of folic acid every day to assist prevent NTDs,” Mr Reilly continues.
In addition, the Implementation Group states that there is a suggested relationship between high levels of folic acid that could result in some adverse effects. Recent laboratory experiments have suggested a potential relationship between excessive folic acid intake and a cancer risk. However, it stresses that the epidemiological data and human studies to date are inconsistent and inconclusive. New data are likely to be available later this year and the Implementation Group recommendation is to await the data’s publication, so that further decisions are based on the best and most up-to-date scientific evidence.
“We stress that this potential link has not been clearly established and studies to date are inconclusive. However, the benefits of folic acid regarding the reduction in the incidence of NTDs are well established,” states Mr. Reilly.
-ENDS-
Note to editors:
The Implementation Group was formed to review and implement the recommendations of the National Committee on Folic Acid Fortification (NCFAFF). The Food Safety Authority of Ireland (FSAI) acts as its secretariat. The NCFAFF comprising a range of independent experts was established by the Minister for Health and Children in 2005 to investigate the most effective public health strategy to increase the intake of folic acid among Irish women of childbearing age to assist reduce the incidence of NTDs.
Report of the Implementation Group on Folic Acid Food Fortification to the Department of Health and Children