Monday, November 19, 2012


The issue of food fortification is a complex one and authorities world over are pulled between the desire to improve the health of their population and apprehension regarding the adverse effect of universal fortification. In a case like iodization of salt there was irrefutable data that even those having adequate iodine level in their system are not adversely affected by iodine coming from fortified salt. However this is not true with fluoridation of water because fluorides in excess can cause problem in many cases. In a country like the US most processed foods are fortified, obviously to restore part of the nutrients lost during manufacturing process but the over all effect of such fortification is still uncertain, some even claiming that such fortification improves only the financial health of the pharma industry which makes these nutrients for supply to the food industry! Latest controversy comes from New Zealand where animated discussions are taking place to make fortification of bread with Folic acid vitamin mandatory. The obvious basis is that such fortification prevents birth of children with neural tube defect (NTD). Like other cases this is also a complicated issue that can have multiple dimensions. Here is a take on this.

"Plans to introduce mandatory folic fortification in a bid to reduce the number of babies born with neurotube defects have been rejected by the Government. Minister for Food Safety Kate Wilkinson said today bakers will be able to decide whether or not tofortify their bread products with folic acid, as they have done for the last two years. "Folic acid plays an important role in reducing NTDs in babies, but fortification of bread is only one part of a wider package of initiatives," said Wilkinson. The plan has been advocated by the Paediatric Society in a bid to see a reduction in neural tube defects which can cause conditions such as spina bifida. However, the food industry has advocated to keep the status quo, saying any change reduces consumer choice and exposes the entire population to folic acid. Food & Grocery Council (FGC) chief executive Katherine Rich said it made no sense to effectively expose every man, woman and child to high levels of a folic acid in an attempt to reach a small number of women. "There is enough evidence to suggest our folate levels have increased considerably under voluntary fortification and that with more time to continue this work that trend is expected to continue. "The food industry supports the Government's aim of improving folate levels in women of child-bearing age." Rich said the last report to the Ministry for Primary Industries showed there were 34 lines of packaged fortified breads already available for consumers".

The argument that to target a small percentage of population vulnerable to NTD, it is not justifiable to force the entire population to consume higher level of Folic acid is indeed valid. Besides the economic cost involved in fortification, no one knows the long term effect of consuming higher levels of Folic acid in humans than that recommended for sound health. Probably voluntary efforts by the industry to target pregnant women only through special Folic acid enriched products may be more logical than making such practices mandatory. Besides it is normal for pregnant women to take additional nutrient supplements during pregnancy as per the advice of their doctor. After all it must be remembered that a normal balanced diet based on a variety of natural foods like whole cereals and pulses, fruits, vegetables and spices may not need any supplementation at all at any time in life. For those eating meat and fish regularly the question of Folic acid deficiency may not arise at all.


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