There would be no additional benefits to making it mandatory to add folic acid to bread or other food types, according to the Food Safety Authority of Ireland (FSAI).
During a special discussion on the issue, co- hosted with Trinity College Dublin, the FSAI said that the prevalence of neural tube defects (NTDs) which occurred at birth, such as spina bifida, was close to the lowest level that could be achieved through folic acid fortification of food.
The FSAI added: “Therefore, no further addition would be of benefit, especially given that some individuals may have high intakes.”
Folic acid is essential for women of childbearing age as it protects against birth defects developing in early pregnancy.
Levels of nutrient
TCD and the FSAI assessed levels of the nutrient in blood samples which were collected from men, women and children from 2005-2007 and 2010-2012. Dr Seán Daly of the Coombe hospital in Dublin counted the number of pregnancies affected by NTDs at around the same time as the first blood sampling survey. He found the incidence rate of NTDs to be 0.93 per 1,000 births.
The FSAI said that while there was no direct estimation for the number of pregnancies affected by NTDs, the recent blood sampling survey indicated that the level was likely to remain below one per 1,000 births.
The high levels of folic acid in these blood samples is mainly due to voluntary fortification by industry. Chief specialist in public health nutrition with the FSAI, Prof Mary Flynn, said the impact of higher levels of folic acid being consumed by other groups in the population was an important consideration.
“Folic acid food fortification is complex because to be successful it needs to provide effective amounts of folic acid to women of childbearing age without providing too much to others in the population,” she said.
She added that there was a need for more EU- wide regulation of this area and for maximum limits to be set for the addition of vitamins to food. Prof Flynn said a mandatory programme would be preferable as it was much easier to monitor and it ensured all socioeconomic groups had access to the nutrient. However, the current levels of folic acid in the Irish population made it unnecessary.
Mandatory fortification
In the 1990s, the US and Canada implemented mandatory fortification policies, which successfully lowered NTD prevalence. None of the 27 EU member states has mandatory fortification while some, such as Denmark, do not allow voluntary fortification.
Folic acid is known to reduce the risk of NTDs by up to 70 per cent if taken before conception and up to 12 weeks after conception. In Ireland, all women of childbearing age are recommended to take 400 micrograms (0.4mg) of folic acid every day, preferably through a food supplement.