Madam, - I refer to a letter from Dr Helen T O'Brien (May 14th) that called for Ireland to introduce a policy for the fortification of flour with folic acid.
Such an initiative is well underway and was recommended to the Minister for Health and Children in July 2006 by the National Committee on Folic Acid Food Fortification (www.folicacid.ie).
Folic acid is a B vitamin, which, if taken for at least eight weeks prior to, and 12 weeks, after conception, is known to reduce by up to 70 per cent the risk of neural tube defects (NTDs), a group of severe birth defects such as spina bifida and anencephaly that can develop in babies during the first weeks of pregnancy.
Ireland currently has one of the highest incidences of NTDs in Europe, with approximately 1-1.5 per 1,000 births nationally, equating to between 49 and 93 babies, affected by NTDs each year.
Within a year most bread on sale in Ireland will be fortified with folic acid at a rate of 120microg folic acid/100g bread. This level of folic acid fortification is expected to provide women of childbearing age with just over 25 per cent of their requirement for folic acid, which is similar to the amount provided to women in North America through mandatory folic acid fortification of flour.
It is expected that the fortification of most breads in Ireland, as recommended, will reduce the incidence of NTDs by 24 per cent, eliminate folate deficiency and still allow for consumer choice. Ireland will be the first country in the European Union to implement a mandatory folic acid food fortification programme - however, the situation in Ireland with respect to NTDs is unique. Ireland has the highest rate of pregnancies affected by NTDs due to a genetic predisposition.
Furthermore Irish society bears a much higher burden of disability due to the lack of the option of termination of affected pregnancies, which is widely used as a secondary preventive measure in other countries. Recent research shows that the current policy in Ireland, whereby women of childbearing age are advised to take folic acid supplements, is not effective at reducing the incidence of NTDs.
Evidence from North America and Canada clearly demonstrates that mandatory folic acid food fortification is very effective where reductions of NTDs by up to 78 per cent have been recorded.
Work is underway by a national implementation group set up by the Minister for Health and Children in July 2006 to move ahead with the safe mandatory fortification of bread-making flour with folic acid. The tasks involved are the introduction of new legislation, measuring levels of folic acid in bread, determining the loss of folic acid which occurs in baking, monitoring the numbers of pregnancies affected by NTDs and assessing blood levels of the vitamin in the general population.
Over three quarters of the submissions to a public consultation carried out by the Food Safety Authority of Ireland in 2006 were in favour of mandatory folic acid fortification. - Yours, etc,
ALAN REILLY, Chair, Folic Acid Implementation Group Food Safety Authority of Ireland, Lower Abbey Street, Dublin 1.