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New Zealand pressured on mandatory addition of folic acid in flour despite new medical concerns

Published: 16 Mar 2012

By Joe Lederman 

FoodLegal Lawyers and Consultants 

© Lawmedia Pty Ltd, March 2012

New Zealand has been at the receiving end of significant pressure to implement mandatory addition of folic acid to flour. In September 2009, New Zealand did not follow Australia in making folic acid fortification mandatory but officially opted to defer its decision. Recent developments suggest that the New Zealanders have strong grounds not to follow the Australian example.

Background

When in September 2009, the Australian food regulatory regime made it mandatory to add folic acid to flour (with a few minor exceptions), the New Zealand government decided not to adopt the same position as food regulators in Australia. This was notwithstanding the bi-national nature of the Australia New Zealand Food Standards Code. Instead, the official New Zealand position was that its decision was being ‘deferred’.

The addition of folic acid to flour was based on scientific assessment that it would have the effect of reducing the incidence of neural tube birth defects caused by folate deficiencies in peri-conceptional  women (the ‘target group’).

The role of folic acid in masking detection of Vitamin B12 deficiencies

In a recent ABC RadioNational broadcast (broadcast on 13 February 2012), Dr David Spence, a neurologist from the University of Western Ontario, suggested that although folic acid is a source of vitamin B6 which benefits peri-conceptional women, it is of little benefit to people outside this group. Dr Spence also told the ABC’s Dr Norman Swan that the studies had proven that there are various subgroups of vitamins and that a general vitamin supplement may not be adequate to address all deficiencies. In particular, the studies had shown that this can occur in relation to a deficiency in Vitamin B12. This deficiency is common in elderly people which causes a condition called pernicious anaemia if left untreated. Dr Spence revealed that because of mandatory fortification of flour with folic acid, doctors must filter out folic acid when measuring Vitamin B12 levels in the blood - as folic acid actually masks the detection of a B12 deficiency. This has significant health ramifications for elderly people, many of whom have an undetected Vitamin B12 deficiency due to excess intake of folic acid. Moreover, the studies by Dr Spence and his colleagues had shown that some Vitamin B supplements may aggravate kidney disease, while others contain traces of cyanide depending on the source from which Vitamin B was extracted.


Pressures from the Flour Fortification Initiative lobby

Meanwhile, despite the pros and cons from a medical perspective, the organization that has been most active internationally in the advocacy of folic acid fortification in flour is an organization called the Flour Fortification Initiative. The FFI is a US-based organisation that consists of a network of partners who have vested interest in advocating for the mandatory introduction of various additives to flour around the world. The FFI website discusses obstacles barring the successful implementation of mandatory fortification in various countries. Some of its members have discussed the problem of convincing the New Zealand government to adopt mandatory fortification. The members or ‘partners’ include a number of large flour milling corporations, and the advocacy position of FFI includes the objective of fortification of flour with vitamins and substances other than just folic acid.

The FFI has published information about the requisite equipment and procedures for fortifying flour. These processes include advocacy for the usage of commercial pre mixes that can be added to batches of flour during the milling process. Although economically feasible for large corporations (including those associated as partners in FFI), major challenges for smaller flour millers has been acknowledged by the FFI. The FFI admits the fact that the investment in processing equipment is large, that the price of premix (which would need to be imported in most cases) is not low, and that maintaining an adequate standard of quality control with sustainable monitoring systems also is not without various difficulties.

FFI also acknowledges that the micronutrients are dosed in minute quantities which necessitates a high degree of accuracy. According to FFI, this requires technologically advanced dosing equipment such as high-power feeders, flour conveyors and a reliable detection system capable of measuring levels of micronutrients added to the flour (see FFI’s diagrams of the required processing equipment). The FFI downplays the challenges faced by small milling businesses that are not financially positioned to obtain costly fortification machinery. Yet, the FFI promotes the fact that ‘the annual investment to provide micronutrients is worthy...returns can exceed the costs by a factor of 15-30’.

Clearly, this cost-benefit analysis favours large flour producers and has been a consideration driving the campaign to extend mandatory fortification around the world.

With new and ongoing health-related concerns still emerging in relation to the effect of mandatory fortification on people outside the target group, New Zealand may be wise to continue to tread with caution in deciding whether to make folic acid a mandatory additive to its flour.

Of course, there is nothing preventing women in the target group in New Zealand, or elsewhere, voluntarily supplementing their folate intake. Mandatory fortification, that has the potential to be harmful to the population outside the target group, is quite a different proposition.

The latest medical findings should be further cause for concern in Australia and good reason for more hesitancy by the New Zealanders.

Addendum:

See also article entitled: "PROTECTING LEGAL RIGHTS WHEN THINGS GO WRONG: LEGAL RECOURSE IF MANDATORY FORTIFICATION OF A FOOD WERE TO HARM HUMAN HEALTH" 

Other relevant FoodLegal Bulletin articles on this issue: