Cabinet is expected to formalise the government’s position when it meets tomorrow, effectively putting the controversial issue on the back burner for three years and, crucially, beyond the next election.

The government is not convinced that making folic acid a compulsory ingredient in all bread is necessary, and wants more time to assess the evidence. Folic acid has been shown to reduce the risk of babies being born with defects such as spina bifida, but bakers say women would need to eat at least 11 slices of bread a day to make a difference to the health of their unborn child.

This is a shame since there are several studies due to come out next year that should provide a definitive  answer as to whether folate supplementation is harmful. Putting the matter to one side until after the next election is political cowardice. As I have mentioned in a previous post, the US and canadian experience with folate supplementation appears to be wholly positive. The supposed increase in prostate cancer was an incidental observation from a study that was not designed to look at the incidence of prostate cancer. Its conclusions are therefore very debatable.

The bakers are being somewhat disingenuous with their 11 slices a day claim. That is the amount of bread you must eat if you wish to get your entire recommended daily dose of folate from bread. In reality, most people will get folate from other sources, including supplementation. The benefits of folate are also proportional; neural tube defects would be prevented even on 2-3 slices of bread a day (just not as many as with 11 slices a day).

Folate supplementation of flour was a simple and effective preventative measure that should not have succumbed to political pressure. People fuss of the iodisation of salt and the fluoridation of water, yet we continue to do this because the health results are good for very little cost. Folate supplementation of flour was in the category. The government has condemned dozens of mothers to give birth to non-viable or severely disabled babies because of their lack of political courage.

Additional:

It seems that I am not the only doctor who thinks that this back down by the government is going to be expensive in human and financial terms.

Delaying plans to add folic acid to all bread will add about $10 million in health costs in the next three years and result in the equivalent of a classroom full of unborn babies being aborted, paediatricians say.

What a complete waste of money and life.

Rotorua paediatrician Johan Morreau, chairman of child health at the Royal Australasian College of Physicians, said doctors were “intensely frustrated” by the holdup. “What should have been a public health decision has become the subject of a political bun-fight. There is no scientific basis to justify the delay.

“Re-adding folate, which was removed from wheat during milling, would cut the incidence of spina bifida by about 80 per cent and of total birth defects by 40 per cent, he said.

In 2004, the most recent year for which data is available, 16 babies were born with spina bifida and 29 pregnancies were terminated after scans showed the condition.

Even on these figures, that is 36 children saved. The figures are almost certainly higher as many aborted spina bifida cases are not reported.

Note that this is not a weird chemical being added to “medicate” the public. This is a normal vitamin in whole wheat bread that is removed in refining. All that is being asked of bakers is to put the folate back into the bread.

It is a mystery to me why people would apparently prefer to see children die rather than be forced to eat a perfectly natural vitamin.

Related posts:

1. Folate Friction
2. Medicating the Masses
3. Vitamin Victims?