Niki Bezzant: Is fortification the best thing since sliced bread?

The fortification of bread flour with folic acid would help prevent birth defects. Photo / 123RF

COMMENT: For some naive reason, it still always surprises me when other people don't agree on the concept of the greater good.

Business owners who rail against paying a higher minimum wage, for example. Or those who object to fluoridation.

Our food supply is an area where it seems often to be a case of the People v The Industry. Country-of-origin labelling is an example, with the current bill before a select committee looking as if it'll be watered down to the point of being meaningless.

A report came out last week which may signal the end to another past political decision favouring industry over the greater good - the mandatory fortification of bread flour with folic acid to prevent birth defects.

Folic acid is important for women in the early stages of pregnancy, when the brain and neural tube are being formed. If folate levels are low, neural tube defects (NTDs) can result - conditions such as spina bifida and anencephaly.

Women are encouraged to take folic acid supplements before they become pregnant and during early pregnancy to prevent this. But this doesn't always happen.

The report by Sir Peter Gluckman, formerly the prime minister's chief science advisor, reviewed the health benefits and risks of folic acid fortification of food. It found that mandatory fortification is unequivocally associated with lower rates of NTDs, and that there is no evidence of harm from doing so. Experts are strongly urging the Government to go ahead and do this to prevent dozens of NTD pregnancies each year.

New Zealand almost had fortification nine years ago, when it was agreed with Australia that flour would be fortified. But the government at the time - presumably under pressure from the food industry – backed off, in favour of a voluntary system.

Australia went ahead with fortification of flour, with a resulting drop in NTDs. Here there's been no significant drop. Instead there have been more families whose lives have been devastated by pregnancies terminated, stillbirth, and others who have had children suffering lifelong disability and pain.

If fortification were in place, eating around two slices of bread a day would've likely been enough to stop this happening.

Some might ask why women can't take supplements. It doesn't quite work that way. That's because about 40 per cent of pregnancies are unplanned. By the time women know they're pregnant, it's likely to be too late.

This is a public health measure that harms no one and helps many. Paediatrician Andrew Marshall - who deals with NTD-disabled children on a daily basis - told Radio New Zealand last week that the new report is "beyond reproach in terms of science".

This may be why certain industry groups are silent when, in the past, they've applauded the government for not enacting mandatory fortification. Perhaps we will see a triumph for the greater good after all.

• Niki Bezzant is editor-at-large for Healthy Food Guide www.healthyfood.co.nz