Voluntary folic acid fortification of bread is sufficient but maximum limits should be set and the market carefully monitored, a public health expert says.
Chief specialist in public health nutrition at the FSAI (Food Safety Authority of Ireland) Professor Mary Flynn addressed delegates at the authority’s international conference on folic acid fortification, organised with Trinity College Dublin.
“The advice we gave in 2008 still stands – voluntary addition of folic acid to food products should not increase further,” she said.
However, Flynn warned that voluntary fortification must be monitored closely.
While mandatory fortification reaches almost everyone in the population, voluntary fortification can be ‘hit and miss’ in that it only reaches those who consume fortified products, she said.
The voluntary status is very ad hoc, she added, with companies able to stop fortification or change the amount added at any time.
“Continuous monitoring is required to establish the levels of folic acid intake in the population, but the widespread variability in voluntary fortification makes this difficult. For example, keeping track of the wide range of food products that are fortified with different levels of folic acid is demanding of itself – but then we have the task of determining who in the population consumes these particular products and to what level.”
EU-wide maximum limits must be set
The chief nutrition specialist said the EU must finalize regulation to ensure companies are fortifying products with enough folic acid to have an impact.
“Now that EU food legislation allows food businesses to voluntarily fortify their food products there is a real need to set maximum limits for the addition of vitamins, such as folic acid, to food,” she said.
As health claim authorisation for food products increases, there will be more food makers fortifying products with folic acid, she added. “This makes the on-going work at EU level to set maximum limits vitally important.”
Voluntary fortification impacts in Ireland
Blood monitoring research conducted by the FSAI indicated that folic acid intake from fortified foods and supplements remains high in the country and there has been no change in the past five years.
In collaboration with Trinity College Dublin (TCD), the authority measured folic acid in blood samples from women of all ages, men and children in two time periods – 2005-2007 and from 2010-2012.
Neural Tube Defects (NTDs) were also decreasing. A complete count of the number of pregnancies affected by NTDs in Coombe Hospital in Dublin showed a drop in occurrence to 0.93 per 1,000 births.
“At this time, there would be no benefit to be gained from further addition of folic acid to food through mandatory fortification of bread,” the FSAI said.
Mandatory folic acid fortification in foods is mandatory in 75 of the globe’s countries – predominantly outside of the EU.