The Government is taking action to prevent spina bifida and similar conditions, with the approval of the addition of the B vitamin, folic acid, to non-organic bread-making wheat flour.
“This is about protecting babies. Low folate levels in mothers cause neural tube defects that result in the death of babies, or life-long disability,” said Minister for Food Safety Dr Ayesha Verrall.
“New Zealand’s rate of NTDs remains too high compared to other countries who have a mandatory fortification approach, such as Australia, Canada, and the United States.
“A little over half of pregnancies in New Zealand are unplanned, so it’s not practical for all women to take a folic acid supplement one month before they conceive – to reduce the risk of these conditions,” Ayesha Verrall said.
“This B vitamin is safe and essential for health; particularly for development of babies early in pregnancy. Folate is naturally present in food; folic acid fortification restores what is lost during processing such as flour milling.
“Organic and non-wheat flour will be exempt from fortification, providing a choice for consumers who don’t want to consume folic acid,” Ayesha Verrall said.
A review by the Ministry for Primary Industries estimates fortifying all non-organic wheat flour for making bread could prevent between 162 and 240 neural tube defects over 30 years, and reduce health, education and productivity costs by between $25 million and $47.4 million over the same period.
“Introducing mandatory fortification is a safe way to ensure women of childbearing age are supported to increase their folic acid consumption.
“This move aligns us with Australia’s fortification approach, which has achieved declines in the prevalence of neural tube defects, particularly in pregnancies among teenagers and indigenous women,” Ayesha Verrall said.
Officials will work closely with industry to ensure the recommended level of folic acid fortification is achieved, by providing support to flour millers; including financial assistance for the purchase and installation of the necessary infrastructure, which is estimated to cost $1.6 million.
There will be a two-year transition period.
New Zealand’s estimated neural tube defect rate (10.6 per 10,000 births) is higher than countries that have implemented mandatory folic acid fortification, including the United States (7.0 per 10,000 births), Canada (8.6 per 10,000 births) and Australia (8.7 per 10,000 births).
In Australia, NTDs rates fell by 14% overall following the introduction of mandatory folic acid fortification. This resulted in improved equity in health outcomes, particularly for indigenous communities (74% decline in NTDs) and teenage mothers (55% decline in NTDs).
During public consultation, the majority of submitters were supportive of a mandatory approach, including public health professionals and organisations, academics, and consumers. Of those who specified a preferred approach, 85% supported mandatory fortification.
The Ministry of Health supports the mandatory approach, and a 2018 report from the Prime Minister’s Chief Science Advisor and the Royal Society Te Apārangi found no evidence that folic acid, when fortified in food, had any harmful effects.
The report, The Health Benefits and Risks of Folic Acid Fortification of Food, is available here: