Reducing neural birth defects: NZ government proposes mandatory fortification of staples with folic acid

25-Nov-2019 - Last updated on 27-Nov-2019 at 01:20 GMT

Folic acid supplementation in pregnant women can reduce the risk of neural tube defects (NTDs) in newborns. ©Getty Images

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The New Zealand government is proposing to fortify staples such as wheat flour with folic acid to reduce the cases of neural tube defects (NTDs), including spina bifida, in newborns.

The Ministry for Primary Industries (MPI) said between 2011 and 2015, the rate of NTD-affected pregnancies was 10.6 per 10,000 total births in New Zealand. This is higher than Australia (8.7), Canada (8.6), and the US (7).

In its proposal, the MPI suggested for a mandatory fortification of non-organic bread, bread-making wheat flour, or all wheat flour.

The country presently adopts a voluntary stance, with the goal of fortifying 50% (by volume) of packaged sliced bread.

As of 2017, the volume fortified was 38%.

The authorities are also considering to keep fortification voluntary but raise fortification rates to 80% of packaged sliced bread.

Not many consume supplements?

Health advocate New Zealanders for Health Research (NZHR) supported the government’s call for higher rates of fortification, pointing out that there has been limited success in promoting folic acid supplement use amongst the public.

An opinion poll conducted by NZHR in April and May found that almost half of the females of child-bearing age do not know the benefits of adding folic acid to staple foods.

In women aged 18 to 34, 47% answered “don’t know” when asked whether adding folic acid to flour and bread was a safe and effective way of preventing NTDs.

“These figures suggest that it would be challenging to convince women to voluntarily take folic acid supplements in numbers sufficient to have a significant impact on the incidence of neural tube defects.

“Such supplements have already been actively marketed in New Zealand for several years with, as would appear from the NZHR poll results, only limited success,” said NZHR CEO Chris Higgins in a statement.

Australia’s experience

MPI said that a number of countries have benefited from mandatory fortification, with Australia as an example.

After introducing the scheme, NTD rates in Australia dropped from 10.2 per 10,000 total births between year 2006 and 2007 to 8.7 per 10,000 total births between year 2009 and 2011.

This also reduced the inequality gap between different communities. For example, the rate of NTDs dropped by 74% in the indigenous people and 55% in teenage mothers.

Elsewhere in Europe, voluntary fortification “have not been effective” in decreasing NTDs rate, the MPI said in its proposal.