Folic acid in all bread 'could put pensioners' health at risk'

A Government-commissioned report is this week expected to back the compulsory fortification of flour with folic acid to prevent babies being born with spina bifida.

But the move has sparked warnings that it would take away individual choice - and could endanger the health of elderly people by masking vitamin deficiencies.

Around 150 babies are born with birth defects such as spina bifida every year and another 750 pregnancies are terminated after scans reveal the problem in an unborn child.

Folic acid can prevent the problem so women are encouraged to take daily supplements of 400 micrograms from the moment they stop using contraception up to the 12th week of pregnancy.

However as half of all births in the UK are unplanned many fail to do so.

Research suggests that adding folic acid to all white and brown flour, as they do in the USA, would cut cases by more than 40 per cent.

In light of this, a new report by the Scientific Committee Advisory Committee on Nutrition, is this week expected to call for folic acid to be added to flour used in the UK.

When its draft report was published, Professor Sheila Bingham, chair of the committee's subgroup on folate and disease prevention, pointed out that many food and drinks are already fortified.

Flour has calcium, iron and vitamin B6 added, while margarine has extra vitamins A and D, plus cereals are already fortified with folic acid.

"It seems that asking people to take a supplement or relying on them to get sufficient amounts through their diet is not enough," she said.

"That is why after two years of research we recommended that the Government fortify flour with folic acid."

Charities for families affected by neural tube defects welcomed the move.

Andrew Russell, chief executive of the association for Spina Bifida and Hydrocephalus said: "Hundreds of abortions are carried out every year in the UK for spina bifida and a lot of severely disabled babies are still being born.

"It is the poorest and most educationally under privileged who are most at risk of a spina bifida pregnancy.

"Unfortunately relying on women to plan pregnancy and take a folic acid supplement in advance is unrealistic in many cases."

However some experts have warned that folic acid can mask vitamin B12 deficiency and for elderly people this can be particularly dangerous.

Dr John Parker-Williams of St George's Hospital in London has warned it can lead to anaemia and in the long-term damage to nerves.

"People should get their folates from a balanced diet - the best sources are leafy green vegetables, citrus fruits, bananas and nuts," he said.

Recent studies have also shown that excessive intake of folic acid could also lead to a rise in IVF twins by boosting multiple birth rates - which can bring extra risks for mothers and babies.

Sue Croft of the campaigning group Consumers for Health Choice said she could not support fortification of flour in this way.

"It is mass medication of 60 million people to benefit a few hundred," she warned.

"If the Government controls your food they control every aspect of your life.

"If you want to improve someone's diet you should give better education and help.

"In matters of health we should be given information so we can make an informed choice, not dictated to all the time."

A spokeswoman for Help the Aged said: "We would need to see more evidence of how this might affect older people, but generally we would not want to see anything introduced that put the well-being of older people at risk.

"People need to have a choice.

"A lot of pensioners are limited in what they can buy and bread is a staple part of their diet.

"Taking away their choice would cause concern."

A spokesman for Age Concern said: "Folic acid may help young people but we need to make sure the needs of older people are also being considered.

"When deciding if this should be put in bread we need to be sure that, although there are benefits for certain people, it does not cause any problems for older people."

A spokeswoman for the Food Standards Agency said the committee's final report is expected to be published on Tuesday and its board will then be launching its public consultation on the issue.

Once that is completed, the FSA board will consider the results and then pass on its recommendation to health ministers.

The row echoes the controversy surrounding the fluoridation of water. Fluoride is added to around 10 per cent of the UK's drinking water to improve children's teeth after research revealed it could cut dental decay by up to 60 per cent.

But some now want an end to fluoride in drinking water as young children exposed to too much can end up with mottled teeth.

Campaigners also claim it may even trigger bone cancer and osteoporosis.

However the World Health Organisation, the Royal College of Physicians and the Department of Health have endorsed water fluoridation as safe.

Spina bifida is what is known as a 'neural tube defect.'

The neural tube forms in the first few weeks of pregnancy and eventually develops into the baby's brain and spinal chord.

Spina bifida occurs when neural tube does not develop properly and this results in an incorrectly developed spine.