The only area of health concern with published data I can find is in relation to excess folic acid masking Vitamin B1 deficiency in the elderly. It is unclear how much folate would need to be consumed for this to be a problem. As for pernicious anaemia sufferers adversely affected? I confess i have not seen any data or even guesses. Steve's posts were the first i had any indication this was another reason for concern - I'll see what i can find out.

As for the breadflour you buy - up until the very final report by FSANZ (pre-Sept this year) the 'plan' had been to put folate in all bread flour so you could not make your own folate-free, but magically, after four years, the plan suddenly changed and the new law will state that BREAD, not breadflour, must contain between 80-180 micrograms of folate /100g. Presumably this gives flour manufacturers the 'choice' to add folate to their breadmaking products.

The problem here is: At what stage of the milling/manufacturing process will it be added? If it is at the milling stage for ease and low costs, then the breadflour they add to bread and the stuff you buy in a pack to make your own will either need to be made in two separate processes or it will all have the added folate. Runing two processes will add to costs so be prepared to pay more for your flour/bread either way.

Why?

Because J H and his ministers (and labor state health ministers!) want you to!
(because they are being told doing so will save the health budgets over $125 million each year. This is a LIE!)

Steve is exactly right - the problem is with women not being aware (or not caring) of the potential (one in a thousand) risk to their child that insufficient folate in the diet brings.

Vitamin Research, Sir Patrick Duns Trinity College Laboratory, St James Hospital, Dublin, Ireland.

Periconceptual consumption of folic acid has been shown to decrease the incidence of neural tube defects. The strategy of universal fortification of staple foodstuffs with folic acid presents the possibility of life-long exposure to unmetabolized folic acid. Chief among the risks of exposure to folic acid in the circulation is that of masking the diagnosis of cobalamin deficiency in pernicious anemia and the progression of neurologic disease. Other effects are unknown. For instance, the effect of in vivo chronic exposure of adult and fetal cells to the synthetic form of the vitamin has never been investigated at the population level.

Department of Human Nutrition, University of Otago, Dunedin.

AIM: To identify a folic acid food fortification programme that will maximise the percentage of women of child-bearing age receiving at least 400 microg folic acid/day, the amount shown to reduce the risk of neural tube defect-affected pregnancies, while not putting population groups at risk of excessive intakes. METHODS: 1997 New Zealand National Nutrition Survey data and a computer modelling programme were used to estimate folic acid intakes from simulated fortification scenarios. RESULTS: Breads fortified with folic acid at 150 microg/50 g, white flour at 100 microg/35 g and liquid milk at 200 microg/200 ml, were found to be the best fortification scenarios. Thirty one percent, 21% and 18% of women of child-bearing age received > or = 400 microg folic acid/day from the fortification of bread, white flour and milk respectively. CONCLUSIONS: The most effective scenario for folic acid fortification is bread fortified at 150 microg/50 g. However, it is impossible to fortify food at a level that ensures the majority of women of child-bearing age receive more than 400 microg folic acid/day without exposing some people to excessive amounts of folic acid. The current public health message encouraging women to select folic acid fortified foods and take folic acid supplements, needs to continue.

I have never heard of a Govt. campaign to advise people about folate.

Good research Steve.

I have to correct a previous error - it's a B12 not B1 deficiency and that's also known as.... pernicious anaemia (embarrased grin).

There have been education campaigns aimed at pregnant women, mostly through GP's, in Oz since the early 90's.

The problem is that lack of sufficient folate in our normal diet can result in pregnancy's affected by NTD's that arise within the first 20 weeks of pregnancy - many women do not become aware they are pregnant before the defect has developed so education does little benefit if they (all women who could become pregnant) don't eat a decent diet BEFORE getting pregnant.

This is part of an ever growing problem: we just don't care that what we eat is kiling us in ever growing numbers - 'That's my choice!' - who cares if it costs billions of dollars a year to the healthcare system we all pay for? I wanna Burger with fries and coke - supersize me! - as often as humanly possible and then some.

Our government's answer - education camapigns don't work well enough - we'll just mass medicate and charge you for the priviledge and not give you a say or choice! (because we can't be trusted to make the right one!)

How many people still smoke knowing the danger to their health and cost to our medical systems despite the 'Quit' campaign?

As for vegemite being banned in America because it contravenes the folate supplementation law.

I tried to find the US regulation on cereal, rice and grain product fortification - without success - but i believe it states the levels of supplementary folic acid allowed in certain foods. I don't believe it provides for the discrimination of a product that contains natural FOLATE (not a synthetic acid) from yeast extract in a food spread - I stand to be corrected if someone can show the legislation.

BTW the cost of folic acid being added to all bread in Australia is less than $60,000pa so i think that rules out any conspiracy to increase drug company profits?

For anyone unsure about why i am concerned with our governments plan see the following data from the US scheme introduced in 1996:

"(d) Folic acid may be added, at levels not to exceed 400 micrograms per serving, to breakfast cereals, as defined under Sec. 170.3(n)(4) of this chapter.
Dated: February 28, 1996.
David A. Kessler,
Commissioner of Food and Drugs.
[FR Doc. 96-5012 Filed 2-29-96; 12:04 pm]" Then from...

"USDA National Nutrient Database for Standard Reference, Release 18
Folate, Content of Selected Foods per Common Measure, sorted by nutrient content DFE (Micrograms):

Cereals ready-to-eat, GENERAL MILLS, Whole Grain TOTAL 3/4 cup (807)
Rice, white, long-grain, parboiled, enriched, dry 1 cup (797)
Cereals, Malt-o-Meal, plain, prepared with water, without salt 1serving (756)
Cereals ready-to-eat, QUAKER, Honey Nut Heaven 1 cup (735)
Cereals ready-to-eat, QUAKER, CAP'N CRUNCH'S P/BUTTER CRUNCH 3/4 cup (711)
Cereals ready-to-eat, QUAKER, CAP'N CRUNCH 3/4 cup (711)
Cereals ready-to-eat, QUAKER, QUAKER OAT LIFE, plain 3/4 cup (703)
Cereals ready-to-eat, QUAKER, CAP'N CRUNCH with CRUNCHBERRIES 3/4 cup (684)
Cereals ready-to-eat, KELLOGG, KELLOGG'S Complete Wheat Bran Flake 3/4 cup (682)
Cereals ready-to-eat, KELLOGG, KELLOGG'S PRODUCT 1 cup (676)
Cereals ready-to-eat, GENERAL MILLS, FROSTED WHEATIES 3/4 cup (676)
Cereals ready-to-eat, KELLOGG, KELLOGG'S SPECIAL K 1 cup (676)
Cereals ready-to-eat, GENERAL MILLS, TOTAL Raisin Bran 1 cup (673)
Cereals ready-to-eat, KELLOGG, KELLOGG'S ALL-BRAN Original 1/2 cup (659)
Cornmeal, self-rising, enriched, yellow 1 cup (518)
Cornmeal, degermed, enriched, yellow 1 cup (501)
Turkey, all classes, giblets, cooked, simmered, some fat 1 cup (486)
Cereals ready-to-eat, GENERAL MILLS, Wheat CHEX 1 cup (404) "

NOT more than 400 micrograms per serving?

The WHO 'safe' UPPER limit for folate/day from ALL sources is 1000 micrograms (=1mg) - The RDI for Aus was 200 microg. but has very recently been 'upped' to 400!

We have fortified cereals here but you cant trust what is on the label! According to Kelloggs (Aus) they ensure their figures are a MINIMUM to meet gov't 'requirements' and rather than be fined for failing to meet them they add extra, as the above US table proves is common practice world wide.

OK I have just read the 274 page final report from FSANZ.

"In addition to the potential health risks described above, there remains some uncertainty about other potential adverse health effects (e.g. cancer incidence and an increase in multiple births) from increased folic acid."

How does this stack up to the stated criteria: Health Ministers have agreed that vitamins and minerals can be added to food where there is evidence of potential health benefit, and fortification will not result in harm."

Their own report states there may be harm.

OK now I am really on the case.

I said i'd follow up on how many people may be adversely affected by this legislation to add folic acid to all bread.

The most commonly stated adverse effect of taking too much Folic Acid is the masking of Vitamin B12 deficiency (also known as pernicious anemia) in the community.

Steve can probably fill us in on the gorier details but PA is a long term developing illness that can be congenital (both parents must pass on the recessive gene) but may take 30 or more years for symptoms to develop.

It is estimated that one in 50 people over the age of 60 have the Vitamin deficiency due to lack of 'intrinsic factor' in the body, which cannot be solved in PA sufferers by taking pills - it needs injections of vitamin B12 for life.

That means there are significantly more people with an increased risk of health problems because of this legislation than FSANZ are claiming will benefit from it. (26 a year on ave. 14 - 49 on best available estimates. I find these estimates incredibly dubious and the 'proofs' proponents claim ignore data that shows decreasing levels of NTD's in communities where this legislation was introduced long before the legislation was mandatory)

I urge all Aussies to do their own research and look beyond the simplistic 'proof' being offered as evidence that we need our bread adulterated for all time, as we have already had for 15 years with thiamin and soon will face with iodine also.

Coming soon to a supermarket/bakery near you - Bread - The Wonder Pill !

Oh yes one other detail... The 'Upper Limit' for daily 'safe' consumption of 1000 mcg/day Folic Acid has been defined so as to be safe for "Almost All individuals in a society" I believe they define 'almost all' as a minimum of 98% of a population. Hence as much as 2% of any population could expect an adverse result from consuming LESS than any UL (1000 mcgs/day for Folic Acid) by standard experimental sampling techniques.