Food Safety Minister Kate Wilkinson's apparent inability to back out of the decision to add folic acid to New Zealand's bread shows the problems with trying to merge New Zealand and Australia's markets

From September, all New Zealand's bread (other than "organic" loaves, thanks to the Greens) must be "fortified" with 135 micrograms of folic acid for every 100 grams of bread. However, the Minister responsible for overseeing this new standard, National's Kate Wilkinson, doesn't want this to happen. Yet there's apparently nothing she can do to stop the new requirement coming into force. What gives? And what does the issue tell us about our developing relationship with our big cousins across the ditch?

A bit of background is needed here. Grabbing the baking metaphor and running with it, folic acid is a necessary ingredient for a healthy baby. If a mother is deficient in it during her early pregnancy, her child has a much, much higher risk of malformations of the spinal cord (the most common of which is Spina Bifida). This is why the Ministry of Health adviseswomen planning a pregnancy to take folic acid supplements 4 weeks before and 12 weeks after conceiving. However, a significant number of women still do not get enough folic acid through their diet, either because they don't follow that advice or because they are not planning a pregnancy and don't realise one has occurred until too late.

To catch these women, a number of countries (including the USA and Canada) mandate that folic acid be added to bread. There is good evidence - such as this, or this- that doing so raises folate levels in the blood, thereby decreasing the incidence of malformations of the spinal cord in newborns. Based on this evidence, in June 2007 Food Standards Australia New Zealand (FSANZ) created a new food standard requiring that Australia and New Zealand do likewise. That standard comes into effect this September (alongside another standard requiring the mandatory addition of iodinised salt, which seems to have completely slipped under the radar).

So far, so simple. Ingesting folic acid helps stop kids from being born with a particularly debilitating condition. Adding folic acid to bread helps ensure women get enough of it. So how can Kate Wilkinson have a problem with any of that?

Well, one potential problem is that while the addition of folic acid to bread is aimed solely at those women who may become pregnant, everyone who eats that bread will ingest it. (Unless they are prepared to pay a significant premium for "organic" bread, that is!) And there is some emerging evidencethat ingesting very high doses of folic acid may contribute to a greater risk of developing prostate cancer. Of course, you'd have to eat a hell of a lot of "fortified" bread to get to the sorts of levels these studies are dealing with. (They have been carried out on men who take folate supplements, in response to earlier suggestionsthat such supplements may help reduce the risk of colon cancer.) But even an outside chance that adding folic acid to bread to protect some children may increase the risk of cancer for all men complicates the cost-benefit calculation.

That calculation can, of course, be settled by better evidence - just how strong is the link between folic acid intake (and what level of folic acid intake) and prostate cancer? But it does then lead to a more ideological concern, one which I suspect really underpins Kate Wilkinson's unhappiness with the policy.

Why should the state intervene to force all "non-organic" bakers to change their recipies, and most bread consumers to alter what they eat, to produce a benefit for a few? After all, is not the responsibility for birthing healthy children the responsibility of the mother? And isn't this just typical of the past Labour Government's nanny-state mentality, to reach for a regulation that limits everyone's choices rather than put the onus on individuals to look after themselves and their children?

Putting to one side the problem of how a woman not planning a pregnancy is supposed to "look after her own child", given that folic acid is needed before conception occurs, you can see why this line of argument might appeal to a National minister. It's a challenge explicitly thrown downby ex-National MP, Katherine Rich, who is now the chief executive of the New Zealand Food and Grocery Council. So why hasn't Kate Wilkinson leapt in and rescinded the new regulation?

Here's where our cousins across the Tasman enter the fray. Successive New Zealand governments have seen the path to economic salvation as lying with closer economic integration with our largest trading partner, Australia.  On the whole, National is a big fan of this process; John Key has even "encouraged debate" on a single currency for the two nations. However, closer economic integration means standardising a whole range of regulatory matters, including questions of food safety. Which is why the FSANZ agency was set up in the first place, to bring Australia and New Zealand's regulatory requirements on such matters into alignment and thereby minimise cross-border barriers to trade.

No doubt Kate Wilkinson could, if she really, really wanted to, find a way to unilaterally override the FSANZ's decision. But if she were to do so, it would undermine the basis of trust and mutual forebearance that underpins these sorts of trans-Tasman relationships. Simply put, why should Australia bother taking the time to negotiate these sorts of common regulatory regimes if a change in government in New Zealand then causes them to get canned? And given that New Zealand has more to lose if these sorts of common regulatory regimes end, why risk pissing off our neighbours like that?

All of which means that Kate Wilkinson is reduced to carping on the newsthat this is "a standard that was put upon us by the last government" (ignoring the fact that in 2007 there was no evidence of any health risks from folic acid), while asking the FSANZ to review its decision. But because Australia is so much bigger than us, it has a much greater representation on the FSANZ, which means any reversal of the standard essentially depends on Australia's members agreeing to let New Zealand off the hook.

Consequently, the issue of folic acid in bread is about more than the ideological question of whether a definite benefit to a few justifies imposing a measure of risk on all; although that certainly is a big part of it. It also is about New Zealand's sovereignty, and the way in which international agreements place constraints on government's ability to do what it wants. Pundit's own Tim Watkin, blogging in his other gig as Q&A producer, already has grumbled about the mania for strengthening our links with Australia. Perhaps other readers have thoughts on whether this is a good idea?

Comments (10)

by Claire Browning on July 09, 2009
Claire Browning

Grabbing the baking metaphor and running with it, folic acid is a necessary ingredient for a healthy baby.

And cleverly MIXING a couple of metaphors, too ...

by Kate Hunt on July 09, 2009
Kate Hunt

it seems to me this proposal has never been on track. Has it occurred to anyone that 20-something-year-old females -- the most likely individuals to get pregnant, you would think -- are the least likely to eat quantities of bread? I have 2 daughters to verify that deduction. And that teenage boys are the most likely to ingest quantities of folic acid through bread? Which, given the concern about prostate cancer, seems to be entirely the wrong target market. (I'm not suggesting that teenage boys are at risk of prostate cancer, but all the same...) It just seems nuts to me on many levels.

by BDB on July 11, 2009
BDB

Folic acid sparks debate and the consumers’ voice was silenced, as usual.

Andrew your comments  are ill informed.
So here is a submission on behalf of the people  of NZ that will have to fund this stupid scheme if we get no supportive help and intelligence from the scientific community.
Critiquing  some of the  unscientific  claims, and stating other omitted scientific findings. Supporting the sensible points of those scientists not living in a State induced void of reason.



Folic acid sparks debate among scientists
Should folic acid fortification be mandatory? Yes/ NO


Concerns have been expressed about the possible negative effects of folic acid fortification.


Women who have inadequate nutrition, substance abuse and psychological  distress  in the early stages of pregnancy are also at increased risk of having a baby with a neural tube defect

Richard Hubner and colleagues say that more research into the harms is needed.

supplements must be taken before pregnancy is confirmed, and most pregnancies remain unprotected.

Voluntary fortification has proved inadequate.(as sited by the same BMJ study you are using).

Mandatory fortification of enriched breads, cereals, flour and other grain products has taken place the USA, for some years and has resulted in a 25% drop in the rate of neural tube defects.
This 25% figure is based on which study?
Site the  proof of claim and study of these stats .

Further, a paper published in the BMJ last week found that in Canada, public health measures to increase folic acid intake followed by a decrease in the birth prevalence of severe congenital heart defects.
How? Through which medium what was the  intake and dosage and what were the measures?.





Elaine Rush is Professor of Nutrition at Auckland University of Technology. Well done.

Folic acid will mask vitamin B12 deficiency. vitamin B12 is also an important factor in the prevention of neural tube defect .



"There is evidence from India that maternal low B12 and high folate status are related to intrauterine growth retardation, and also with adiposity, insulin resistance and poor neuro-cognitive performance during childhood. We have measured pre-adolescent Indian girls and adults here in New Zealand, and B12 is also a problem for them.

"In isolation, the addition of single nutrients to a food supply may cause other unintended effects and the issue of fortification does need thinking though carefully so that all the population groups in New Zealand benefit".

Jan Milne is Executive Director of the New Zealand Dietetic Association.






"The New Zealand Dietetic Association's preferred option throughout the consultation process with Food Standards Australia New Zealand was the continuation of voluntary folic acid fortification in foods in combination with increased education to women of childbearing age about the role of folic acid in reducing the risks of neural tube defects.

"NZDA is concerned that the success of the mandatory fortification process relies on women of child bearing age continuing to take a folic acid supplements. In relation to this, NZDA is concerned that the dose of the folic acid supplement that is available to women has not been altered to take account of the change in folate and folic acid available in the food supply as a result of mandatory fortification"


Dr Claire Wall is a senior lecturer in nutrition from the University of Auckland. Funded by the State.

Supportive of mandatory folic acid fortification in New Zealand as  there could be, but may not be ,  benefits in terms of reducing neural tube defects and no adverse effects have been recorded, followed up  or investigated in the USA where there has been mandatory fortification of folic acid for several years.
IE the cancer rate has increased, but there is no way to blame it on the fortification



Lydia Buchtmann  for Food Standards Australia New Zealand. And if she didn’t have Conflict Of Interest  she may say :

We have concluded that at the levels we are proposing to add folic acid  will not greatly reduce the risk of neural tube defects.

"Mandatory fortification of folic acid has taken place in the USA for over 12 years and during this period there is no evidence that neural tube defects have been reduced by  fortification, and there is no other reliable evidence to prove its safety or efficiency
Cancer.a big testicular problem  and it may be yours, so be a good chump & chug down on the pharma.Fund this ill health incentive without opposition.Baa baa.

by BDB on July 11, 2009
BDB

OH and Andy thanks to the Greens?

For what? in this case they did not point out that there is no scientific or cost benefit evidence that supports this nasty unhealthy 'scheme'.

Do the Greens have stock in NZ Organic- is that why we are thankful?

 

by Andrew Geddis on July 12, 2009
Andrew Geddis

BDB,

I gather you disagree with the addition of folic acid to bread. Fair enough. But I'm not sure exactly why you think I'm such a strong supporter of it ... I simply pointed out that the predominance of scientific evidence (like this, or this) is that it works to reduce one problem in newborns (neural tube defects, and possibly congenital heart disease also), while the potential harms are (as yet) still unproven. This doesn't necessarily mean that fortification should go ahead - it is quite possible to apply the precautionary principle here and say more evidence of risk is needed before acting. That's a valid argument ... but you're simply lying to claim there is no evidence of potential benefits.

As for your criticism of the Greens, you might like to read this press release from Sue Kedgley, calling for a pause in implementing the addition of folic acid to bread. So you and she appear to agree with each other. Now, your problem with the Greens is, what exactly?

by BDB on July 12, 2009
BDB

You are a supporter- of way of  your unresearched bias piece. I am  supporter of consumer rights, including the right to be informed.So I am against this false  fortification claim as it is not in NZ's best interest.

You can keep carping on about "what about the babies?" till the cows come home, and   neural tube defects (that was claimed by a scientist  would not  even be prevented by implementation of this policy).

You did not site evidence you sited a claim.

 

What is your scientific evidence of potiental benefits?You are the one that is lying, thank you very much,  as I researched this topic. The claimed evidence  does not exist in any empirical/scientific form.Possibly is the emphasis.

 

I love Sue Kedgley.I wish she was PM and not the insecure investment banker.

"other than organic loaves, thanks to the Green'"

My problem was that was not good enough, as the Greens know  most people cannot afford organic bread as a solution to  flawed, possibly unsafe, unsound and costly policy for NZ (NZAustralia).

 

 

 

 

 

 

by Andrew Geddis on July 12, 2009
Andrew Geddis

BDB,

It is difficult to argue with someone who does not seem capable of acknowledging the evidence I provided through my links. So on the principle that it is unwise to argue with a fool as people might not be able to tell the difference, I quit.

by BDB on July 12, 2009
BDB

 

You published your claims  without research or any empirical data as evidence, and the links you sited do not contain scientific evidence.

I acknowledge you provided me with no empirical evidence in your links.

There is a big difference between claims and evidence Andrew.

So, since you quit  I hope you or anyone you love, does not get cancer from this forced costly  fortification aus/nz  plan.

And thank you for attempting to insult me following my feedback on the unsafe information you passed on as facts  in your Folic acid debate post.

Did you win debates at school by quiting and calling your opponent a fool.

What year was it claimed that  eggs bad for you, and which year did the claim that they were good for you surface?Do not insult your readers intelligence, if they want to research this health issue(unlike you)they will, and may  be able to see the difference-  that these are unsound claims not based empirical evidence.

by BDB on July 12, 2009
BDB

Andrew, just found out why you do not understand the concept of scientific evidence V.S a claim.Your specialty is Law, I am so sorry.

The following link may help you.

smc@sciencemedicentre.co.nz

Since your recent blog was very much a medical( and now made a political )issue, and  you insisted in using  the same unsubstantiated medical claims that the State too has been using to push their policy.& As you felt I am a fool to tell you that  you provided no evidence on your medical claims- ask a couple of medical scientists/researchers.

The reference for your medical claims should be sited, and you cannot/should not  make a claim i.e folate increases likelyhood of prostate cancer, or  lack of folate ( without  genetic cause )causes neural defects without empirical evidence.

by Andrew Geddis on July 12, 2009
Andrew Geddis

BDB,

I'd take you more seriously if you knew how to spell "cited". And if you showed signs of really understanding what "empirical evidence" meant and/or knew how to follow hyper-links to other webpages. But you don't. So I don't. This correspondence is closed.

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