Kiwiblog

No surprise, but the Government has confirmed there will be no mandatory addition of folic acid into bread – at least for the next three years.

Today, Food Safety Minister Kate Wilkinson said mandatory fortification of bread would be deferred until May 2012.

The Government and Bakers were now likely to focus on introducing a voluntary range of fortified breads.

The deferral was the “best way forward”, Ms Wilkinson said.

“I agree with public health advocates that folic acid is beneficial to the health of women and can prevent neural tube defects, but I also understand consumers overwhelmingly want to be able to choose whether or not the bread they buy is fortified.

“This approach will provide for consumer choice while also helping to address folate deficiency and increase the protection for babies resulting from unplanned pregnancies.”

Works for me.

John Armstrong writes:

The political furore over putting folic acid in bread is not confined to arguing the scientific merits of putting folic acid in bread.

It is about much more than that. It is an argument about the morals of mass medication. That raises all the connotations of “nanny state” knows best .

And no one is against people being able to buy bread with folic acid added to it. But why should every male, and every female aged under 16 or over 50 be dosed with folic acid, when the main benefit of it can not apply to them, and there is some uncertainity about risks.

Her handling of this hot potato has been lambasted largely on the back of a less than impressive performance on TVNZ’s Q&A programme the Sunday before last. Wilkinson seemed woefully under-prepared for the bombardment she received from interviewer Paul Holmes and the Greens’ food safety campaigner, Sue Kedgley. …

While making it clear she was looking for a means for New Zealand to escape its transtasman obligations, she looked like a minister hostage to the advice of her officials and seemingly powerless. Her solution that the decision to mix folic acid into bread be reviewed after its introduction may have satisfied legal considerations but it seemed somewhat farcical.

There were three basic positions you could take. One is you are against compulsory addition of folic acid in bread and are not going to let it happen. Another is you think it is a good thing to have folic acid added to bread and defend that decision. The third is that you are against adding folic acid to all bread, but won’t or can’t stop it happening. That is the worst position to adopt as it is saying I agree it is wrong, but I’ll let this bad thing still happen because I am powerless. It is a lesson for other Ministers.

Exit Wilkinson. Enter the Prime Minister. The Government will release a discussion document tomorrow with three options – deferral, rejection or the status quo. But Key has already said he prefers deferral, bringing the matter to a close. If this is another example of Key’s brute pragmatism, there are also lessons for his Administration.

The reason Key is so popular, is he is always getting involved and sorting out problems like this one, the old s92A etc etc. But over the longer term, the Government as a whole needs to be seen as performing very well – not just the Prime Minister.

Labour’s unwavering backing for folic acid in bread might have meant the issue was dead in terms of parliamentary politics. However, it has turned out to be very much alive politically outside the Beltway.

And Labour still back the mass medicating of folic acid. This means it may be an issue in the 2011 election as Labour will effectively be campaigning on their plans to make folic acid compulsory in bread. The review of the decision is timed for just a few months after the 2011 election so parties will be expected to have a position.

NZPA report:

Deferring a decision on whether folic acid should be added to bread was “a cheap cop out” in response to lobby group scaremongering, the Labour Party said today. …

Ms Dyson said the previous government considered a great deal of information before deciding to go ahead with the introduction of folic acid to bread.

Labour – the party of mass medication – even if we don’t know whether it causes cancer or not.

According to the Sunday Star-Times, Cabinet tomorrow will throw out Labour’s decision to introduce mandatory addition of folic acid to bread:

THE BUN-FIGHT is over. Bakers will not be forced by law to add folic acid to our bread, bagels, crumpets and English muffins. The Key government will announce this week that it is throwing out the former government’s policy.

Cabinet is expected to formalise the government’s position when it meets tomorrow, effectively putting the controversial issue on the back burner for three years and, crucially, beyond the next election.

The government is not convinced that making folic acid a compulsory ingredient in all bread is necessary, and wants more time to assess the evidence. Folic acid has been shown to reduce the risk of babies being born with defects such as spina bifida, but bakers say women would need to eat at least 11 slices of bread a day to make a difference to the health of their unborn child.

The Key government favours a voluntary regime. It has been looking for a way to wriggle out of the trans-Tasman agreement, struck by the former Labour government, and due to take effect on September 1.

Community pressure mounted as the deadline approached. Radio talkback shows were last week inundated with indignant callers.

The Star-Times understands that Food Minister Kate Wilkinson on Thursday reached an agreement with the Australian parliamentary secretary for health, Mark Butler, that exempts New Zealand from the new standard.

That is a nice exclusive for the SST, by their political editor Grahame Armstrong.

And the agreement with Australia is much better than unilaterally pulling out. As I have said before, Australian politicians will understand how something can become a major issue.

Under the trans-Tasman agreement, folic acid was to be mandatory in all wheat flour products, including sweet breads and rolls, bagels, foccacia, English muffins and flat breads that contain yeast.

Crumpets, scones, pancakes, pikelets, crepes, yeast donuts, pizza bases and crumbed products were also to be fortified with folic acid.

It was going to be in pizzas also?

Katherine Rich, chief executive of the Food and Grocery Council, said many New Zealanders would breathe a sigh of relief because they did not like the idea of the government tampering with their bread.

There were genuine concerns about the health effects and the prime minister was right to delay any decision until all the facts were known, she said. It was also an issue about freedom of choice.

“It’s quite a scary intervention to dose an entire country,” Rich, a former National MP, said.

“A trip to the baker should not be a trip to the chemist.”

Heh – nice line.

The Herald on Sunday also reveals that Rodney Hide has warned and lobbied fellow Ministers about the issue three months ago.

Colin Espiner reports:

Prime Minister John Key has asked Crown lawyers to help the Government get out of the new folic acid food standard.

Yesterday, Key asked Crown Law to find ways to free the Government from its legal obligations to implement a requirement that folic acid be added to bread from September.

Pleased to see the PM get involved. It is highly desirable to get an out before September.

And Martin Kay has good news:

New Zealand has effectively been given the green light to axe rules forcing bakers to add folic acid to bread from September.

The office of Australian parliamentary secretary for health Mark Butler told The Dominion Post it was New Zealand’s call whether to proceed with the trans-Tasman standard, agreed in 2007.

“Whilst the Australian Government will maintain a keen interest in what New Zealand decides, decisions on New Zealand standards are the responsibility of the New Zealand Government. As permitted under the [food] treaty, New Zealand has opted out of the joint standard and so their standard is nothing to do with the Australian Government.”

That sounds encouraging. If the Ausies are not going to get upset, what is the issue?

To give some balance to the debate, here are some extracts from a PR from the Coalition of Parents of Children with Spina Bifida:

• Folic acid does not cause postrate cancer in humans. The negative studies referred to involve extreme levels of folic acid fed to rats. Levels humans would never consume.
• UK has approved folic acid fortification – the delay is because they are still deciding on the best vehicle ie bread or flour (including pastries/biscuits etc)
• Neural tube defects (NTDs) are more common and deadly then meningitis
• 14 babies were born with NTDs in New Zealand last year. Specialists know this number should be quadrupled because many NTD affected babies are aborted and these are not recorded in the birth register. NTD miscarriages are also excluded.
• The level suggested is not the full 400mcg RDI but it works (US data since 1998 implementation) in reducing the number of NTD births, and has been proven to reduce heart disease and stroke, colon and stomach cancers, congenital heart defects in babies and onset of Alzheimers.
• Folic acid is a b-group vitamin necessary for healthy cell development and is comprehensively proven as beneficial for general health
• The Bakers Association, including president Laurie Powell, have all agreed to the proposal many times during face to face meetings over the past 10 years. Sue Kedgley has also pledged her support as long as organic bread was not fortified
• National and Labour MPs over three successive governments have agreed to this proposal – often unanimously
• This is the most important preventive health initiative since iodised salt to prevent goiter and the rubella vaccine.

And to balance that, a PR today from the Association of Bakers:

A day after Food Safety Minister Kate Wilkinson all but accepted that the new folic acid food standard should go, she has now seized on an unpublished study as conclusive proof that her plan to mass-medicate every New Zealander is safe. …

Her turnaround appears to follow statements by Professor Murray Skeaff, of Otago University, regarding his attendance at a conference in Prague at which an as-yet unpublished pooled analysis of all the randomised control trials of folic acid to date were revealed. We welcome the entrance of Professor Skeaff to the national debate on this important issue. However we note this respected academic has changed his mind from his previous view that “mandatory folic acid fortification would represent an uncontrolled clinical trial with all New Zealanders as participants”.

Professor Skeaff previously got to the nub of the whole issue being debated when he asked, in a research paper in 2003: “Preventing even one case of spina bifida is a priceless relief for the afflicted child or family, but is the prevention of four cases of spina bifida each year sufficient justification for accepting the risks of exposing four million people?” …

Her plan to dose every loaf of bread simply to provide folic acid for pregnant women robs New Zealanders of freedom of choice and her own officials have confirmed to her that there will be “unknown effects” of such a widespread medication plan. It’s the exactly the kind of nanny state intervention in their lives that many kiwis thought would change with the new Government.

Kate Wilkinson’s plan to dose every New Zealander is an experiment – an experiment that very few New Zealand voters want. We welcome the Minister’s continued commitment to a review of the standard but suggest it should take place before – not after – its implementation.

Strong views on both sides.

Former National MP Katherine Rich is now Chief Executive of the Food and Grocery Council. She writes:

If any government decides to mass-medicate every bread-buying New Zealander with a certain additive, it has to be very sure that the costs to the community don’t outweigh any health benefits, and that there are no long-term ill-effects on the population.

Minister for Food Safety Kate Wilkinson faces an interesting test as she decides whether to review or delay a controversial new food standard, which will force all bakers to add folic acid to every single loaf of bread.

The question is, will this centre-right politician – who campaigned vigorously on ridding New Zealand of the “nanny state” – endorse such a major intervention?

An excellent question.

Political ideology and the centre-right principle of freedom of choice aside, however, the big issue is the growing concern that too much folic acid might create long-term health problems for bread-loving Kiwis.

Folic acid has been seen as a miracle vitamin since the 1980s, when increasing pregnant women’s folic acid intake was linked to reductions in birth defects.

No one, and in particular bakers, disputes the beneficial effects on pregnant women. Pregnant women can benefit hugely from taking supplements and eating a healthy diet.

Where some part company is when regulators turn from targeted health programmes for small numbers of women at risk, to a programme of effective mass medication – dosing every man, woman, and child.

I prefer targeting.

Official reports written by the New Zealand Food Safety Authority (NZFSA) have been made publicly available. Parts of the reports make disturbing reading to any sandwich-making Kiwi parent.

While it’s been estimated that a pregnant woman will have to eat 11 slices of bread a day to receive the amount of folic acid required, the NZFSA reports confirm in black and white that some New Zealand children will, as a result of mandatory fortification, eat more than their recommended daily intake of folate/folic acid.

In rather alarming advice, the minister at the time was told by NZFSA: “There are unknown risks that may not become apparent for one or two generations. Children will be exposed to much higher levels of folic acid than in previous generations. It may not be until this generation of children have their own children that adverse effects become apparent.”

Does not sound reassuring.

“We continue to have concerns that 13.8 per cent of males aged 5 to 8 years and 8.2 per cent of New Zealand females are going to exceed the upper level intake for folic acid …”

These are the “concerns” that will need to be explained in the event the Government endorses the food standard. It may not be a task the minister will relish.

Katherine is not going soft on her former colleagues!

It’s potentially a very unpopular move.

New Zealanders simply don’t like the idea of governments tampering with their bread. The New Zealand Food Safety Authority’s own research concluded “84 per cent of consumers interviewed, even after providing information on the reasons for fortification, did not support mandatory fortification”.

So listen to them, and don’t do it.

My God. Labour in their dying days snuck through a regulation forcing bakers to plant a synthetic form of folic acid into every loaf made in NZ.

The plan aims to reduce the number of brain-damaged babies, although the fall may be a few as four a year.

But new research shows folic acid may cause an increase in colon cancer cases. And another study suggests it may cause colon cancer to grow faster.

The Bakers’ Association has labelled the compulsory introduction “mass medication” of the population, and warned that bread containing folic acid will be less safe than it is now.

This is like National Hospital’s unfortunate experiment – no informed consent for the test subjects.

The scheme was a favourite of former Health Minister Annette King but never went before Parliament. It was passed under special rules which do not allow the same level of public scrutiny.

The mandatory scheme was developed after it was decided the current scheme – in which specific brands are fortified with folic acid – was unsuccessful.

So the public didn’t choose the right sort of bread, so Labour passed a special law (regulation) to force everyone to have folic acid in their bread.

To me this is different to the flouridation debate, where the water supply is centralised. But at least with that debate, people can get their own water tank and supply. But this regulation will mean people have no choice to get bread without folic acid.

Bakers’ Association head Laurie Powell said it was difficult to address the issue because the industry did not want to put consumers off bread. “Our products are safe but probably not as safe with folic acid.”

He confirmed concerns about the scheme had led the association to ask the Government for legal indemnity.

“If it is found in 15 years’ time this stuff is bad and it causes health problems, we would be sued,” he said.

Powell was also concerned the industry could not regulate the amount of folic acid going into each individual loaf.

“It is a mass medication experiment that won’t work,” he said. “A trip to your baker should not be a trip to the pharmacy.”

The bakers have a point – they could get sued.

Authority officials confirmed pregnant women would not get enough folic acid from fortified bread and would still need to take supplements.

Which means the scheme may be counter-productive as it could mean women think they don’t need the supplements.