Decrease in neural tube defects since folic acid added to bread

Mandatory fortification of bread with folic acid (in Australia) and iodine (in Australia and New Zealand) was introduced in 2009 to address two important public health issues: to reduce the prevalence of neural tube defects (serious birth defects such as spina bifida) in Australia and to deal with the re-emergence of iodine deficiency in both Australia and New Zealand.

The introduction of the mandatory fortification has resulted in improved health outcomes, particularly for teenagers and Aboriginal and Torres Strait Islander women, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Monitoring the health impacts of mandatory folic acid and iodine fortification, shows that the increase in folic acid and iodine in the food supply since the introduction of mandatory fortification has resulted in notable health improvements.

“There was a significant (14.4%) overall decrease in the rate of neural tube defects (NTDs) in Australia following mandatory folic acid fortification. However among teenagers, the rate of NTDs decreased even more, by almost 55%, and for Aboriginal and Torres Strait Islander women, the rate of NTDs decreased by 74%, which is a very positive outcome,” said AIHW spokesperson Ann Hunt.

Following mandatory iodine fortification, iodine intakes increased in both Australia and New Zealand. For Australia, the increased amounts were sufficient to address the re-emergence of mild iodine deficiency in the general population.

In New Zealand, several small surveys showed some improvements in iodine intakes following mandatory fortification. Provisional results from the latest New Zealand Health Survey have since confirmed that iodine status in the general population is now adequate.

“Further work is needed to expand the data collection and ensure these early, promising results are accurate and sustained,” Ms Hunt said.

This report forms part of an independent review to ensure that the key policy objectives of mandatory fortification are being met.

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