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Bread addiditive costing a penny a year could reduce birth defects by 60 percent

Fortifying bread sold to the general public with folic acid could reduce the number of birth defects by up to 60 per cent, policymakers convening in Austria for the Gastein Health Forum have been told.

Adding the acid to flour has been shown to substantially reduce the prevalence of neural tube defects such as spina bifida, says Scott Montgomery, Director of the Flour Fortification Initiative.

He told the conference at the four-day forum, where policymakers will mull a range of issues under the theme of "healthcare in an age of austerity" - that that there have been declines of between 31 and 58 per cent in those defects after flour fortification. There was also a drop in health care costs.

He said: "Flour fortification has been particularly successful at reducing the prevalence of neural tube defects, and studies in three countries have reported reduced health care expenditures when these birth defects are prevented through flour fortification."

Folic acid, known as folate in its natural form, is one of the B-group vitamins. It works together with vitamin B12 to form healthy red blood cells, and helps reduce the risk of central nervous system defects such as spina bifida in unborn babies.

The UK Department of Health recommends that folic acid supplements are taken by women who are pregnant or thinking of having a baby.

Whether or not to fortify bread in Britain has been debated for several years, and it is estimated that there are between 700 and 900 pregnancies affected by neural tube defects each year in the UK alone.

Concerns about mandatory fortification include worries that it may lead to excess consumption of folic acid, that it may cause cancer, and the removal of consumer choice.

But Dr William Dietz, a former director of the Division of Nutrition art the US Center for Disease Control and Prevention says these concerns are unfounded: ``Folic acid fortification of flour carries few risks and has substantial health benefits," he will tell the conference.

Folic acid is not the only compound that could be used for fortification, vital supplies of iron and iodine could be given through the same route too.

There are significant levels of anemia among women, especially pregnant women, where iron deficiency can be an important contributor. And in several European countries, there are schoolchildren with mild or moderate iodine deficiency. The conference will hear that both groups could benefit from fortification.

"The cost-benefit of interventions to reduce deficiencies of iron, iodine and folate is well established," says Sue Horton, Chair in Global Health Economics, Centre for International Governance Innovation.

"Fortification of staple foods costs only pennies a person each year, but has the potential to reduce loss of cognitive function, where iron and iodine are concerned, and neural tube defects, for folate.

"Fortification is also the best way to reach women peri-conception. For women who only boost their micronutrient intake once they know they are pregnant, the damage already done may be irreversible."

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