You are not permitted to download, save or email this image. Visit image gallery to purchase the image.
Caution is appropriate when additives are mandated, whether that be to food or fluoride in water.
First, of course, is the issue of safety. Authorities must be assured any risks are so tiny as to be virtually insignificant. Second, comes the matter of choice. Consumers, under most circumstances, should not be forced to ingest additives — "mass medication" as it is sometimes emotively called. Businesses, too, have rights.
Nonetheless, there are cases when such individual rights are trumped by community need. Rights are not absolute and need to be weighed against the greater good.
We are not islands to ourselves. We are part of families, communities and our nation. We have responsibilities to others as such. Fortifying bread with folic acid is one of these cases. It will take place from mid to late 2023 in an attempt to prevent crippling birth defects. This is despite the opposition of the Food and Grocery Council, representing food manufacturers, which argues it still should remain voluntary. It cites emerging evidence of possible health risks.
The National Party before the last election was opposed to change on consumer choice grounds. New Zealand and Australia had agreed to the move taking place in 2009, but the new National government, amid concerns about "nanny state", pulled out after a campaign by the council and bakers.
Supporters say fortifying bread and other food staples with folic acid, a B vitamin, significantly reduced birth defects of the brain, spine, or spinal cord in the United States, Canada, Australia and other countries.
The list of some of those in favour is impressive and underlines the need: Consumer NZ, the Ministry of Health, Dieticians NZ, the district health boards, the Medical Association, the College of Obstetricians and Gynaecologists, the Paediatric Society, the College of Physicians, the Nurses Organisation and the College of Midwives.
Food Safety Minister Ayesha Verrall last week said the move was about protecting babies. Low folate levels in mothers caused neural tube defects that result in the death of babies, or lifelong disability, she said.
"Folic acid fortification restores what is lost during processing such as flour milling."
Some consumer choice will remain because organic and non-wheat flour will be exempt.
The change is expected to prevent 162 to 240 neural tube defects over 30 years, and save many millions of dollars over the same period in health, education and productivity costs. It has also been estimated up to 200 miscarriages a year could also be prevented.
The neural tubes close over 15 to 28 days after conception, making clear the importance of the vitamin immediately at the beginning stages.
Spina bifida is the best-known defect.
The Ministry for Primary Industries estimates up to 171 pregnancies affected by a neural tube defect could have been prevented in the 10 years after 2009 if mandatory fortification of bread had gone ahead.
Flour millers will receive $1.6 million to help with equipment needed. Although folate is found in the likes of leafy green vegetables, dried beans and lentils, it is difficult to get enough from diet alone. Women are advised to take folic acid tablets when contemplating pregnancy.
After Australia proceeded in 2009, neural tube defect rate dropped by 14% overall, by 74% for indigenous women and by 55% for teenage mothers.
The positive impact of folic acid will be most marked for the socially disadvantaged, including those groups most likely to have unplanned pregnancies. It is they who are least likely to be taking folic acid tablets or eating the requisite foods.
The advantaged, and the majority, owe it to others and wider society to allow and even encourage this "mass medication". A little folic acid in mainstream bread can go a long way in preventing a lot of heartbreak, agony and cost.