Decrease in Neural Tube Defects since Folic Acid Added to Bread

Introducing the mandatory fortification of bread in Australia and New Zealand 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).

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: reduce the prevalence of neural tube defects (serious birth defects such as spina bifida) in Australia; and deal with the re-emergence of iodine deficiency in both Australia and New Zealand.

The AIHW report monitoring the health impacts of mandatory folic acid and iodine fortification shows that the increase in these elements in food 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 intake 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 the 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,” Hunt said.

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

The AIHW is a major national agency set up by the Australian government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.