Folic Acid (Hansard, 18 March 2002)

§ Mrs. Helen Clark
To ask the Secretary of State for Health (1) when the Food Standards Agency is expected to complete its consideration of the legal, technical and health implications of fortification of flour with folic acid and make its recommendation to Government; [40777]
(2) when he will announce his policy on the fortification of flour with folic acid. [40781]

§ Yvette Cooper
The Food Standards Agency (FSA), together with Health departments, is hosting a stakeholder meeting on the issue of fortification of flour with folic acid on 18 March 2002. The aim of this meeting is to ensure that, all relevant information and points of view are taken into account.
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I understand that following the stakeholder meeting, the FSA board plans to consider the issue at its open meeting on 9 May 2002. Health Ministers will, thereafter, consider the way forward on the issue taking the agency's advice into account.

§ Mrs. Helen Clark
To ask the Secretary of State for Health what the recommended dose is of folate for women to reduce the risk of spina bifida pregnancy. [40780]

§ Yvette Cooper
The Committee on Medical Aspects of Food and Nutrition Policy issued advice on the prevention of neural tube defects (the most common of which is spina bifida) in 1992.
Women who are trying to conceive or who are likely to become pregnant, are advised to take a daily 400 tg supplement of folic acid until the I Th week of pregnancy. In addition, all women who may become pregnant are advised to increase their daily intake of folic acid by eating more folate-rich foods and foods fortified with folic acid—especially breads and breakfast cereals.
To prevent the recurrence of a neural tube defect, folic acid supplements are a daily dose of 5 milligrams (5000 lag) are advised and this can be reduce to 4mg, if this dose becomes available.

§ Mrs. Helen Clark
To ask the Secretary of State for Health what assessment he has made of the evidence relating to the effect flour fortification with folic acid has on rates of(a) homocysteine levels, (b) stroke, (c) stroke mortality, (d) heart attacks and (e) colon cancer. [40779]

§ Yvette Cooper
The Committee on Medical Aspects of Food and Nutrition Policy (COMA) report on folic acid and the prevention of disease (2000) noted that fortification of flour with folic acid might result in a reduction in the risk of cardiovascular disease (CVD, especially strokes and heart attacks).
In otherwise healthy people, an increased blood level of homocysteine is associated with increased risk of CVD. Studies have shown that low intakes of folate are an important cause of increased homocysteine level in the general population and increasing folate intake can reduce homocysteine level. However, whether there is a causal relationship between folic acid intake and cardiovascular disease still requires confirmation. There are on-going randomised controlled trials assessing the impact of lowering homocysteine levels (by increasing folic acid intake) on incidence of heart disease.
In 1998, the COMA report on the nutritional aspects of cancer concluded that there was insufficient evidence for any specific links between folate intake and the development of cancer.