Posts Tagged ‘alice in wonderland’

Alice in Wonderland was used as the basis for a talk by Professor Barry Borman, Director of Environmental Health at Massey University. His title was Down the Rabbit Hole: The Wonderland of New Zealand’s Folic Acid Saga, and he pointed out that Lewis Carroll’s book had lots of resonance with the story of folic acid in our country. This reminded me of when I once did a Continuing Education course on Statistics in the Social Sciences, and the recommended prior reading was Alice in Wonderland. Barry pointed out that the only two countries mentioned in this book are New Zealand and Australia.

In 1992 with several randomised trials it was scientifically proved that the incidence of Spina Bifida and other Neural Tube Defects (NTDs) could be reduced if mothers had sufficient Folate before and during pregnancy. Folate is the natural form of Vitamin B9, and its synthetic form is Folic Acid. This can be provided through diet, supplementation, or fortification, and the latter can be voluntary or mandatory. In the U.S. Folic acid was given in the late 1990s (Folic before you frolic), and in ten years led to a 36% reduction in NTDs.

In 1993 it was decided that there was no need for fortification of Folic Acid in Aotearoa because we eat green leafy vegetables (although you would have to eat a tremendous amount to get sufficient Folate). In 1997 Kellogg’s added Folic Acid to some of their cereals, and in the early 2000s some supermarkets added Folic Acid to their bakery products. Millers and bakers said then they were willing to add Folic Acid, but the Government declared such fortification must be voluntary only. There was concern that “mass medication” could cause problems for the elderly, but this was theoretical only, and never proved.

It was agreed that the science endorsing fortification was accurate, but there was disagreement as to how it should be done. In 2006 both Australia and Aotearoa decided it would be best if fortification was mandatory. Annette King, who was the Minister of Health at the time, promoted the idea, but Green M.P. Sue Kedgley was against it. There were a number of public consultations over this ethical dilemma, with some believing the fortification might increase the risk of cancer although there was no evidence for this. In 2009 John Key cancelled the idea, mainly because of the influence of Katherine Rich and her colleagues. In 2018 a report by Peter Gluckman, the Prime Minister’s Chief Science Adviser, recommended fortification, and it was finally made mandatory in 2021, with a two year implementation period. There will be huge cost savings for the Health Department with fewer NTDs. Previously milling wheat has removed 80% of the Folate, so the fortification is simply putting back what has been milled out.

I went home and checked our bread, but could find no reference to Folic Acid in either my Home St organic bread, or Stephen’s white toast loaf. As there’s no likelihood of my getting pregnant, I presumably don’t need additional Folate anyway.

Today has been the first day when masks were no longer required. It was lovely to be able to see people’s faces and smiles, both in the lecture theatre and at Turanga.

Women are warned before they frolic
they’d best top up with acid folic

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