To the Editor: The recent viewpoint by Kamien1 and letter by Gunasekera2 rightly highlight the benefits of folate fortification and the unlikely occurrence of masking pernicious anaemia. Food Standards Australia New Zealand recently submitted a proposal supporting the mandatory fortification of bread-making flour to increase folate intakes in women of child-bearing age, with the aim of reducing the risk of children being born with neural tube defects.3 This proposal has had extensive public comment and will be considered by the Australia and New Zealand Food Regulation Ministerial Council. Several public groups and individuals continue to raise concerns that higher dietary folate levels could increase B12 deficiency. Our data, collected from a population-based sample of 2596 older people in the Blue Mountains region, from 1997 to 2000, do not suggest that this is a likely outcome.
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- 1. Kamien M. The repeating history of objections to the fortification of bread and alcohol: from iron filings to folic acid. Med J Aust 2006; 184: 638-640. <MJA full text>
- 2. Gunasekera H. The repeating history of objections to the fortification of bread and alcohol: from iron filings to folic acid [letter]. Med J Aust 2006; 185: 343-344. <MJA full text>
- 3. Bower C, de Klerk N, Hickling S, et al. Assessment of the potential effect of incremental increases in folic acid intake on neural tube defects in Australia and New Zealand. Aust N Z J Public Health 2006; 30: 369-374.
- 4. Flood VM, Smith WT, Webb KL, et al. Prevalence of low serum folate and vitamin B12 in an older Australian population. Aust N Z J Public Health 2006; 30: 38-41.
- 5. Mills JL, Kohorn IV, Conley MR, et al. Low vitamin B12 concentrations in patients without anaemia: the effect of folic acid fortification of grain. Am J Clin Nutr 2003; 77: 1474-1477.
Victoria Flood and Paul Mitchell received a Kellogg’s Research Grant 1998–2000.