Folate Pilot Health Claim Program

In 1994 the NHMRC recommended a revision of the food standards to allow for voluntary folate fortification of key staple foods to reduce the incidence of neural tube defects (NTDs), such as spina bifida, in Australia.

In 1995 an amendment to the food standards regulating the addition of vitamins and minerals to food products on sale in Australia (Standard A9) and New Zealand allowed flour, bread, savoury biscuits, breakfast cereals, pasta, yeast extracts and fruit and vegetable juices to be fortified with up to 50% RDI of folate per serving on a voluntary basis.

As an incentive to food manufacturers to reformulate food products and/or develop new products with additional folate, ANZFA amended the food standards to pilot the use of a health claim (relating to the benefits of folate in helping reduce the number of babies born with NTDs) on approved products. To make a folate/NTD health claim, foods must contain at least 40 (g of folate in each serving.

Why is folate fortification necessary?

Epidemiological studies suggest that maternal folate deficiency increases the risk of NTDs, especially in women with a family history of NTDs. NTDs are the most common congenital abnormality which can affect 400-500 births each year in Australia. Folate fortification has the potential to prevent 50-66% of these NTDs.

Folate is a water soluble vitamin B found in a wide range of fresh fruit and vegetables, legumes, cereal grains and derived products. The recommended dietary intake for people aged 12 years and over is 200 (g folate/day and 400 (g folate/day for
pregnant women.

Surveys at the time indicated that few women achieved the folate RDI for pregnancy. According to the 1995 National Nutrition Survey, folate intake in women of childbearing age, prior to voluntary folate fortification, was approximately 230 (g/day from foods and beverages, indicating that there was a need to increase folate intake via food fortification.

Dietary modelling indicated that folate fortification to 50% RDI per serving of staple foods would result in a mean folate intake of 500(g/day in the target population without placing the population, as a whole, at risk. Folate fortification of the food supply has the advantage of reaching most women of childbearing age, particularly unplanned pregnancies.

Technical aspects of folate fortification of bread

• The average folate content of wholemeal bread, prior to fortification, is
  40 (g/100 g and for white bread, 20 (g/100 g. To achieve 100 (g of folate in a
  50 g serving of bread, approximately 4 mg of folate per kilogram must be added to bread-making flour.
• Folate is water-soluble, heat labile and alkali sensitive. Folate in bread comes from the yeast and the flour. Added folate appears to be stable throughout the bread baking process with small losses at high temperature. It has also been shown to be stable during storage in enriched flour as well as in the finished baked product for up to 5 days.
• Folate has no noticeable effect on the flavour, colour or appearance of the enriched cereal grain.

Evaluation to date

The effectiveness of the NHMRC and ANZFA policies depend on the extent to which food manufacturers fortify foods with folate. The NHMRC recommended that voluntary fortification be reviewed three years after the date of gazettal to determine its effectiveness and whether there is a need to introduce mandatory fortification of flour. ANZFA is evaluating implementation of the folate pilot program. For information on the progress of this program, visit the ANZFA website.

In 1998, over 40 products, mainly breakfast cereals, were fortified with folate. Breads fortified with folate contain from 50-200 (g folate/100 g and breakfast cereals,
111-333 (g folate/100 g2.

In September 2000, 35 bread products and 20 breakfast cereals provided at least 40 (g folate per serving of food.

References
1. Lawrence M. Why fortify foods with folate? Food Australia 1998;50(10):503-505
2. Lawrence M, Rutishauser IHE, Lewis JL. An analysis of the introduction of folate-fortified food products into stores in Australia. Aust J Nutr Diet 1999;56(1):15-21

For Further Research

Additional links

• Folate