Next Tuesday, the FSA board will meet to discuss whether folic acid should be added just to bread or to flour - which would mean it could also go into cakes and biscuits.

The blanket addition of folate is justified, it says, because a lack of folic acid before and during pregnancy has been linked to disabilities in babies. A study published in health journal The Lancet last week added weight to the FSA's cause by suggesting that regular doses of folic acid could also reduce the risk of stroke in adults by up to 30%.

But not everyone is convinced of the merits of mass medicating - or the costs likely to be entailed.

So far, the FSA has agreed to a series of controls if compulsory fortification is adopted, such as wholemeal flour being exempt. Controls on voluntary fortification of products such as breakfast cereals and spreads, some of which already contain folic acid, would also be included in its recommendation, says the FSA.

However, opponents of the move point out that an increase in folic acid can mask a vitamin B12 deficiency, which can be dangerous in the elderly. Plus, they point out, the effects of too much folic acid in a diet are not fully understood.

Manufacturers have expressed concerns about how the move will affect not just bread producers but the wider cakes and biscuit industry, if the FSA recommends that folic acid is added at the milling stage, the cheapest and easiest way to do it.

"We support the FSA's decision, and would welcome clarification about how folic acid can be

added to bread without affecting cakes or biscuits," says a spokeswoman from the Biscuit, Cake, Chocolate and Confectionery Association.

The idea of mandatory fortification has also drawn fire from campaigners for natural and organic food.

"The FSA has confirmed that wholemeal flour will be exempt from the fortification, supposedly because it wants the consumer to feel like they have a 'choice'," says a spokesman for Garden Organic, a charity dedicated to researching and promoting organic gardening, farming and food.

"That's because wholemeal flour already has folic acid in it. So why not just tell women of child-bearing age to eat more wholemeal bread?"

The FDF agrees that there are other simpler measures that

could be taken to ensure the public gets the recommended amount of the vitamin B compound in their diet.

Why not encourage greater use of voluntary fortification, for instance, or disseminate the message through schools, supermarkets and GPs' surgeries that young women should take folic acid supplements?

There is also the cost to consider, says the National Association of British and Irish Millers. "We are happy to support the FSA's decision, but this is a public health exercise and, as such, we think it is only right that the government should foot the bill," says NABIM director, Alex Waugh.

"If this is not covered by government then it will be the millers who probably pick up the costs, which could end up as an additional cost to the consumer. At the end of the day, paying for the folic acid would be cheaper for the government than running a big public health campaign, so hopefully it will see sense."

The FSA board, which has already voted unanimously for the move, will make a final recommendation to the Department of Health after next week's meeting.n