Joanna Blythman's view that mandatory fortification of folic acid could increase health risks for millions of people is misleading, ill-informed and sensationalist ('Expect bread plan to fail the acid test,' The Grocer, 16 February, p27). The FSA has a responsibility to weigh up all available scientific evidence and be open and transparent in how it makes decisions. This includes weighing up scientific evidence, keeping a watching brief on new research and seeking expert advice as required. Low intake of the vitamin folate is an established risk factor in neural tube defect affected pregnancies, which can result in miscarriage, neonatal death and lifelong disability. The decision to recommend mandatory fortification, which will help prevent babies being born with neural tube defects, followed a comprehensive assessment of all available scientific evidence by the Scientific Advisory Committee on Nutrition, which advises the government. The issue was also extensively debated by the FSA board in open session. The risks and concerns Blythman mentions were considered at length by SACN before making the decision to recommend mandatory fortification, alongside controls on voluntary fortification and clear guidance on the appropriate use of supplements containing folic acid. Rather than endangering people's health, this combined approach would redistribute folic acid intakes by increasing the intake levels of people with low intakes and lowering the intake levels of those with high intakes.

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