The UK Food Standards Agency (FSA) looks set to recommend the mandatory addition of folic acid to white and brown bread and flour (wholemeal would be exempt). Whilst I applaud the motives of those behind this plan it still makes me uneasy.

The reason for this proposal is to reduce the number of birth defects caused by folic acid deficiency. Some 900 pregnancies a year in the UK are affected by this resulting in Neural Tube Defects (NTD). Compulsory fortification in other countries has cut NTD rates by up to 50%.

So what's the problem?

Well, one issue is that extra folic acid might theoretically harm some people. In particular there is a possibility of additional folic acid masking B12 deficiency in the elderly. These are however strictly theoretical risks.

My problem with this is political rather than medical, it's a matter of principle. This plan would be - for all the best reasons - enforced medication. It simply isn't the role of government to do this unless there is risk of contagious disease. Enforced medication of the entire population to prevent a problem that only affects a minority of pregnant women cannot be justified.

This isn't the same as water fluoridation. Whilst fluoridation concerns me for the same reason it's not practical to give the choice of fluoridated or non-fluoridated water supplies. When buying a loaf there is plenty of choice.

The role of the government is to advise and encourage - not force. Saying that people can switch from white bread to wholemeal isn't really "choice".

One of the other options that was considered by the FSA was simply to encourage the food industry to provide more folic acid fortified bread. That I'd support. A government sponsored campaign to subsidise and promote properly labelled "Folic enhanced bread" would have my backing since it would leave the choice with the individual.

This isn't a major issue that's going to get me marching on the streets. However it does reflect a "we know best" attitude that is increasingly being adopted by the government in the UK and beyond. Forcibly improving our diet for our own good is just a symptom of a far wider problem.

bread folic acid UK politics ukpolitics