Medicating the food supply so some can get a partial dose

"Eat 11 slices a day to get the necessary amount."

Mandatory fortification would deliver pregnant women half the dose of folic acid needed to avoid the neural tube defects, which affect 350 newborns a year.
- Bakers may be forced to add folate, Sydney Morning Herald

How does the decision to make folic acid mandatory in bread so that some pregnant women can get the benefit of a partial recommended dose (excluding the rest of the population, especially children and the aged, from concerning themselves with the adverse effects of folic acid intake) add up to "a triumph for humanity and common sense " ?

Mark Lawrence, an expert on folate fortification, believes a proposal by Food Standards Australia New Zealand (FSANZ) to add folic acid to all bread-making flour, is premature and constitutes a "population-wide experiment".

Dr Lawrence, a senior lecturer in the School of Exercise and Nutrition Science at Deakin University, said it was well documented that folic acid supplementation reduced the rate of birth defects such as spina bifida. But the level of fortification proposed by the food regulator (approximately 200 micrograms of folic acid per 100 grams of flour) would reduce neural tube defects by an average of only 8 per cent - or 26 conceptions - a year.

Meanwhile, an entire population, not just women of child-bearing age who were the target of the proposal, could be exposed to potential health risks, he said.
- Health Risk Fears as fortified flour faces acid test, Sydney Morning Herald

The "common sense" is revealed later in the article:

However, the regulator's chief scientist, Marion Healy, said the benefits of adding folic acid to bread far outweighed any potential risks . . . Nevertheless, the food regulator had taken a cautious approach and proposed a very low level of fortification, she said. Women planning a pregnancy would still need to take a folic acid supplement.

What if you want to make your own bread?

Britain's Food Standards Agency board on Thursday gave the go-ahead for plans to add folic acid to foods . . . The FSA, a government body designed to protect the public's health and consumer interests in relation to food, voted to back mandatory flour fortification last month.At its board meeting on Thursday, the FSA said the voluntary addition of folic acid to products such as breakfast cereals and spreads should be controlled to prevent over-consumption.
- UK's FSA backs folic acid in flour, curbs on food, Reuters, June 14, 2007

Following a trend

Lessons from other countries
In recent years the US, Canada, Chile and the Czech Republic have all introduced mandatory fortification of flour with folic acid to ensure that all pregnant women are receiving adequate amounts of the nutrient. Despite the fact that the amount of folic acid added into the food supply does not provide enough to fully protect unborn children, recent reports from Canada and the USA indicate fortification of cereal grains has been very effective, with reduction in neural tube defects of between 27% and 50% (SACN 2005). Rates of cardiovascular disease also appears to have fallen. Unfortunately, there are as yet no data from these countries on population trends in the incidence of B12 deficiency or any related neurological damage that can help to clarify the risks involved.
- Folic Acid: Time to fortify? EuroFIR (European Food Information Resource Network)

And what are the implications for bread and flour makers, if they wish to advertise?

On so many grounds (balanced diet, obesity epidemicising, health risk to the a much larger population than that targetted, and substance abuse), I can't see how they can get away with it, compared to the zealous banning due to false fears regulators have of anyone pushing "an egg a day". But then, what has regulation to do with science any more than common sense?

The Lancet asks: Fortified Europe?