Fortification programme successful in Chile

Fortification of wheat flour with folic acid has substantially improved folate status in a population of women of reproductive age in Chile, report researchers in this month's Journal of Nutrition​.

Similar initiatives, designed to reduce the incidence of birth defects, have already shown positive results in the US and Canada. The effect of the Chile's programme on the occurrence of birth defects is still being assessed but higher folate status among the women studied suggests that flour fortification is an effective way of supplementing the diet.

The Chilean government launched the initiative in January 2000, requiring 2.2 mg folic acid per kg wheat. The policy was expected to result in an average increase of 400 micrograms of folic acid daily.

Researchers from the University of Chile in Santiago measured the folate content of 100 bread samples bought at retail bakeries. They estimated average wheat flour consumption and calculated post-fortification folic acid dietary intake.

They also compared the blood folate concentration in 605 women of childbearing age in Santiago, Chile, with their nutrient status prior to the programme start. Mean serum folate concentrations increased from 9.7 to 37.2 nmol/L after fortification, while red blood cell folate concentrations increased from 290 nmol/L to 707 nmol/L on average.

The researchers calculated the median folic acid intake of the group to be 427micrograms daily based on an estimated intake of 219g daily of wheat flour, mainly as bread.

Folic acid fortification has proven its value in reducing birth defects in US and Canada but in Europe governments have been reluctant to implement similar initiatives. The UK's Food Standards Agency last year decided against fortification on the grounds that not enough was known about the potential adverse effects on older people. Campaigners in Switzerland have also met with resistance.