Please refer to anzfa’s guide to applications and proposals for a more detailed explanation of the process on how to undertake

Flour used in predusts, batters and crumb produced from returned bread would be affected by mandatory fortification as labelling changes would need to made;

this would potentially affect hundreds of products.
The 12 month transition period would not be enough time to make changes to some frozen products with a 2 year shelf-life unless there was an additional stock in trade provision.

Considers dietary modelling predicts that mandatory fortification will result in approximately 13% of children and adolescents in Australia consuming above the established Upper Limit for folate on a daily basis.

and incomplete data on status and voluntary folate fortification of the food supply.

Considers NTDs are a public health issue relevant to a specific population sub-group only (about 20% of the Australian & NZ population). Concerned mandatory fortification will affect the entire Australian & NZ population.

Notes NZ monitoring of NTDs only includes the birth prevalence not terminations.

US has only reduced the incidence of NTDs by 27% - significantly less than the predicted 41% reduction, whereas Western Australia has seen a 35% reduction in rates of NTDs since voluntary fortification was introduced.

Considers mandatory fortification has the potential to mislead consumers through minimal labelling requirements & decreased consumer choice.

Considers the proposal may facilitate an anti-competitive environment for food manufacturers e.g. organic and all natural claims will no longer be possible on such foods containing synthetic folic acid.

Considers monitoring is imperative, relevant to the target audience.

Notes the Draft Assessment Report did not account for monitoring costs in the CBA, nor has any government agency taken responsibility for this program.

Considers data available for voluntary fortification, and education shows it has been successful, if not more so than mandatory fortification.

Notes a lack of ongoing campaigns targeting folic acid fortified food consumption.

Lewis, et al 1999

Abraham & Webb, 2001

Suggests voluntary permissions should include dairy products, and be considered for peanut butter and nut/seed spreads. Believes this should be trialled and assessed before mandatory fortification.

Considers it unclear whether those classified as B12 deficient would readily absorb folic acid fortificants.

Food industry could suffer the loss of a competitive advantage if fortification becomes mandatory. If fortified products are not able to be promoted as such, this is a further competitive disadvantage.

There is limited data on folate intake (e.g. trend data) as the NNS is almost a decade old. Limited data indicates NTDs are falling with voluntary fortification.

Concerned the general population who are not deficient in folate may not be given the choice of an unfortified product.

Mr David Roberts

Supports a modified Option 1 with additional permissions and changes to the application and claim conditions for folate, for the following reasons:

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  industry is the best place to identify foods consumed by the target group, market trends, and to develop appropriately fortified foods;
  
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  the current process for approval to use a folate health claim is overly prescriptive, and the mandatory nature of wording has reduced its use on products otherwise permitted to make the claim; and
  
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  wider permissions are needed to address the identified health need.
  

Rejects the proposed mandatory fortification option for the following reasons:

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  failure to meet FSANZ objectives
  
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  failure to provide a balanced risk/benefit economic assessment which fails to address the costs of:
  

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  requiring fortification of all flour not just wheat flour;
  
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  imposing an upper limit to the fortificant;
  
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  monitoring of the health outcome;
  
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  costs associated with increased twinning; and
  
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  the adverse impact on export markets.
  

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  implications for the organic produce industry;
  
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  dietary modelling fails to take account of the new (higher) nutrient reference values for folic acid;
  
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  liability issues for food businesses have been ignored and
  
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  the false claim that voluntary fortification has failed.
  

Consider that due to the above, FSANZ has made an incorrect decision in recommending the mandatory addition of folic acid to bread-making flour.

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  it indiscriminately increases folate intake of the entire population;
  
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  removes consumer choice; and
  
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  fails to meet the Ministerial Council policy guidance.
  

Consider that if the proposal to mandate the addition of folic acid to bread-making flour is to be implemented, that a clause be inserted in the standard that permission revert to voluntary after 4 years, should there be no demonstrated health effect of a reduction in NTD pregnancies across Australia and New Zealand.

AFGC propose:

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  widening permissions to fortify foods known to be consumed by the target population;
  
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  continue to provide health education on the importance of folate in healthy pregnancies; and
  
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  simplify the wording of the health claim and the application process, to increase industry participation.
  

Consider foods likely to take up such permissions are low fat yoghurts, milk drinks and milk substitutes, breads and ready to eat meals.

Considers the proposal fails to meet the FSANZ objective to reduce NTDS by the maximum extent possible. Notes FSANZ figures that just 5% of women of child bearing age in Australia (2% NZ) would meet the recommended intake of 400µg through this level of fortification.

Notes around 20% of women of childbearing age do not consume products containing bread making flour.

Considers the Access Economic report is flawed and incomplete (see above).

As the incidence of twinning is an order of magnitude greater than NTDs (15.1/1000 vs. 1.32/1000) the lifetime costs of a twin should have been modelled, plus the additional health burden of complications associated with producing twins.

Organic standards would not allow organic labelling of synthetic folic acid was added.

Notes the new nutrient reference values for folate are higher than existing values within the Food Standards Code for the purpose of making a claim. Therefore all foods currently making a claim as a source of folate will have to increase folate fortification to continue to claim. Considers this was not considered in the FSANZ modelling.

Contends that mandatory fortification creates a liability for companies given the uncertainties about health risk, especially from long term exposure to higher intakes particularly from childhood onwards, as acknowledged by FSANZ. This will require increased insurance premiums for food industry, which has not been considered in analysing cost benefits.

Considers voluntary fortification has not failed and refers to FSANZ figures indicating a 19% increase in mean serum folate concentrations for women, and a fall in NTD rates of between 10-30% reported in SA, WA and VIC since the introduction of voluntary fortification.

AFGC considers none of the industry actions proposed at IAR have been acted on by FSANZ i.e.:

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  folate supplements be made available through a Government subsidy;
  
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  industry incentives be considered for voluntary fortification of certain foods;
  
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  existing permissions to fortify be reviewed with a view to widening permissions;
  
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  a trans–national program of monitoring NTD pregnancies and birth outcomes;
  
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  monitoring of the food supply to be part of the rolling NNS; and
  
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  convene a workshop on detection of folate in the food matrix prior to any decision to mandate folate fortification.