New research has found that the number of food staples fortified with folic acid in Irish supermarkets is continuing to decline despite its proven role in preventing severe birth defects.
The bottom line is women can no longer rely on getting folic acid in the food chain, said principal investigator Mary Rose Sweeney.
“They should be taking supplements until we work out a way to introduce mandatory fortification because the evidence has demonstrated that mandatory fortification works,” she said.
Ms Sweeney, Association Professor in Health Systems Research at Dublin City University (DCU) said she acknowledged the economic cost “of adding and maintaining” folic acid in the foodchain, but the cost of caring for someone born with a neural tube defect (NDT) - like anencephaly and spina bifida - was far higher.
These are life-limiting conditions and caring for and providing for the person with the NDT is far greater.
The research, entitled 'Voluntary folic acid fortification levels of food staples in Ireland continue to decline', published in the Journal of Public Health, compares the level of folic acid fortification with the levels found by another DCU audit conducted in 2014.
Over a period of eight weeks between June and August 2017, the nutrition labels of 1,081 foodstuffs were examined. These included bread products, milk, fruit juices, spreads, cereals, cereal snacks, milks, fruit juices, yogurts/yogurt drinks and energy drinks in SuperValu, Tesco, Dunnes Stores, Lidl, Aldi, Marks & Spencer, Centra and a non-multiple supermarket.
Of 270 bread products, only four were fortified with folic acid (FA) of which three were more expensive niche products from a gluten-free range.
Prof Sweeney said the likelihood of picking up bread with folic acid was tiny.
Only one fortified mainstream type of bread (a multigrain toaster bread from Tesco) was found. There was no FA fortified white sliced pan.
FA fortified milks were typically from what could be considered to be ‘vitamin-enriched/light milks and not ‘regular’ milks.
There was a small increase in the number of folic acid fortified foods in Lidl and Aldi.
Prof Sweeney said their research showed that passive intake of FA - through food staples rather than buying supplements - was “no longer doing its job”.
She said instead of leaving it to the food industry, the government needed to look at making fortification mandatory, especially as the Republic of Ireland has one of the highest incidences of NTD-affected pregnancies, and rates have risen in recent years.
A separate study involving researchers at the Irish Centre for Maternal and Child Health Research (INFANT) at University College Cork (UCC) and the Karolinska Institute in Sweden found babies who suffer mild oxygen deprivation at birth have impaired cognitive outcomes compared to children with uneventful deliveries.
The condition, known as Hypoxic Ischaemic Encephalopathy (HIE), causes brain injury due to lack of oxygen and can leave newborns with permanent neurological damage or cerebral palsy.
The only proven treatment for HIE is Therapeutic Hypothermia (known as cooling therapy) if introduced within the first six hours of birth.
The research raises the question as to whether these babies should be treated at birth with cooling therapy, which is currently reserved for babies with more severe degrees of HIE.
INFANT Principal Investigator, UCC Professor Deirdre Murray, said at present, doctors who care for these newborns do not know whether to treat them or not.
"No trials have studied effects in these infants with milder injury. Our study has shown that their development at two years is significantly lower than expected. A large, adequately powered, trial is urgently needed to answer this question and to guide doctors in their care of infants with mild HIE.”
The study analysed data from 471 children between 2007-2015. Its findings are published in the Journal of the American Medical Association (JAMA).
Lack of oxygen to the newborn brain affects almost 200 babies in Ireland each year.