Vicky

5⃣What are the potential risks? - Dosing Before I get onto summarising why this is a bad policy that should be reversed, I want to talk a bit about doses. One of the main arguments from the pro-fortification camp (and indeed the government) is that the amounts of folic acid going into food are low compared to what is in a typical supplement. This argument is bogus. It doesn't stand up to the evidence. First, a bit of context: 💊A typical folic acid supplement targeted at women of child-bearing age is 400 micrograms/day. 🔝The "upper limit" which has been adopted as the "safe maximum" for adults, is 1000 micrograms/day. (You'll remember from previous posts in the thread that some of the adverse effects of folic acid supplementation were observed in studies involving supplementation of 1000ug per day, so I'm not sure how "safe" this safe level is). 🧑‍🔬In 2009, the UK Chief Medical Officer was advised by the Scientific Advisory Committee: "For people who choose to take supplements, as a precaution, it would be advisable for those aged over 50 years not to consume supplements containing folic acid above the recommended nutrient intake (RNI) for folate of 200 µg/day since the risk of developing colorectal adenomas/colorectal cancer increases after this age". (Page 9 of: assets.publishing.service.go… ) Let's have a look at a typical day's eating for someone who's not especially health conscious, and how much folic acid they will consume after these new rules are in force: Breakfast 🥣Bowl of corn flakes, whole milk 50-120 ug 🍞2 slices of white toast 100-120 ug with Marmite 100ug Orange Coffee with milk Mid morning 🍪2 digestive biscuits 15-30 ug Cup of coffee with milk Lunch 🍞Coronation chicken sandwich, three slices of white bread 150-180ug Packet of crisps Bottle of orange juice Banana Mid afternoon 🧁Slice of sponge cake 20-40ug coffee with milk Dinner 🍕2/3rd of a typical supermarket Margherita pizza 80-150ug 🧄Portion of Garlic bread 30-50 ug 🥧slice of apple pie 15-30ug custard cup of coffee with milk Supper 🍘🧀cheese with crackers 10-20 ug hot chocolate Total folic acid intake from food alone = 500 to 700 ug So the folic acid supplementation here is around 3 times the maximum recommended for the over 50s, and approaching twice what is in a folic acid supplement for pregnant women. Add in a few more slices of bread or pizza or cake, and the 1000ug "upper limit" - the one where adverse effects were observed in several studies - is at risk too. So no, dear government, the amounts of folic acid in food are not going to be insignificant at all - for many people with a diet rich in baked and processed foods they will be highly significant and easily exceed what is in a folic acid pill. 14/n