Minutes of the meeting of the National Committee on Folic Acid Food Fortification
Thursday 15 September 2005

Minutes of the meeting of the National Committee on Folic Acid Food Fortification at the Food Safety Authority of Ireland held on Thursday 15 September 2005 at 11:00, in the FSAI offices, Abbey Court , Lower Abbey Street, Dublin.

PRESENT:
Ms Maureen Lynott (Chair) [ML]
Dr Louise Sullivan [LS]
Prof. Albert Flynn [AF]
Dr Catherine Hayes [CH]
Ms Joanna Gibson [JG]
Dr Mary Flynn [MF]
Dr John Devlin [JD]
Dr Cliodhna Foley Nolan [CFN]
Ms Margot Brennan [MB]
Mr Alan Reilly [AR]
Prof. John Scott [JS]
Dr Orla Healy [OH]
Dr Fenton Howell [FH]

IN ATTENDANCE:
Ms Eileen Lippert [EL]

APOLOGIES:
Dr Sean Daly [SD]
Dr Davida de la Harpe [DdlH]
Dr Harry Comber [HC]
Dr Ailis ni Riain [AnR]
Prof. Joe McMenamin [JMc]
Dr Kevin O'Donnell [KO'D]
Mr Nick Killian [NK]
Mr Eamon Corcoran [EC]

1 Agree Minutes of the Last Meeting

Agreed: The minutes of the meeting of 23 June 2005 were adopted subject to two amendments.

2. Matters Arising

Noted: Funding issues relating to the implementation of recommendations are under discussion with DoHC.

Noted: The full report from Mori on the Public Consultation results will be circulated when it is received by the FSAI.

Noted: All other matters arising were addressed or were agenda items.

3.  Declarations of Interest / Conflict of Interest

Noted: There were no declarations of interest.

4.  Update on Omnibus Survey

Noted: The FSAI gave a short update on the findings of the omnibus survey. The overall finding that 46% of the target population (a nationally representative sample of women aged 15+ years) had seen the advertising for the Public Consultation on folic acid food fortification was very positive in terms of showing that the campaign to raise awareness about the Public Consultation was very successful. There was some discussion on the matter of future health promotion campaigns which will be needed to raise awareness about the continuing need for women to take folic acid supplements no matter what decision is reached on national fortification. This is a matter for the implementation stage of the recommendations of the NCFAFF and some funding may be available from the budget of Health Promotion Managers to undertake this.

5 Sub-committee on Technical Issue

Noted: A detailed submission from industry was received and in principle, industry is in favour of mandatory fortification, subject to several industry issues which have to be resolved, which included:

•  Cost

•  Technology needed to add folic acid to wraps and pitta bread which undergo different processing

•  Monitoring to regulated standards and costs associated with such quality assurance;

•  Packaging issues;

•  Exported products to Northern Ireland and the UK ;

•  Imported products (currently very low cost breads available in some major supermarket outlets) – if these were curtailed it would impact on consumers;

•  EU legislation on barriers to imported unfortified breads

•  Logistical issues regarding imported breads.

Noted: The issue of voluntary fortification was put forward as a possible solution to some of these obstacles, but it was agreed that this would be addressed in more detail later

Noted: It was confirmed by the FSAI that it has already anticipated the legislation aspect of mandatory fortification and the whole legislation process is underway.

Agreed: Dialogue will have to take place with the relevant authorities, the bread industry and retailers.

6 Sub-committee on Risk, Adverse Effects and Benefits of Folic Acid Fortification

Noted: The Chair of this Sub-committee gave a presentation on the work of this Sub-committee to date. The main areas touched upon in the presentation included:

•  Proposed fortification options;

•  Benefits of fortification;

•  Reduction of folate deficiency;

•  Possible risks of fortification;

•  Risk of excess folic acid intake;

•  Modelling of folic acid food fortification;

•  Risk/benefit of folic acid fortification of bread;

•  Effect of folic acid fortification of bread on NTD;

•  Effect of folic acid fortification of bread on probability of excess

•  Which level of folic acid and the issues involved;

Noted : A copy of the presentation was circulated to members for information and members were informed the new modelling was based on the comments and opinions of the members. The Chair attempted to gauge what percentage of the population might be exposed to excess intakes of folic acid due to fortification and it transpires that at the lower levels of fortification there is little or no risk for older people. The issues surrounding the selection of a suitable level were put forward and it was pointed out that Ireland could learn a lot from the UK experiences, which could not proceed with folic acid food fortification due to the risks associated with the high level of folic acid proposed.

7 Conclusions and Recommendations of Committee Members

Noted: A draft document outlining the recommendations and conclusions of the Committee was put forward for comments and opinions. These will be signed off at the next meeting.

8.  Outline Report

Noted: An outline report was distributed to the members and the members were asked to volunteer to help in preparing the report.

Agreed: The FSAI will lead on the executive summary, the introduction, the dietary and nutritional aspects of folates/folic acid in the diet and neural tube defects.

Agreed: Albert Flynn will lead on the chapter on the benefits and risks of fortifying foods with folic acid.

Agreed: FSAI will deal with the chapter on the public consultation on food fortification with folic acid.

Agreed: The technical issues for the food industry is done.

Agreed: The full Sub-committee on the Register of Congenital Birth Defects will meet to discuss the chapter on monitoring, on which some work has been completed.

Agreed: CH volunteered to lead on the section on public education.

Noted: Policy options and recommendations will be dealt with when the draft conclusions and recommendations report is agreed. It was proposed and accepted that the report should include an appendix entitled ‘Issues for the Minister'.

Agreed: The report should also include a note on suggestions regarding implementation of fortification.

Action: All initial drafts of the various chapters/sections must be with the FSAI by 30 September.

9 Date of Next Meeting