Launch of Folate Awareness Day

Good afternoon and welcome. I am very pleased to be able to speak to you today, because I strongly support the efforts being made to prevent as many babies as possible from being born with neural tube defects, such as spina bifida.

It is encouraging that the number of babies born in New Zealand with spina bifida continues to decrease. The number of children born with spina bifida halved in the period between 1988 and 1999. Of all the live births last year, 17 babies were born with this condition, and about 10 still births a year are attributed to spina bifida. While this is still too many, it is an improvement on previous years.

As many of you will know, adequate intakes of folate for four weeks prior to and for 12 weeks after conception are known to reduce the number of babies born with neural tube defects by two-thirds. By increasing their folate intake around the time of conception, many women will be able to avoid much of the suffering and anguish that comes with neural tube defects, and contribute to major savings in the health sector.

It is estimated that the 20-year healthcare costs, including treating, managing, and caring for one spina bifida child in New Zealand is $355,000. It is also estimated that doubling the folic acid intake in women of childbearing age to 400 micrograms will reduce the number of spina bifida affected births by 50 to 70 percent. That means the number of spina bifida births can be expected to reduce by about 10 a year.

Doing the sums is one thing, but ensuring that women of childbearing age have an adequate intake of folate is not easy. Dietary intakes of folate remain lower than recommended for most population groups, including women, in New Zealand.

Otago researchers found in their recent work that even though more than half the women studied knew of the benefits of adequate folate, it did not mean that they consumed folic acid supplements when they were pregnant.

Two key reasons for this are that about 50 percent of pregnancies in New Zealand are unplanned, and because consuming folic acid supplements regularly is simply not a common practice among women.

So it is important to consider additional approaches to ensuring that folate intakes are adequate. These include increasing the consumption of foods fortified with folic acid and consumption of folate-rich foods. I hope my little shopping expedition this morning at New World supermarket will go some way to publicising the importance of a folate-rich diet.

And we know that awareness days like these do work. In 1998, researchers from Otago University conducted a nationwide mail survey of about 1000 randomly selected people. One of the survey aims was to assess awareness of, and attitudes, toward vitamin and mineral fortification.

Thirty-three percent of respondents claimed awareness of the role of folate in the prevention of neural tube defects, and about 45 percent of women knew about the role of folate in the prevention of neural tube defects. Women were more than twice as likely to know this compared with men, and women in the 25 to 44 age group were more aware of the relationship than the other age groups. The findings of this survey were similar to one the Ministry of Health conducted in 1994.

Kelloggs also carried out a survey of awareness about folate, around the time of the 1999 Folate Awareness Day. They found that before Awareness Day, 37 percent of women of childbearing age were aware of folate and its effect on the risk of neural tube defects. The proportion increased to 53 percent following Folate Awareness Day.

Generally, awareness tends to increases following a campaign. The challenge is to try to maintain that awareness and to get women to increase their folic acid intake - every day of the year, not just today.
To support this year's Folate Awareness Day positively, I have taken action to promote an increase in the folate available in New Zealand's food supply.

As a result of the cross-party meetings I held in conjunction with the Folate Replenishment Plus Committee late last year and earlier this year, in July I sent a letter to the Flour Millers' Association and the Association of Bakers, asking them voluntarily to fortify bread with folic acid, as permitted by the food regulations since 1996.

My Associate Ministers of Health, members of the Health Select Committee, and representatives from most of the major political parties also signed the letter - an achievement in itself - and the Association of Bakers is to consider the logistics of fortification at its next executive meeting in November.

I was interested to learn from a recent research report from the United States that there has been a reduction of 19 percent in births affected by neural tube defects. This is considered to be due at least in part to the mandatory fortification of some foods with folic acid.

Although the level of fortification in the United States is lower than allowed in New Zealand, it includes the addition of folic acid to all enriched grain products and has been mandatory since 1998. That is food, as they say, for thought.

I would like to thank you all for your ongoing efforts in this area. I can assure you that I strongly support the work you are doing to increase awareness of the importance of adequate folate intakes so that we can further reduce the number of babies born with neural tube defects.

I would particularly like to thank Lyall and the team at CCS for their work in this area and for the invitation to speak today. I wish you all the best for the rest of Folate Awareness Day, and for your continuing dedication.