Mandatory fortification of flour with folic acid has led to a reduced rate of congenital heart disease, research from Canada has shown.
Since the policy was introduced to the country in 1998 to reduce rates of neural tube defects, there has been an 11 per cent decrease in the condition in Quebec, said Raluca Ionescu-Itta, a PhD student from McGill University in Quebec.
A time-trend analysis of administrative data from Quebec looked at live births from 1990 to 2001. In all, 2,238 live births with severe congestive heart failure were recorded.
Before fortification, the rate was 1.94 per 1,000 live births. This dropped to 1.72 per 1,000 live births after mandatory fortification was introduced.
The effect is even more pronounced when older maternal age and obesity - key risk factors for congenital heart disease - have increased over this time, Ms Ionescu-Itta told the AHA scientific sessions last week.
Although the link between pre-conception folic acid levels and congestive heart failure has been suggested before, this is the first population-based study to back up the theory.
It also shows the protective effect of low levels of folic acid against congestive heart failure, said Ms Ionescu-Itta. The decision as to whether folic acid should be added to flour in the UK is still to be made.
The Food Standards Association approved the move earlier this year, but CMO for England Sir Liam Donaldson has recently asked for more investigation into suggestions that folic acid fortification could increase risk of bowel cancer.
The UK Institute of Food Research last month warned that adding folic acid to food could cause health problems.
AHA scientific sessions 4-7 November 2007, Orlando, Florida
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