Perspectives on adding folic acid to flour to prevent spinal bifida | Letters

Dr JK Anand, Chris Page and Pam Lunn reflect on the UK government’s decision

Of course the planned fortification of flour with folic acid will help – where the cause of spina bifida is nutritional deficiency of folic acid (All UK flour to be given folic acid additive, 15 October). However, it can not conceivably prevent the defect where it is due to genetic factors – two defective genes from two parents coming together.

In some parts of the world consanguineous marriages are commoner than in others. An academic paper in the Journal of Health, Population and Nutrition (Vol 32, No 2, June 2014) by Nazish Jabeen and Sajid Malik from a university in Pakistan is useful reading. The practice has nothing to do with religion. It is purely “custom and practice”.

Given that the matter is one of medical genetics and religion does not come in to it, could the government seek the advice of the medical and social scientists, on the value of banning first-cousin marriages in this country, and of refusing legal recognition to such unions when contracted abroad?
Dr JK Anand
Peterborough

• Your article on the mandatory addition of folic acid to flour in the UK to prevent neural tube defects contained an inaccurate assertion about spina bifida – that it inevitably means having to use a wheelchair. As someone with the condition, I can assure you this is not a given. It is dependent on the type of spina bifida and the severity of resulting paralysis.

I am a wheelchair-user, but have met people who were only made aware they had the condition as a result of an X-ray. They looked and walked as most non-disabled people do. For the record, I am against the addition of folic acid. I would be happier if this government concentrated on treating existing disabled people better instead of trying to prevent future generations of us.
Chris Page
Letchworth, Hertfordshire

• On Sunday, Claire Perry, the minister for energy and clean growth, declined to endorse the IPCC’s strong recommendation that we should reduce our meat consumption in order to curb greenhouse gases. She regarded this as too much of a “nanny state” action, as she doesn’t regard it has her job to tell us not to eat steak and chips. On the same day, it was announced that the government will mandate the addition of folic acid to flour to reduce foetal developmental problems. This, presumably, isn’t regarded as the action of a “nanny state”?
Pam Lunn
Kenilworth, Warwickshire

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