[Netherlands Health Council report:'Risks associated with folic acid fortification': those who don't risk, don't win].Ned Tijdschr Geneeskd. 2001 Jul 07; 145(27):1282-5.NT
Because the advice to take folic acid supplements is insufficiently followed by women who wish to become pregnant, a committee of the Health Council of the Netherlands investigated the possible risks associated with increasing folic acid intake through fortification of food products. The committee concludes that the risk of inducing or exacerbating neurological abnormalities by increasing the intake of folic acid in people with a vitamin B12 deficiency cannot be excluded. Therefore the fortification of food products should, for the time being, be limited to those foods which are especially aimed at women who wish to become pregnant. It is unlikely, however, that such a restricted food fortification program will lead to a decrease in the incidence of neural tube defects. Like the use of folic acid supplements, the purchase of special food products presupposes that the individual woman will undertake a positive action. Moreover, most women do not want their shopping to reveal their wish to have a child, and the need to cook their own meals will meet practical difficulties. The hypothetical and avoidable side-effects of food fortification have to be balanced against the certain benefit of preventing neural tube defects in unplanned pregnancies and pregnancies in women unaware of the benefits of folic acid supplementation. A revision of the report is recommended.