The Food Standards Agency (FSA), jointly with the UK's Health Departments, will host an open stakeholders meeting on folic acid at the Queen Elizabeth II conference centre on 18 March. 

Further to the findings of a public consultation carried out in 2000, this meeting will help to shape and inform the Agency's and Health Departments eventual recommendations to Government on whether flour should be fortified with folic acid.

Fortification of flour with folic acid could significantly reduce the risk of babies being born with spina bifida and other neural tube defects (NTDs). However folic acid is only effective if taken by women before and during early pregnancy.

The Government's former advisory committee the Committee on Medical Aspects of Food and Nutrition Policy (COMA) estimated that its recommendation to fortify flour would reduce the risk of NTD-affected births by 41%. This would prevent a small number of annual NTD-affected births, 38 out of a total of 93 in England and Wales, 30 out of 74 in Scotland and 6 out of 14 in Northern Ireland.

However, high daily intakes of folic acid can potentially mask anaemia, an early symptom of a vitamin B12 deficiency in older people. If such a deficiency is not identified early enough then there is a possible risk of neurological damage to this vulnerable group.

While fortification could reduce the numbers of babies born with spina bifida and neural tube defects (NTDs), the dosage would have to be balanced. The level of fortification suggested by COMA maximises the opportunity to prevent against NTD-affected births and minimises the risk of masking a vitamin B12 deficiency in the elderly. Those planning their pregnancy would still need to further supplement their intake with an additional dose of folic acid in order to protect against the risks.

Suzi Leather, deputy chair of the FSA, explained: "The question of whether we fortify flour with folic acid is a highly emotive one. The main reason to do so is to reduce the numbers of babies being born with neural tube defects. 

"That is an important issue, but we also need to consider the risks involved for other groups such as the elderly, who may be exposed to a potential risk connected with  undiagnosed vitamin B12 deficiency.

"There are a range of options and important ethical, medical and practical issues that need to be fully debated before any recommendation can be made."

The open meeting includes the following five speakers:

· Professor Alan Jackson, chair of the Scientific Advisory Committee on Nutrition;
· Andrew Russell, of the Association for Spina Bifida and Hydrocephalus;
· Professor Sir John Grimley Evans, Department of Clinical Geratology at Oxford University;
· Alexander Waugh, from the National Association of British and Irish Millers; and,
· Sue Davies, of the Consumers' Association.