Katene Rahui: Motions — Food Standards—Folic Acid in Bread 
Katene Rahui: Motions — Food Standards—Folic Acid in Bread 
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RAHUI KATENE (Maori Party—Te Tai Tonga) 
: 
 Today our caucus held a baby shower for one of our staff members who is expecting her first baby in less than a month’s time. We have another staff member due to give birth to her second child in February and we have another staff member who delights us all by occasionally bringing her 5-month-old wonder Kori-Lee into our offices. I am not laying down these facts as a parliamentary challenge to see which party has the most fertile office but more to remind ourselves how absolutely blessed we are with the arrival of any new baby when that baby comes into our lives. I hasten to suggest that if one were to ask any of the members of our party what featured amongst their most significant moments in life it would be the birth of their children. So we come to this debate absolutely clear about the wonder of whakapapa the miracle of conception and the joy of welcoming a newborn into our midst. 
We understand that the proposal to establish mandatory fortification of bread with folic acid comes from much the same thinking as investing in folate as an incentive to protect and preserve the health and well-being of women who are in their early stages of pregnancy and their developing babies. We recognise the motivation in the motion put forward by Moana Mackey to disallow the New Zealand (Mandatory Fortification of Bread with Folic Acid) Amendment Food Standard 2009. I place on record the complexity associated with this issue and the considerable thought it has provoked. The Maori Party supports any move that can be taken to encourage pregnant women to either take or abstain from whatever substances will assist in protecting the unborn child whether that be folic acid—the synthetic form of folate—natural folate as in leafy vegetables citrus fruits wholegrain bread or yeast or indeed being smoke-free or alcohol-free. But we note the view of Consumer New Zealand that mandatory fortification would not fully address the health issue as there would still be the need to promote a diet high in folate-rich foods. Women planning a pregnancy would still need to take a folic acid supplement. Consumer New Zealand suggested and it was reiterated by the New Zealand Food Safety Authority that pregnant women should increase the folate in their diet by eating fruit and vegetables and wholegrain breads and cereals. The authority also confirmed that folic acid as a supplement is readily available and affordable and sold over the counter as a medicine at pharmacies. 
But another statement from Consumer New Zealand raised the antenna for us and that was its concern at the move to mandatory fortification because it might result in limited consumer choice and nutrient imbalances and excesses in children and the elderly. Consumer New Zealand supported the suspension of plans to compel bakers to add folic acid to bread but emphasised instead that the Government should publicly fund an awareness campaign stressing the importance of folate supplements. This is where the Maori Party states our preference. There appear to be a number of issues that our members have found hard to resolve. I want to share some of the questions with the House to explain our discussions on this issue. If the target is pregnant women and unborn babies then what will be the impacts for all other sectors of the population from increased levels of folate? What is the reliability of the information that suggests that folic acid fortification is associated in time with an additional risk of colon cancer? 
We have come across some studies in the US and Canada and Chile that suggest there is a causal relationship albeit a weak one between folate enrichment and colorectal cancer. However the point for us is that it raises the question. As lawmakers we must debate the ethics and morality behind every issue that comes before this House. We cannot afford to look at the issue without considering all the impacts and implications for people. 
We appreciate the views of Dietitians New Zealand which does not support mandatory fortification with folic acid until more research is done. It recommended that further good-quality baseline data should be collected prior to major fortification to determine the benefits or potential harm for a population-wide intervention. It also argued that the mandatory fortification programme in America has actually reduced the amount of pregnant women taking the folic acid supplements which are still needed to ensure sufficient amounts are reached during pregnancy. We have heard very clearly that folate has been proven to prevent neural tube defects and that as a consequence the Ministry of Health has recommended that extra folate is crucial a month before conception and 12 weeks after conception. We have also heard that approximately one-third of women do consume the recommended amount. 
There are some real concerns for us around unplanned pregnancies or women who simply do not realise they are pregnant until well after the time they have started taking the supplement. As New Zealand has high rates of youth pregnancies this group is at high risk as they may be low in both iron and folate. During the course of our research we contacted Te Hotu Manawa Maori which raised some of the issues specific to Maori in relation to this issue. The fact is that so many of our women may have low iron low baseline folate intake and potentially low vitamin C intake and if that is associated with oral contraceptives all of those will increase the risk of low serum folate levels and neural tube defects. 
So the overriding question for us is how we can assure this group that it will be aware and able to access the foods that are fortified. What sort of information do we need to promote to this group the value of consuming green leafy vegetables such as asparagus broccoli and spinach or to increase their intake of mushrooms potatoes legumes and seeds? How do we encourage this group to eat breads cereals and in some cases pasta or dairy products which will increase their folate intake? We absolutely agree with Te Hotu Manawa Maori that gaining knowledge of and education on the importance of folate for everyone and specifically for women of childbearing age is something that all of us can do and we would particularly encourage the Minister of Health to look further at promoting this possibility. 
Finally I raise a question about the way in which this debate has been discussed with particular reference to the focus on the risk of having a child with spina bifida. I will share the views of Ruth Jones from Kanohi ki te Kanohi Ltd who has issued the challenge that an assumption is made by those without disabilities that people with spina bifida and related conditions are seriously disabled. I will share some of her statements with the House as I believe they remind us of some of the issues we should consider. She said: “I am aware that when we talk about ‘reducing these birth defects’ we are actually talking about a distinct population group within the disability community and the assumption is made by those without disabilities that people with spina bifida and related conditions are ‘seriously disabling’. … The conditions that are disabling are not the impairment but society’s response to us. Therefore mandatory fortification of bread for me means that again a whole population group gets ignored misrepresented and marginalised.” 
There are so many issues associated with the proposal to introduce a synthetic form of folate into bread as a universal intervention to prevent folate deficiency. For a start it would be great to hear that the Government is reviewing my bill to take GST off healthy foods which would support a move to increase the consumption of folate an essential B vitamin found naturally in leafy vegetables and citrus fruits. We believe that the vitamins and supplements that help to make pregnant women ready for baby should be freely available for whanau in order for them to make good choices. If we are serious about building capacity and caring for future generations then we need an approach that combines the provision of these supplements with an effective education campaign. We do not support the member’s motion.