Targeted Folic Acid Supplements Outperform Mandatory Bread Fortification in

A risk-benefit assessment published in Food Safety and Risk concludes that targeted folic acid supplements for women of childbearing age in Portugal would deliver larger population health gains than mandatory bread fortification. Researchers modeled 15 dietary scenarios using national survey data and Monte Carlo simulations, tracking impacts in disability-adjusted life years. Supplementation with 400 micrograms of folic acid daily—without fortifying bread—was estimated to reduce 1,285 DALYs versus baseline intake. In contrast, mandatory fortification produced net population health losses at every concentration tested, reaching 2,888 DALYs lost at the highest scenario. The analysis links the divergence to demographic tradeoffs between preventing congenital malformations and increasing irreversible neurological harm among older adults amid folate inadequacy.