Financial incentives for bread manufacturers
The Folic Acid Illusion: Rethinking Fortification in the Age of Genetic Diversity Let me begin by stating what should be obvious: public health policy is not immune to the distorting influence of financial incentives, bureaucratic momentum, or intellectual inertia. When the state mandates a biochemical intervention across an entire population — as it has done with folic acid fortification — we are entering a realm that requires careful scrutiny, not blind acceptance. And yet, in most countries where folic acid fortification is law, very few questions are asked about its long-term effects on genetically diverse populations. Approximately 40–60% of the global population is estimated to carry a polymorphism in the MTHFR gene — most commonly the C677T (rs1801133) variant. This gene encodes an enzyme critical to the methylation cycle, converting folic acid (the synthetic form) into its biologically active form, 5-methyltetrahydrofolate (5-MTHF). Carriers of this variant have reduced en...