Wonder vitamin or mass medication? Media and academic representation of folate fortification as a policy problem in Australia and New Zealand

Objective: The aim was to examine how representations of the 'problem' of folate fortification as policy strategy to reduce neural tube defects (NTDs) had been produced by examining the underlying discourses in media and health and medical journals. The objectives were to evaluate the various framings of the folate fortification 'problem', and discuss ways in which this policy problem could have been repositioned or reframed. Methods: All articles found in the Australian and New Zealand print media and in health and medical journals from June 1995 when the first expert report was released to one month after the approval of mandatory fortification in July 2007 were identified using two newspaper indexing databases (Factiva-Dow Jones Interactive & Proquest ANZ NewsStand) and multiple databases including PubMed, Expanded Academic ASAP and Informat (Australian Public Affairs). Results: 176 print media articles and 83 peer-reviewed journal articles identified from the database analysis. Critical discourse analysis of these 259 articles resulted in three main discourses being evident in the representations; the dominance of biomedicine in the process of prioritisation of fortification of the food supply, issues of professional encroachment by nutritionists and the representation of fortification as iatrogenic. Conclusion and Implications: Food fortification as a policy response to nutritional deficiencies has implications for influencing food and nutrition policy implementation. Examining how policy problems are represented in the media and journals can help guide public health policy decisions.