Mandatory folic acid flour fortification: UK government asking “what products should be included?”

13 Jun 2019 --- A 12-week consultation on proposals has begun to explore what kinds of products should be included in the UK government's proposals to add folic acid to flour in a bid to reduce neural tube defects (NTD). Ministers estimate that such a policy would prevent up to 200 birth defects a year. The move has been welcomed by the Association of UK Dieticians (BDA), however, the organization says this has been a “long time coming” as recommendations for folic acid fortification in flour date back to the early 1990s and much suffering could have been prevented if these proposals had been adopted sooner.

“Experts from across the UK, including the Scientific Advisory Committee on Nutrition (SACN), have repeatedly called for the implementation of such a policy. Implementing this change would improve the lives of hundreds of families each year,” says BDAs Head of External Affairs, Jo Instone.

“Neural tube defects, such as Spina Bifida, cause moderate to severe disability leading to significant human suffering and higher health care costs. A recent study estimated that more than 2,000 NTD pregnancies could have been prevented since 1998 had the UK adopted flour fortification.”

Folic acid, or vitamin B9, is essential to the development of a healthy baby during early pregnancy. Not having enough of it can lead to babies being born with brain, spine and spinal cord problems known as NTD.

Women in the UK who are trying to become pregnant are advised to take a daily supplement of 400 micrograms of folic acid before they conceive and during the first 12 weeks of pregnancy. However, roughly half of all pregnancies in the UK are unplanned and evidence suggests that even for planned pregnancies, many women do not follow health advice to take folic acid supplements before pregnancy.

Around 1,000 pregnancies are diagnosed with NTD each year in the UK. Of these, more than 40 percent of cases are fatal. Spina bifida accounts for about half of these cases and the majority of babies with this disease need ongoing care.

Health departments in England, Northern Ireland, Scotland and Wales are now asking for people’s views on their proposal to add folic acid to flour.

“The 12-week consultation process will allow for a full and frank discussion of this policy and give us an opportunity to set out the very strong, evidence-based case for fortification of flour with folic acid,” Instone adds.

“It will also allow us to allay any fears that people may have. Similar policies have been implemented in over 60 countries around the world already and many have seen significant reductions in neural tube defects as a result.”

The BDA has worked alongside SHINE, the Spina Bifida charity, the Royal College of Obstetricians and Gynaecologists and others to campaign for the introduction of this policy for a number of years.

In Australia, NTD fell 14 percent after the country introduced the legal requirement to add folic acid to bread flour. In the UK it is common for foods to have vitamins or minerals voluntarily added for nutritional benefit. UK wheat flour millers already have to add thiamine, niacin and iron to restore what is lost in the milling process, and calcium for health benefits.

“We all want to give our children the best start in life and a birth defect diagnosis is devastating for parents. The simple measure of adding folic acid to flour would help spare hundreds of families from such a life-changing event,” says Public Health Minister Seema Kennedy.

“Women from the poorest areas are less likely to take folic acid supplements and it is right that we do all we can to protect the most vulnerable in society,” she urges.

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