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Add folic acid to flour, experts urge policy makers

The government should ensure all flour is fortfied with folic acid, members of the Scientific Advisory Committee on Nutrition (SACN) have advised.

This comes after the requirement that flour is fortified with folic acid was introduced in 78 countries in 1998, including America but not including the UK, as supplements were preferred.

If the UK had introduced this policy, there would have been around 21% fewer babies born with neural tube defects since 1998 (around 2,000 babies), the nutrition experts revealed in a letter. 

Folic acid supplementation is known to help the formation of a baby's brain and spinal cord if it is taken around conception and early pregnancy. It also reduces the risk of a baby being born with neural tube defects, the most common being spina bifida.

To improve women's uptake of folic acid, flour should now be fortified along with action to reduce folic acid intake from voluntarily fortified foods (eg fat spreads) and supplements, the report stated.

However, some sectors of the food industry “have already reduced the amounts of folic acid in their products in partial compliance with SACN's recommendations.”

This “unforeseen conjunction” of reduced voluntary fortification without the fortification of flour “may unintentionally have reduced folic acid intakes and worsened the folate status of the population since the publication of SACN's 2006 Report,” the letter stated.

Currently 85.5% of UK women aged 16-49 years are failing to achieve the recommended intake of folic acid.

The number of abortions due to neural tube defects (NTD) has increased in England and Wales, with 420 in 2013, up from 390 in 2012 and 299 in 2009.

Women of reproductive age should exceed a red cell folate level of 906 nmol/l to minimise their risk of an NTD-affected pregnancy, and women are urged to take 400mcg of folic acid daily while trying to conceive and for the first three months of pregnancy.