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UK introduces folic acid fortification of flour to prevent birth defects

14 October 20213 min reading

Folic acid will be added to non-wholemeal wheat flour across the UK to help prevent life-threatening spinal conditions in babies. Adding folic acid will mean foods made with flour, such as bread, will actively help avoid around 200 neural tube defects each year – around 20% of the annual UK total.

Non-wholemeal flour is already an established vehicle for fortification in the UK and the costs of fortification to industry are expected to be minimal. The addition of folic acid to food has been a successful public health policy in a number of countries worldwide such as Australia, New Zealand and Canada, resulting in falls in neural tube defects.

The neural tube forms the early part of the brain and spine within the first 12 weeks of pregnancy – usually before the mother knows she is pregnant. Folic acid is the synthetic/man-made form of folate. Not getting enough folate (Vitamin B9) at this crucial time can lead to neural tube defects and result in spinal conditions such as spina bifida or anencephaly.

Folate helps the body make healthy red blood cells and is naturally occurring in certain foods, such as leafy green vegetables. Folic acid is already voluntarily added by food manufacturers to breakfast cereal, including some gluten-free products, meaning people can usually get all they need from eating a balanced diet, but a higher intake is required in the first 12 weeks of pregnancy.

The National Health Service strongly recommends women who could become pregnant or are planning a pregnancy take a 400 micrograms folic acid tablet every day before pregnancy and until they are 12 weeks pregnant. This advice will continue, but with around 50% of pregnancies in the UK unplanned, the government is taking action to increase folic acid intake nationally to help protect more babies, especially where a pregnancy is unplanned and supplements are not taken early enough. Over 99% of British households buy bread and over a quarter of all groceries in the four biggest supermarkets contain flour, making adding folic acid to flour-based products a simple way to increase folate levels for tens of millions of people across the UK.

Since the Second World War, flour has been fortified with calcium, iron, niacin and thiamin during milling to support the nation’s health. UK joins 80 countries, such as Australia, New Zealand and Canada, adding folic acid to staple food products to help reduce neural tube defects. This public health decision is not anticipated to require major overhaul for industrial-scale flour producers. Folic acid will need to be added to the labelling of all foods made with flour – as is the case with other fortification.

Wholemeal flour and gluten-free foods are not subject to mandatory fortification and these products are not in the initial scope of this policy. Wholemeal flour has more naturally occurring folate than non-wholemeal wheat flour, and some wholemeal and gluten-free foods are already voluntarily fortified with folic acid in the UK.

Alex Waugh, Director of UK Flour Millers said: “Flour, whether white brown or wholemeal, is an ingredient in many foodstuffs and supplies a big proportion of our daily fibre and protein along with essential nutrients such as calcium, iron and B vitamins. If it is decided that folic acid should be added to flour for public health reasons, flour millers will do all they can to overcome any practical challenges to make it happen.”

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