News focus: folic acid

Global mandatory flour fortification increases

By Lorraine Heller

- Last updated on GMT

Related tags: Folic acid, Vitamin b12, B vitamins

The number of countries requiring wheat flour to be fortified -
primarily with folic acid - has increased from 33 to 54 in the last
three years, according to the US Centers for Disease Control and
Prevention (CDC).

The government body's special report on global trends in folic acid fortification comes during the national Folic Acid Awareness Week (January 7-13). According to a CDC analysis of data from the Flour Fortification Initiative (FFI), the amount of wheat flour being fortified around the world has increased from 18 percent in 2004 to 27 percent in 2007. This means that around 540 million people around the world are currently thought to have access to fortified wheat flour. Folic acid a chemical form of a common B vitamin (folate), has been linked to a reduced rate of a specific birth defect that affects the development of the spinal cord and central nervous system. For nearly a decade, folic acid has been added to wheat flour and other grain products in the US and Canada. Since that time, ecological studies have documented decreases of 26 percent and 42 percent respectively of the rate of neural tube defects (NTD) at birth. Such findings, together with the continued emergence of science that supports the benefits of folic acid, have contributed to the increased number of countries with documented national regulations for mandatory wheat flour fortification. According to CDC's report, 50 out of the 54 countries with mandatory fortification in 2007 required fortification with both folic acid and iron. Two required fortification with folic acid but not iron, and two with iron but not folic acid. Twenty-four of those countries also mandated wheat-flour fortification with thiamin, riboflavin, and niacin; two with thiamin and riboflavin; and two with thiamin. By region, the greatest increase in the percentage of wheat flour being fortified was in the Eastern Mediterranean region, which saw a rise from 5 percent in 2004 to 44 percent in 2007. In the Americas - the region with the highest percentage of wheat flour being fortified - the portion of fortified wheat flour increased from 90 percent to 97 percent in the Americas Region. In Europe - which has lagged behind in implementing mandatory folic acid fortification - the increase in fortified wheat flour was minimal, from three percent in 2004, to six percent in 2007. In the UK, debate has been raging for more than five years over whether folic acid fortification should go ahead. The nation's Food Standards Agency (FSA) had last year recommended giong ahead with a program of mandatory fortification, but a postponement was called over fears of a connection between folic acid and colorectal cancer. Other concerns include that folate consumption in excess of 1000 micrograms (1mg) per day could delay the detection of vitamin B12 deficiency (which can have severe neurological consequences) in older people. However, additional research has since indicated that B12 deficiency would be masked only with folate consumption of more than 5000 micrograms per day. In the US, women who might become pregnant are advised to consume 400 micrograms of folic acid per day, either in the form of a vitamin supplement or in enriched foods. To access CDC's report, click here​.

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