UK makes pivotal move to fortify flour with folic acid

By Nikki Hancocks

- Last updated on GMT

Getty | mars58
Getty | mars58

Related tags Folic acid Regulation Fortification

Folic acid will be added to non-wholemeal wheat flour across the UK in an aim to avoid hundreds of potentially life-threatening spinal conditions in babies every year, the Government announced yesterday (September 20).

The authority says that 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.

Prime Minister Boris Johnson said: "Few things are as important as a baby’s health – and folic acid-fortified flour is a quick, simple win to enhance their development. This will give extra peace of mind to parents and families, as well as helping boost the health of adults across the country."

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 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 NHS 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.

Dr Kourosh Ahmadi, Reader in Nutritional Genomics at the University of Surrey, directly contributed to this legislative change alongside his colleagues in the Nutritional Sciences team. He says this is a ground-breaking announcement for the UK.

"It is well known that folic acid is an essential nutrient for health, and in particular for the unborn foetus... Our National Diet and Nutrition Survey (NDNS) has consistently shown folic acid intakes and intakes of the vitamin B complex, in general, to be low amongst women of childbearing age.

“This is a pivotal moment for the UK. We have been amongst the first groups to report heritability estimates of B-vitamin biomarker status among the general population and more recently high rates of B-vitamin deficiency and insufficiency, including folates and vitamin B12, among pregnant mothers and healthy women of child-bearing age.

"This move to now put folic acid in all white flour products has the potential to not only prevent 200 birth defects a year but to also ensure that all newborn babies have the best possible start to their long and healthy lives.” 

Kate Steele, CEO of Shine, the charity that provides specialist support for people whose lives have been affected by spina bifida and hydrocephalus, says this is a move the charity has campaigned for over thirty years.

"In its simplest terms, the step will reduce the numbers of families who face the devastating news that their baby has anencephaly and will not survive. It will also prevent some babies being affected by spina bifida, which can result in complex physical impairments and poor health. This is truly a momentous day’."

Since the Second World War, flour has been fortified with calcium, iron, niacin and thiamin during milling to support the nation’s health.  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.

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