UK set to fortify flour with folic acid to prevent spine defects among newborns

By Dr. Ananya Mandal, MDOct 24 2018

Public Health Minister Steve Brine added that the move would be discussed with the ministers and is likely to raise folic acid consumption among pregnant mothers.

There have been population studies that have shown that folic acid fortification in wheat flour has reduced the incidence of congenital spine and brain deformities by raising folate status in blood of the pregnant mothers. The Scientific Advisory Committee of Nutrition (SACN) evidence too points at the benefits of folic acid during pregnancy.

Image Credit: BW Folsom / Shutterstock

Mr Brine said, “All women should be able to access the nutrients they need for a healthy pregnancy and in turn, reduce the risk of devastating complications. We have been listening closely to experts, health charities and medical professionals and we have agreed that now is the right time to explore whether fortification in flour is the right approach for the UK.”

According to Professor Louis Levy, head of nutrition science at Public Health England (PHE), “The vast majority of women between 16-49 have blood folate levels below global thresholds, highlighting a risk of neural tube defect-affected pregnancies. Comprehensive evidence shows that mandatory fortification of flour would go a long way towards reducing the number of complications some experience during pregnancy as well as improving the folate status of the general population.”

The current recommendations state that all pregnant women or women trying to conceive must take a daily supplement of 400 micrograms of folic acid. Folic acid is naturally found in green leafy vegetables such as spinach, cabbage, broccoli, kale, beans and legumes and in citrus fruits. This is often missed in many pregnant women especially in cases of unplanned or accidental pregnancies. Neural tube defects and spinal deformities affect 700 to 900 pregnancies annually in the UK. UK would be one of the other 80 nations that have already fortified their flour with folic acid.

Dr Alison Wright, vice president for the Royal College of Obstetricians and Gynaecologists (RCOG), said in her statement, “There are approximately 1,000 diagnoses of neural tube defects in utero in the UK, such as anencephaly and spina bifida per year, 85% of which currently result in an abortion. The evidence is clear that fortification will prevent around half of these neural tube defects.”

Professor Dame Sally Davies, the Chief Medical Officer in a statement said, “The evidence shows that fortifying flour with folic acid is a practical way of reducing folate deficiencies in pregnant women and reducing birth defects. However, as with any intervention of this kind, we need to be certain it is also safe, and that means considering what the wider implications would be for the rest of the population who eat flour. I am pleased to see the government taking action on this issue and hope to see the wider scientific community feed in their views to this important consultation which could benefit and improve the lives of many women and babies in this country.”

The taste and appearance of the fortified flour would remain same say the officials. UK already fortifies white flour with iron, calcium and two other B vitamins - thiamin and niacin. These are lost during milling of the flour. Gluten-sensitive population however would not benefit from this fortification add experts.