Fortified flour: folic acid and the fight against birth defects

The US has been including the health supplement in cereals for the last 20 years, so why is the UK so far behind in bringing the vitamin into the food chain?

5 February 2018

Fears that too much folic acid could cause neurological damage have been dismissed in a new study from Queen Mary University.

It is hoped busting this myth – which came from previously flawed research – will lead the way for the UK Department of Health to introduce mandatory fortification of flour. This would ensure folic acid would be flushed throughout the food chain to protect babies from neural tube defects, like spina bifida.

Already, 81 countries, including the US, have introduced mandatory folic acid fortification of cereals, with the number of neural tube defects decreasing by up to a half.

So why is the UK dragging its feet?

Folic acid fail

There is tough talk from the Queen Mary University researchers. Lead author of the study Professor Nicholas Wald said failing to empower flour with folic acid is like having a polio vaccine and not using it.

Professor Joan Morris, who co-authored the study, tells Food Spark that there isn’t a logical reason why the Government hasn’t made it mandatory. Lingering concerns over excessive folic acid in the system partly prompted the research, but the results showed there was no need for an upper limit on intake, she said.

Milling around

Retailers have also indicated that they are quite happy to add folic acid to bread, Morris says, adding: “We already have fortification of flour, so we put in iron and calcium, but we also put two other B vitamins, so it’s not that that it’s anything new.”

“What happens is the millers get given a pre-mixed mix of the right vitamins and minerals to put in the flour, so from their point of view they just put in a slightly bigger bag,” she continues. “There is a slight cost attached – it’s quite cheap, but obviously if you are producing a million loaves a day you need to know that your competitors have to put the same amount in as you.”

But it’s not just bread that would be boosted with folic acid, says Morris.

“The idea is you put folic acid in the beginning where you have milled the flour and then it goes into all other food stuff, so it will end up in cakes and thickening in sauces, so it’s a way of getting it into the food chain,” she says.

“It’s not that you’re going to have to eat more bread – everything you eat will have a little bit more folic acid in it.”

Figures from the United States have shown just how beneficial folic acid can be. From 1998 (when America introduced mandatory folic acid fortification) to 2017, an estimated 3,000 neural tube defects could have been prevented if the UK had adopted the same level of fortification as in the US, Morris says.

“It’s a completely avoidable tragedy,” she added.

House ministers in Wales, Scotland and Northern Ireland have all written to the government in England asking for folic acid fortification to be a standard regulation.

Hopefully, Westminster will heed the calls – and stop loafing about.

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