The idea of adding folic acid to foods like flour has been a frequent request for many years. It’s based on the notion that serious birth defects could be avoided. Serious birth defects include spina bifida, anencephaly, various neural tube defects (NTD), stillbirths and the ending of pregnancy through unexpected terminations. Neural birth defects affect one in every 500 to 1,000 pregnancies. Supplementation of folic acid in flour exists in 81 countries including the USA
In 1991, the UK’s Medical Research Council conducted a randomised trial showing how increasing folic acid intake immediately before and early pregnancy prevented most cases of neural tube defects. The findings lent considerable weight to the idea of fortification.
The Scientific Advisory Committee on Nutrition in the UK (see their web-site) recommends that folic acid in the form of folate be added to flour. At the moment, the policy has not yet been implemented but the Scottish government is recommending that the UK government agree to a consistent and uniform approach to folic acid supplementation.
Sources Of Folic Acid
Folate is found in a number of common foods such as nuts, bread (especially brown and granary), wholegrain foods, wheat bran and green leafy vegetables. Some of the best natural food sources are broccoli, Brussels sprouts, kale, spinach, cabbages, asparagus, peas, chickpeas, liver, brown rice, orange and orange juice, poultry, shellfish, yeast and beef extracts.
Folates are added to breakfast cereals but it is reckoned that pregnant mothers cannot rely on these foods to supply the necessary amount of this important nutrient.
Research
A recent study in the Archives of Disease in Childhood considers that the UK needs to follow the USA in fortifying flour with folates. The USA introduced folate fortification in 1998 and noticed a 23% reduction in babies with neural tube defects. The research team think that with a similar policy in the UK, there would be a similar drop in pregnancies where the same issues occur.
A recent study at the Queen Mary University of London and the School of Advanced Study at the University of London establishes there is no need for an upper limit for folate intake.
Lead author Professor Sir Nicholas Wald from the Wolfson Institute of Preventive Medicine at Queen Mary stated:-
“Failing to fortify flour with folic acid to prevent neural tube defects is like having a polio vaccine and not using it,…With the upper limit removed there is no scientific or medical reason for delaying the introduction of mandatory folic acid fortification in the UK.”
Revision: 1st February 2018 to include statements regarding Queen Mary Research study in UK.
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