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Folic acid 'to be added to flour' to reduce serious birth defects in UK

Experts call for change to be introduced as soon as possible

Alex Matthews-King
Health Correspondent
Monday 15 October 2018 14:16 BST
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The UK is set to begin fortifying bread flour with folic acid in a bid to cut potentially serious birth defects which affect an estimated two children born every week, reports suggest.

For decades medical experts have been calling for the UK to follow the lead of 80 other countries, including the US, and start adding the essential vitamin to prevent developmental defects like spina bifida.

Pregnant women and those trying to conceive are already told to take a daily 400 microgram folic acid supplement, deemed essential for the development of the brain and spine “neural tube”.

But this crucial stage of foetal development occurs in the first 12 weeks of pregnancy and some mothers may not be aware they are pregnant until later, in which case it is too late to correct the folic acid deficiency.

Pregnancy experts say the UK has one of the highest rates of neural tube defects in Europe and fortification could tackle the issue. A recent study suggested that there are two terminated pregnancies a day in the UK as a result of neural tube defects.

Reports published by The Guardian on Sunday suggest that Theresa May has now backed a plan to add folate supplement to food to tackle this burden.

Though the Department of Health and Social Care said the proposal was still being considered, they did not challenge the claim was due to be approved.

In 1991 a major clinical trial established the link between folic acid and the defects. Many other countries subsequently began fortifying wheat flour to improve the “folate status” of the population and reduce the risk of these birth defects.

The UK has resisted in part because a of an American Institute of Medicine trial suggesting too much folic acid could also be harmful, though subsequent studies has called the quality of this research into question.

But now senior government sources suggest the change could be made a reality within weeks.

The Royal College of Midwives urged the government to introduce mandatory fortification “as soon as possible”.

Clare Livingstone, professional policy advisor for the college, added: “This will significantly help to reduce the number of foetal anomalies related to folic acid deficiency.

“This means fewer babies will be born with neural tube defects, and the sooner this is done, the sooner this will start to happen.

“Many pregnancies are not planned, meaning many women will not have taken folic acid around the time of conception and very early in their pregnancy. This is when folic acid is most effective and that is why this announcement – if correct – is so important.”

Public Health England told the newspaper that fortifying flour with folic acid “is an effective and safe measure to reduce the number of pregnancies affected by neural tube defects”.

A Department of Health and Social Care spokesperson said: “Ministers are considering expert advice and will respond in due course.”

Clare Murphy, director of external affairs at the British Pregnancy Advisory Service (Bpas) said: “The UK has one of the highest rates of neural tube defects in Europe.

“Around 1,000 pregnancies are affected every year, and the vast majority will end in the painful decision to terminate what is often a very much wanted pregnancy. Most foetal anomalies sadly are not preventable, but those related to folic acid deficiency can be reduced.

“Folic acid fortification is a straightforward public health intervention which will spare hundreds of women the heartbreak of receiving the news that their baby has a serious condition.

“After years of delay, we urge the government to bring forward folic acid fortification as soon as possible in order to get the best possible pregnancy outcomes for as many women as possible.”

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