British flour could be fortified with folic acid ‘to reduce birth defects’

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Flour in the UK could be fortified with folic acid in a move to help reduce birth defects, the Government has announced.

Public Health Minister Steve Brine said that ministers plan to consult on the move, saying that it will increase folate intake among pregnant women and in turn reduce their baby’s risk of spina bifida and other birth defects.

Medics have long called for the move, saying that it could reduce the incidence of some foetal abnormalities.

Pregnant women, and those trying to conceive, are urged by health officials to take a daily supplement of 400 micrograms of folic acid, at least until the 12th week of pregnancy.

But many women do not take the supplements – especially if a pregnancy is unplanned.

The NHS Choices website says that folic acid is important to foetus growth and can significantly reduce the risk of neural tube defects such as spina bifida.

There are around 700 to 900 pregnancies affected by neural tube defects each year in the UK.

If the move goes ahead then Britain will join more than 80 countries which already fortify flour with folic acid.

It has previously been recommended that wheat flour is fortified with folic acid to improve the “folate status” of the population and reduce the risk of these birth defects.

The consultation, which will be launched in early 2019, will propose the fortification of all white flour sold in the UK.

“All women should be able to access the nutrients they need for a healthy pregnancy and in turn, reduce the risk of devastating complications,” said Mr Brine.

“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.

Bread could be fortified with folic acid (David Jones/PA)

Professor Louis Levy, head of nutrition science at Public Health England, said: “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 consultation will consider whether there are any risks to other members of the general public; for instance, whether additional folic acid in the diet could mask other conditions such as pernicious anaemia.

England’s chief medical officer Professor Dame Sally Davies 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.”

Commenting on the announcement, Dr Alison Wright, vice president for the Royal College of Obstetricians and Gynaecologists (RCOG), said: “The RCOG has long supported calls to fortify flour with folic acid across the UK, as a public health measure to prevent neural tube defects in babies. We will continue to work together with politicians and charities to achieve this.

“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.

“Fortifying flour with folic acid is a simple, safe and evidence-based measure that will reach women who don’t receive enough folic acid through their diet, as well as those who may not have planned their pregnancy.

“This is a real opportunity to improve outcomes for families and society as a whole.”

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