Not adding folic acid in flour is ‘tragedy’

By Michelle Perrett

- Last updated on GMT

Calls for flour to be fortified with folic acid
Calls for flour to be fortified with folic acid

Related tags: Folic acid

The failure to fortify flour with folic acid has been called a “missed opportunity” and a “tragedy” in a report published in Public Health Reviews today (January 31).

According to the researchers, adding folic acid to flour could help prevent anencephaly and spina bifida, collectively known as neural tube defects (NTDs), which are two of the most common serious birth defects throughout the world.

The report has put pressure on bread manufacturers and the government to consider the issue.

In fact, the document calls for government action and highlighted previous interventions such as the law on the use of car seat-belts and the ban on smoking in public places.

It said it showed responsible governments “can and do act”​ to reduce the risk of harm to others, even if personal freedoms are reduced.

“Fortification of flour with folic acid to prevent these defects has been implemented in 81 countries without public objection or indication of harm,”​ the report stated.

The researchers claimed reluctance to introduce a public health intervention that would prevent death and disability is “hard to understand​”.

It also said the European Commission Scientific Committee on Food, had focused almost entirely on “hypothetical harms”​ such as neurological symptoms in not implementing such legislation.

However, despite vigorous campaigning by public health authorities, many women do not take folic acid supplements before pregnancy.

The report said: “Fortification alone does not achieve full protection, but it provides a population safety net that contributes to the overall preventive effect, particularly important for the large number of women who have not taken supplements before becoming pregnant.”

In the UK, flour is already mandatorily fortified with other B vitamins (thiamin and niacin), as well as with iron and calcium.

The researchers argued that extending fortification to include folic acid would save babies from NTD as well as those with folate deficiency, which can cause of anaemia.

Researchers in the report were representatives of the Wolfson Institute of Preventive Medicine and Queen Mary University of London.

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