Folic acid will be added to non-wholemeal flour in the UK from the end of 2026 to prevent birth defects, the Government has announced, making the country the first in Europe.
Ministers said the UK-wide legislation would prevent around 200 cases of neural tube defects every year and improve health of pregnant women.
It has been estimated that the move to include folic acid in flour will reduce neural tube defects by 20% in the saving the NHS £20m over 10 years and boosting the economy by more than £90m.
NHS recommendations that women who are trying to conceive a baby take folic acid supplements for around three months before getting pregnant and for at least 12 weeks after will remain in place.
But with around half of all pregnancies in the UK being unplanned, it is hoped the new regulations will help to provide women with a higher baseline intake of folic acid.
The move follows a public consultation in 2022 on the amount of folic acid that should be added to flour.
Flour is already fortified with calcium, niacin, thiamine and iron to improve public health, the Government added.
But experts said the measures were too ‘timid’ and did not go far enough to prevent more cases of anencephaly and spina bifida.
Andrew Gwynne, minister for public health and prevention, said: ‘Shifting care from sickness to prevention is one of the leading ambitions in our 10 Year Health Plan, as we work to make our NHS fit for the future.
‘These measures are a simple and effective intervention to improve health outcomes in babies, giving them the best start in life.’
Professor Chris Whitty, England’s chief medical officer, said: ‘The fortification of flour is a simple and effective way to help to reduce cases of neural tube defects, although it is important that women who are pregnant or intending to become pregnant continue to take folic acid supplements before and during the first 12 weeks of pregnancy.’
Professor Ian Young, chair of the Scientific Advisory Committee on Nutrition, said they welcomed the move having consistently recommended folic acid fortification since 2006.
Professor Sir Nicholas Wald, professor of preventive medicine at University College London, who conducted the original 1991 study that showed folic acid deficiency to be a leading cause of neural tube defects, said the decision was ‘good news’.
‘However, more could be done to prevent an estimated 800 cases [of neural tube defects] instead of 200 if all flour and rice were fortified (unless labelled as unfortified) and the level of fortification mandated by the Government were increased,’ he said.
Dr Jonathan Sher, former deputy director of Queen’s Nursing Institute Scotland, said fortification was long overdue but the plans in their current form were ‘timid, unscientific and will predictably fail to prevent most of the harm currently caused by neural tube defects’.
Professor Neena Modi, professor of neonatal medicine at Imperial College London, said the good news was tempered by the decision to restrict fortification to non-wholemeal flour only ‘as this will disadvantage groups such as women who are sensitive to gluten, eat rice in preference to bread, and products made from wholemeal flour, excluding them and their babies from benefiting, and thus add to the considerable health inequities that already exist in the UK’.
A version of this article was originally published by our sister publication Pulse.
