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UK governments looks to folic acid fortification to reduce birth defects

Feb 25, 2019 | 3 min read
UK government plans folic acid fortification

The UK government is setting out new plans to fortify flour with folic acid which will bring the country in line with fortification guidelines in the EU that prevent birth defects such as spina bifida.

UK thought to have the highest rate of Neural Tube Defects

The UK is thought to have the highest rate of Neural Tube Defects (NTD) recorded in Europe with one study concluding that an estimated 2000 pregnancies associated with a neural tube defect would have been prevented if the UK had adopted the same fortification regimen seen in the USA from 1998.

Taking enough folic acid in pregnancy is estimated to reduce by as much as 70% the risk of a NTD such as anencephaly, a condition in which the foetus develops without a major portion of the brain, skull and scalp. This results in the death either in utero or shortly after birth.

It is estimated that two women a day in the UK have an abortion because doctors have identified an NTD and two children a week are born with an NTD, often spina bifida. In some cases, not all, it can necessitate the use of a wheelchair.

Government's change of mind has been brought about by calls from a number of MP's, government, NHS and advisory bodies

Official advice from the UK's department of health recommends a daily supplement of 400 micrograms of folic acid when trying to become pregnant and up until the 12th week of pregnancy. But many women, especially those in poorer homes, do not take enough.

The UK has up until now resisted repeated pleas for mandatory folic acid fortification but at one point Ireland's voluntary fortification of foods with folic acid was widespread. However the number of fortified foods in Ireland is now declining along with increasing incidences of birth defects of the brain and spine.

The government's change of mind has been brought about by calls from a number of MP's, government, NHS and advisory bodies, scientists and baby health campaigners, who have all urged the authorities to back food fortification and now welcome the decision. 

Mandatory fortification most effective way of reaching those with lowest folate intakes

Kate Steele, the chief executive of the charity Shine, which helps families affected by neural tube (birth) defects, said:

“Mandatory fortification will be a game-changer for the UK. A government decision to introduce mandatory fortification will mean a major positive impact for the health and wellbeing of babies born in the future. In many cases, it will be the difference between life and death.”

Dr Alison Tedstone, chief nutritionist at Public Health England, said:

“Three-quarters of 16- to 49-year-old women have folic acid levels below the new World Health Organization recommendation for women entering pregnancy. Fortifying flour with folic acid is an effective and safe measure to reduce the number of pregnancies affected by neural tube defects.”

The Food Standards Agency (FSA) said that if bread or flour were fortified with folic acid this would increase folic acid intake of women with otherwise low intake who become pregnant.

This approach could also be the most effective way of reaching sections of the population with the lowest folate intakes i.e. young women from the most socioeconomic deprived areas.

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