'Overwhelming' evidence for adding folic acid to flour

Should bread be fortified with folic acid?Cultura Creative /Alamy Stock

Should bread be fortified with folic acid?Cultura Creative /Alamy Stock

Now flour is fortified with folic acid in more than 80 countries worldwide, but isn't in the UK.

Experts have commented that fortification of flour could provide extra cover.

The UK already fortifies flour with iron, calcium and other essential B vitamins, and Professor Nicholas Wald, from the Wolfson Institute of Preventive Medicine, said: "Failing to fortify flour with folic acid to prevent neural tube defects is like having a polio vaccine and not using it".

The latest research, published in Public Health Reviews, claims evidence for limiting intake of folic acid to no more than 1mg a day is out-of-date and flawed.

Prof Wald said: 'Unfortunately, most women do not follow this advice, either because the pregnancies are unplanned or they don't know about folic acid.

Increased intake of the B vitamin has been found to be particularly important before and during early pregnancy to help protect babies from central neural tube defects (NTDs) such as spina bifida. In countries that have introduced fortification, the number of neural tube defects has decreased by up to a half.

The IOM concluded that treating individuals with vitamin B12 deficiency with higher doses of folic acid might lead to an increased risk of neurological damage.

Compared with pregnant women who didn't restrict their carbohydrate intake, those on a diet that reduced or eliminated carbs were 30 percent more likely to have babies with neural tube defects.

Lead author Professor Sir Nicholas Wald from the Wolfson Institute of Preventive Medicine at Queen Mary, who also led the original 1991 randomised trial, said: "With the upper limit removed there is no scientific or medical reason for delaying the introduction of mandatory folic acid fortification in the United Kingdom and other countries that have not yet adopted this proven public health intervention".

An average of two women a day have abortions after discovering their developing baby has a neural tube defect.

"It's hard to get the amount of folate recommended for pregnancy from food alone, which is why it is important to take a folic acid supplement".

But researchers found taking the supplements for the full pregnancy also improved children's "emotional intelligence".

Study co-author Prof Sir Colin Blakemore, from the University of London, said: "If you can dispel the argument for harm. you are left only with the fact that not fortifying flour denies a proven and clear benefit to a significant proportion of the population".

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