Folic acid fortification

bread rolls
In 2006 and 2009 the Scientific Advisory Committee on Nutrition (SACN) recommended mandatory fortification of flour with folic acid should be introduced alongside restrictions on voluntary fortification of foods with folic acid and guidance on supplement use. In 2016/17 SACN reviewed this evidence following a request from Food Standards Scotland.

SACN's recommendation

On 12 July 2017 the Scientific Advisory Committee on Nutrition (SACN) published a review of the evidence that has emerged on Folic Acid since the previous reports which were published in 2006 and 2009. SACN continue to recommend mandatory fortification of flour with folic acid, along with the controls on voluntary fortification.

The FSA has previously recommended the mandatory fortification of bread or flour with folic acid in order to reduce the risk of neural tube defects in foetuses.  In 2007, the FSA Board confirmed it agreed with SACN's 2006 recommendations. In reaching its decision, as well as considering SACN’s report, the Board also considered the risks and benefits to both specific groups of the population as well as the whole population, the public consultation on a range of options, consumer research on the options, the ethnics of adding folic acid to a food, and the impact that mandatory fortification has had in other countries.

Rationale for folic acid fortification

There is strong evidence that consuming higher folic acid intakes before pregnancy and in the first 12 weeks of pregnancy will reduce the risk of neural tube defects.

Almost half the pregnancies in the UK are unplanned and even though women are advised to take folic acid supplements many do not, or they start taking them too late.

If bread or flour were fortified with folic acid this would increase folic acid intake of women with otherwise low intake who may become pregnant and the most effective way of reaching sections of the population with the lowest folate intakes i.e. younger women from the most socioeconomically deprived areas.

It has been estimated that there are between 700 and 900 pregnancies affected by neural tube defects each year in the UK.