Researchers urge UK to make folic acid fortification mandatory
A study published in Public Health Reviews suggests that the United Kingdom’s failure to enact legislation to make food manufacturers fortify flour with folic acid is based on flawed analysis and should be reversed.
A study published in Public Health Reviews suggests that the United Kingdom’s failure to enact legislation to make food manufacturers fortify flour with folic acid is based on flawed analysis and should be reversed. The researchers from Queen Mary University of London and the University of London wrote that there is no need for an upper limit on folate intake because there is no risk of harmful overdose. However, deficiency in folate can cause pregnant women to have babies with anencephaly and spina bifida—serious birth defects also called neural tube defects.
Folic acid is a synthetic form of the B vitamin folate, which is found in asparagus, broccoli, and dark leafy vegetables. It can also be taken as an oral supplement or added to staple foods such as flour and cereals.
Eighty-one countries have introduced mandatory folic acid fortification of flour, and all studies of the consequences have shown a reduction in the incidence of neural tube defects, according to the researchers. While expert committees have recommended fortification, no European Union country has yet implemented the measure and European neural tube defect rates have not declined between 1991 and 2011. In countries that have introduced mandatory folic acid fortification, neural tube defects in babies have fallen by as much as 50%. “The reluctance to introduce a public health intervention that would prevent death and disability is hard to understand,” wrote the researchers.
The United Kingdom has not introduced mandatory folic acid fortification, partly due to concerns it might lead to some people having too high a folate intake. However, according to the researchers, there is no scientific basis for setting an upper level of intake for folate. Having such a limit, which has been set at 1 mg per day, has “acted as a barrier to the wider introduction of mandatory fortification of flour with folic acid to prevent neural tube defects. For both reasons, the upper limit should be discarded,” wrote the researchers.