Fortifying Flour with Folic Acid

You may have heard a lot of talk recently about folic acid and the potential fortification of flour in the UK. Although for many this may have come out of nowhere, it’s actually been a topic under discussion in the UK for a number of years. Additionally, many countries have already been fortifying foods with folic acid for years. So in the UK we might be somewhat behind with the fortification of our flour.

Fortifying Flour with Folic Acid

Folate vs Folic Acid

You may see these two words being used interchangeably throughout the media, but as similar as they may sound, they actually refer to two different things. Folate is a member of the family of B vitamins, more specifically B9; and folic acid refers to the synthetic form of folate – this is the type that is used in the fortification of foods and in food supplements.

Folate naturally occurs in a variety of foods such as green leafy vegetables (spinach and broccoli), avocado, potatoes and peas. It plays an important role in the everyday function our bodies supporting growth and the formation of DNA (pretty essential stuff!)

On the other hand, folic acid is the chosen form of folate that is added to a range of processed food products such as breakfast cereals and milks. It is suggested that folic acid is chosen for fortification as it is a lot more stable and is more readily absorbed than folate itself.

Folate deficiency

Folate is fairly widely available in a number of foods commonly eaten in the UK. However, if your diet is low in folate-rich foods, you’re likely to be at risk of becoming deficient, which can cause a range of symptoms including fatigue, mouth ulcers, muscle weakness, pins and needles and even anaemia. In addition to this, the NHS state that taking high doses of folic acid may mask the symptoms of vitamin B12 deficiency which could eventually damage the nervous system if not treated.

If you’re worried you may have folate deficiency anaemia or may be suffering from a vitamin B12 deficiency, the best thing to do is see you GP as this can often be diagnosed with a simple blood test.

Infographic about Fortifying Flour with Folic Acid

Folic acid and pregnancy

On top of this, low levels of folate in the body before and during pregnancy can have implications for a growing baby. Folate is essential for the development of the neural tube (spine and skull) during gestation and, without enough of it, there is a risk of a baby being born with severe abnormalities such as spina bifida, which affects around 1000 pregnancies in the UK every year.

Spina bifida is when a foetus’ spinal cord does not develop as it should during the early stages of pregnancy, which causes a gap in the spine and leads to a whole range of issues for a baby.

Folate and folic acid recommendations

It is for this reason that all women who are planning a pregnancy in the UK and for those who are pregnant (up until 12 weeks) are advised to take a daily supplement (400ug) of folic acid.

Below is a table adapted from the British Dietetic Association which shows this and other folic acid recommendations:

Fortifying Flour with Folic Acid

Folic acid added to flour in the UK

At the moment, fortification of flour with folic acid is simply on a voluntary basis but over the last few weeks it has been announced that the Government will consult on the idea to make the fortification of flour with folic acid in the UK mandatory.

As seen in the table above, it’s not enough to just have food sources of folate during pregnancy and before. Recommendations state that in order to lower risks of neural tube defects (such as Spina Bifida), it’s important to take folic acid when planning a pregnancy and during the first 12 weeks of being pregnant. Despite this advice in the UK, many women don’t follow the recommendations and 50% of pregnancies are unplanned, making it hard for many to be aware of the need for supplements.

Therefore fortification of flour with folic acid is a simple way to ensure that everyone in the population, including women of childbearing age and pregnant women, are getting enough.

Are there any risks of fortifying UK flour with folic acid?

If folic acid is added to flour, this won’t make a difference to the look or the taste of flour. In fact, white flour is already fortified in the UK with nutrients such as niacin, thiamine and iron.

The Scientific Advisory Committee on Nutrition (SACN) has considered potential harm that could occur as a result of fortification of folic acid and have concluded that there is no cause for concern. However this will continue to be considered in the next few months before the decision to fortify all our flour is made in Spring next year.

Fortifying Flour with Folic Acid

Take home points:

  1. Folate is an important B vitamin and folic acid is its synthetic form which can be taken as a supplement and used to fortify foods.
  2. Any women considering pregnancy are recommended to take a folic acid supplement (of 400ug) and must ensure that they are meeting the recommendations of 200ug of folate through a wide range of food sources.
  3. It may soon be mandatory for flour to be fortified with folic acid in the UK, but the decision will not be made until Spring 2019.

I hope you enjoyed reading and have found this post interesting!

Article written by Holly Roper MSc student University of Sheffield with support from SR Nutrition.

See below the sources I used and found incredibly interesting when putting together this post!