Folic acid in the UK: Bread vs flour debate unresolved

The measure has been under consideration in the UK for a number of years as a way to reduce the incidence of pregnancies affected by neural tube defects (NTDs) by between 11 and 18 per cent. Between 700 and 900 pregnancies in the UK are affected by NTDs each year, not including miscarriages. The FSA made the decision to recommend mandatory fortification its board meeting last month, and it was expected that a call would be made yesterday over whether to add the nutrient at the flour milling or bread manufacturing stage. However a spokesperson for the agency told NutraIngredients.com that in the event the board has decided it is not best placed to make the decision. Rather, it prefers to leave the technicalities to the FSA executive. The spokesperson said that ongoing flour/bread debate will not hold up the general recommendation, which will go ahead to the Department of Health "shortly".​ The FSA executive will provide the board with progress reports as it continues to investigate implementation. It will then be up to the Department of Health to act on the recommendation as it sees fit. The FSA was not able to comment on what the timescale for implementation may be. FSA chair Deirdre Hutton said: "Having made the our decision in principle last month, we have had a comprehensive discussion on the practicalities. I think it is clear where the responsibilities now lie and it is for agency officials to take forward the implementation of this package with industry and other stakeholders."​ At the open meeting, the board also discussed several other aspects of the measure. For instance, it is expected that mandatory fortification will go hand-in hand with control over voluntary fortification in products like cereals and spreads, to prevent over-consumption by some groups. At the same time as boosting folic acid intake, the agency is also aiming to maintain a degree of consumer choice, consider the impact of mandatory fortification on industry - while at the same time prioritising public health - and ensuring that products carry appropriate labels. Moreover, it agreed that clearer advice should be given to people planning a pregnancy of the importance of folic acid. It is presently recommended that women take 400 micro grams in supplement form prior to conceiving. It is estimated that around 13.3 million people in the UK currently consume too little folate, natural dietary sources of which include grains, lentils, chick peas and green leafy vegetables. If the Department of Health does decide to press ahead, the UK will follow in the footsteps of the US and Canada, which made fortification mandatory in 1998. No other European country has yet introduced the measure, but Ireland is at an advanced stage in the process. Part of the reason the decision-making process has dragged on for years, however, is that excess folate consumption can mask detection of vitamin B12 deficiency, particularly in other people. If B12 deficiency is not detected and addressed, it can have a serious and permanent effect on cognitive function.