For nutrition in Northern Ireland, we recommend the mandatory fortification of bread or flour with folic acid to reduce the risk of defects in foetuses. Alongside the Scientific Advisory Committee on Nutrition (SACN) we consider the dietery modelling and rationale for folic acid fortification.
Fortifying flour with folic acid
There is strong evidence that suggests consuming higher folic acid intakes before pregnancy and in the first 12 weeks of pregnancy will reduce the risk of neural tube defects. Pregnant women are advised to take folic acid supplements.
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.
Supporting research on folic acid
In 20 the Scientific Advisory Committee on Nutrition (SACN) recommended it should be mandatory for flour to be fortified with folic acid. These recommendations were made in reports from 2006 and 2009. SACN recommended that restrictions on voluntary fortification and guidance on supplement use should be introduced.
In 2017, SACN reviewed the evidence following a request from Food Standards Scotland. In July 2017, SACN published a review of the evidence that has emerged on folic acid. SACN continue to recommend mandatory fortification of flour with folic acid, along with the controls on voluntary fortification.
We agreed with SACN’s recommendations in 2007 – the board considered the risks and benefits to public health and vulnerable groups. The consultation also considered consumer research, the ethics of adding folic acid to food and the impact that mandatory fortification has had in other countries.
Dietary modelling of folic acid
In conjunction with Northern Ireland, Food Standards Scotland, Welsh government and Scottish government we have funded new research on dietary modelling techniques which can be used to inform mandatory fortification of wheat flour.
The updated modelling followed a similar strategy that was outlined in the original 2006 SACN report. It also updated the modelling outlined by us in 2008 which looked at different fortification instances of folic acid and the reduction in risk of neural tube defects for pregnant women.
Stochastic modelling to estimate the potential impact of fortification of flour with folic acid in the UK
NDNS blood folate supplementary report
Public Health England published revised blood folate results from the National Diet and Nutrition Survey (NDNS) rolling programme in November 2017.
The report covers results for the UK as a whole and separately for Scotland, Northern Ireland and Wales. The results are based on blood sample analysis collected over four years.