Birth defects to fall as folic acid added to white bread
ACTION WELCOMED AS REPORT SHOWS 15 PER CENT OF BRITISH ASIAN WOMEN TAKE FOLIC ACID
THE risk of women suffering birth defects is expected to decrease with the addition of folic acid to flour, according to medical experts.
Doctors and charities have welcomed the UK government’s announcement that folic acid will be in non-wholemeal wheat flour to help prevent spinal birth defects in babies.
Women are advised to take the B vitamin, which can reduce the risk of spina bifida in unborn babies, before and during pregnancy.
A fifth of white British women reported taking folic acid prior to becoming pregnant compared to 15 per cent in the British Asian community and 10 per cent in the black community, according to research published by Public Health England in 2018.
It is thought that adding folic acid to food items, such as bread, could prevent up to 200 birth defects a year.
Dr Nikita Ved, co-founder of research group The 1928 Institute at Oxford University, told Eastern Eye: “The fortification of flour with folic acid is a great step towards reducing the incidence of neural tube defects, such as spina bifida.
“This is particularly beneficial for our community given that south Asian women are more likely to experience diabetic pregnancies, also known as gestational diabetes.
“Gestational diabetes increases the risk of neural tube defects in the infant, by up to four-fold. This is further complicated by the fact that nearly half of all pregnancies are unplanned.
“Furthermore, as the foetus’ organs are fully formed by week eight of pregnancy, it can be difficult to know when to take supplements because by the time one finds out they’re pregnant it could be far along in the pregnancy and thus, less effective.
“Therefore, the fortification of flour with folic acid will go a long way to help prevent south Asian babies from having neural tube defects.”
Spina bifida is a neural tube defect that occurs when the developing spinal column does not close properly, leaving nerves exposed.
In most cases, surgery can be carried out to repair the defect after birth, but often nerves have already been damaged
– leading to paralysis, incontinence and loss of skin sensation.
Women are advised to take 400 micrograms of folic acid a day for at least a
month before conception and up to the 12th week of pregnancy. Professor Gurch Randhawa carried out a study with other academics on a sample of mothers from Pakistani, Bangladeshi and white British backgrounds in Luton, Bedfordshire.
The researchers found that the women had limited knowledge about the risks linked to adverse birth outcomes and they did not have a good understanding of genetic risk factors in pregnancy nor knew the benefits of taking folic acid before conception.
Professor Randhawa, who is the director of the Institute for Health Research at the University of Bedfordshire, told Eastern Eye: “Interviews with health care professionals revealed that there was conflicting opinion on whether women actually consumed folic acid pre-conception.
“This study identified that very few women consumed folic acid before conception, nor did they understand the benefits of consumption, which would otherwise prevent congenital anomalies, including NTD [neural tube defects] in the early weeks of meiosis.
“Therefore, mandatory fortification of flour will be of benefit to women of child-bearing age, given the current evidence suggesting that consumption of folic acid preconception is low.”
The new rules, announced on September 20, will not apply to gluten-free foods and wholemeal flour.
Health and social care secretary Sajid Javid said preventing life-threatening health problems like spina bifida would mean fewer people needing hospital treatment.
A study in 2014 found that 20 per cent of females of South Asian heritage said they took the supplement before pregnancy, compared with 25 per cent of east Asian women and 35 per cent of white women.
Clare Murphy, chief executive of the British Pregnancy Advisory Service, said the fortification of flour with folic acid is a straightforward public health intervention that could spare hundreds of women every year “from the painful decision to end a wanted pregnancy after a diagnosis of a neural tube defect.”
She added: “Most foetal anomalies sadly are not preventable, but those related to folic acid deficiency can and must be reduced.
“It is now 15 years since the UK’s Scientific Advisory Committee on Nutrition (SACN) first recommended flour be fortified with folic acid.
“This measure has already been introduced in more than 70 countries around the world, including the US, Canada and Australia, and there is clear evidence that fortification leads to a decrease in neural tube defects as a result.
“In the UK, we have been adding calcium, thiamin,
niacin and iron to wheat flour for more than 50 years - so both the principles and the mechanics of fortification are already in place.”
Baby charity’s Tommy’s midwifery manager Kate Marsh said folic acid helps babies’ nervous system grow and reduces the risk of them developing health conditions.
She added: “Even mums-to-be who eat a healthy diet don’t get enough folic acid to give their baby the best protection, so supplements are very important and it’s good news that flour will be fortified.
“Recent Tommy’s research found around half of mums-to-be didn’t take folic acid supplements when preparing for pregnancy, so many people may not be aware of the benefits – and since pregnancies are often unplanned, not everyone has the chance to do this anyway.”