Scientists urge fortification of flour to limit birth defects

BRITAIN’S failure to legislate to make food producers fortify flour with folic acid to help prevent babies being born with birth defects is based on flawed analysis and should be reversed, scientists said on Wednesday.

Urging the UK to follow more than 80 other countries, including the United States, who have mandatory fortification, the scientists said there was no need for an upper limit on folate intake because there is no risk of harmful overdose.

Deficiency in folate, by contrast, can cause pregnant women to have babies with serious birth defects called anencephaly and spina bifida. Also known as neural tube defects, the conditions affect 1 in 500-1,000 pregnancies in Britain.

Folic acid is a synthetic form of the B vitamin folate, which is found in asparagus, broccoli and dark leafy vegetables. Folic acid can be taken as pills or added to staple foods such as flour and cereals.

In countries that have introduced mandatory folic acid fortification, neural tube defects in babies have fallen by as much as 50 per cent, according to experts from Queen Mary University of London and the School of Advanced Study at University of London, who published a study on the issue on Wednesday.

The US Centres for Disease Control and Prevention estimates the cost of folic acid fortification at around one cent per person per year.

“Failing to fortify flour with folic acid to prevent neural tube defects is like having a polio vaccine and not using it,” Nicholas Wald of Queen Mary’s Wolfson Institute of Preventive Medicine told a briefing in London.

He said that on average every day in Britain, two women terminate pregnancies because of neural tube defects, and every week two women give birth to an affected child.

“It’s a completely avoidable tragedy,” said Joan Morris, who works with Mr Wald.

She said that from 1998, when the US introduced mandatory folic acid fortification, to 2017, an estimated 3,000 neural tube defects could have been prevented if the UK had adopted the same level of fortification.

In the UK, white flour is already fortified with iron, calcium and the B vitamins niacin and thiamin.

Yet despite recommendations from experts, Britain has not introduced mandatory folic acid fortification, partly due to concerns it might lead to some people having too high a folate intake.

However Wednesday’s new research, published in the journal Public Health Reviews, found those concerns were unjustified.

“With the upper limit removed there is no scientific or medical reason for delaying the introduction of mandatory folic acid fortification,” Mr Wald said.