The government has announced that it will consult on the mandatory fortification of flour with folic acid to prevent foetal abnormalities such as spina bifida.
The aim of the proposal, which has been talked about for a number of years previously, is to prevent birth defects, including spina bifida and anencephaly, by increasing folate intake in pregnant women.
“My priority is to make sure that if introduced, we are certain it is safe and beneficial for all”
The consultation will launch in early 2019 to consider the evidence around folic acid fortification, as well as the practicality and safety. The move has been debated in the UK for at least a decade but today’s announcement is the nearest that it has come so far to being introduced as a policy.
The government highlighted that it had taken evidence on the issue from its Scientific Advisory Committee of Nutrition (SACN). It noted that approximately 700 to 900 pregnancies were affected by neural tube defects each year in the UK.
It cited current advice for women trying to become pregnant, which advises them to take 400 micrograms of folic acid daily before they conceive and during the first 12 weeks of pregnancy. However, previous research has indicated that this advice is being ignored.
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In addition, around half of pregnancies in the UK are unplanned, so many women are missing out on these nutrients early in their pregnancy, the government statement warned.
It added that plans to fortify flour with folic acid were thought to be an effective way of reaching those with the lowest folate intakes – for example, younger women from deprived backgrounds.
The consultation will also consider if there are any risks to other members of the general public, said the government.
“Introducing the mandatory fortification of flour will bring the UK in line with over many other countries”
These include whether additional folic acid in the diet will mask the diagnosis of conditions such as pernicious anaemia, which is a deficiency in the production of red blood cell.
Public health minister Steve Brine said: “All women should be able to access the nutrients they need for a healthy pregnancy and in turn, reduce the risk of devastating complications.
“We have been listening closely to experts, health charities and medical professionals and we have agreed that now is the right time to explore whether fortification in flour is the right approach for the UK,” he said.
He added: “My priority is to make sure that if introduced, we are certain it is safe and beneficial for all.”
Professor Dame Sally Davies, chief medical officer for England, said: “The evidence shows that fortifying flour with folic acid is a practical way of reducing folate deficiencies in pregnant women and reducing birth defects.
“However, as with any intervention of this kind, we need to be certain it is also safe, and that means considering what the wider implications would be for the rest of the population who eat flour,” she said.
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The move is already supported by the Royal College of Midwives. RCM professional policy advisor Clare Livingstone said: “The RCM has been calling for this for some time so it is a welcome announcement.
“Introducing the mandatory fortification of flour will bring the UK in line with over many other countries including the United States and Canada,” she said.
“They have this in place because the evidence about the benefits of this is very strong,” she said. “The impact of this in those countries has been marked in reducing incidences of foetal abnormality.
“Many women will not have taken folic acid around the time of conception and very early in their pregnancy. This is when folic acid is most effective and that is why this announcement is so important,” said Ms Livingstone.
“This will significantly help to reduce the number of foetal anomalies related to folic acid deficiency,” she said. “This means fewer babies will be born with neural tube defects, and the sooner this is done, the sooner this will start to happen.”
She added: “The RCM will be responding to the consultation and we urge the Government to introduce this as soon as possible following the consultation.”