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Plans to fortify flour with folic acid to slash the risk of birth defects moves a step closer

The Government will consult on its plans to add folic acid to all white flour sold in the UK to try and reduce the number of babies born with birth defects.

Health Minister Steve Brine today revealed ministers will open the plans to the public next spring after the Prime Minister’s office last week backed the idea.

Folic acid is a B vitamin used to create red blood cells. Pregnant women are advised to take it to avoid defects like spina bifida.

Experts have said in the past there is no unsafe amount of folate – the type of folic acid found in food – for people to consume.

And they have called it a ‘public health failure’ that thousands of babies have been born or aborted with birth defects which could have been prevented by sufficient levels of folic acid.

Folic acid, which all pregnant women are advised to take to avoid problems with the development of babies’ brains, spines and spinal cord, could be added to flour to make sure all women get enough

Mr 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.

‘My priority is to make sure that if introduced, we are certain it is safe and beneficial for all.’ 

The consultation will last for a minimum of three months, suggesting the plans could be put into place as soon as summer 2019, if they go ahead. 

Fortification – adding folic acid to food – is already done in more than 80 countries.

In the US, there has been an estimated 23 per cent drop in neural-tube defects since the policy started in 1998.   

Campaigners have called for the same thing to be done in the UK for years but governments have never moved forward on the issue. 

‘This is a hugely welcome announcement from Government and long overdue,’ said Owen Smith, MP for Pontypridd and chair of a parliamentary group campaigning to put folic acid in the food supply.

‘Over 3,000 children might have been spared the tragedy of being born with anencephaly or spina bifida if either Labour or Tory Governments had acted on evidence that has been clear since the early 1990s, and this Government should be commended for listening to our campaign.

‘The experience of countries around the world, including the United States and Canada, shows that adding folic acid to flour can prevent 70 per cent of these birth defects, saving and improving lives, without any ill effects for the wider population.’ 

The NHS recommends pregnant women, and those trying to conceive, take 400 micrograms of folic acid a day, until at least the 12th week of pregnancy.

But many women do not take the supplements – especially if a pregnancy is unplanned. 


Neural tube defects are deformities of a person’s brain, spine or spinal cord which occur in the very early stages of pregnancy.

They happen when the foetus does not develop properly, usually during the first four weeks after conception.

The most common forms of NTD are conditions called anencephaly, spina bifida and encephalocele.

Anencephaly is when a foetus does not develop its entire brain or skull – almost all babies which are born with it die shortly after.

Spina bifida, a deformity of the spine, is less often fatal and many children survive well into adulthood, but it can cause severe disability.

Encephalocele happens when part of a baby’s brain and membranes protrude out of the head through a hole in the skull. This may be treated with surgery but will likely cause long-term brain problems.

Women are advised to take 400 micograms of folic acid per day during and before pregnancy until at least the 12th week after conception, because it has been proven to reduce the risk of neural tube defects. 

There are around 700 to 900 pregnancies affected by neural tube defects each year in the UK, and many of them result in abortions.

A scientific study done in 1991 found taking folic acid reduces the likelihood of people being born with neural tube defects by 72 per cent.

Neural tube defects are problems with a baby’s brain, spine or spinal cord which start within the first month of pregnancy. 

Because the defects happen so early on, women should be taking folic acid before they get pregnant if they are planning to conceive.

But women may get pregnant by accident or not realise for a number of weeks, meaning might miss the window to prevent the defects – including folic acid in the entire population’s diet could remove the need to worry about this.

The Government’s move is a significant U-turn as ministers in the past have ignored campaigners’ repeated pleas on the issue.  

Dr Alison Wright, vice president of the Royal College of Obstetricians and Gynaecologists said: ‘There are approximately 1,000 diagnoses of birth defects in the UK, such as anencephaly and spina bifida per year, 85 per cent of which currently result in an abortion.

‘The evidence is clear that fortification will prevent around half of these defects.

‘Fortifying flour with folic acid is a simple, safe and evidence-based measure that will reach women who don’t receive enough folic acid through their diet, as well as those who may not have planned their pregnancy. 

‘This is a real opportunity to improve outcomes for families and society as a whole.’

Everybody other than pregnant women should get enough folate from their diet – it is found in spinach, broccoli, beans, oranges, poultry, pork and some cereals.  

The consultation, which will be launched in spring 2019, will aim to confirm there are no safety concerns about adding folic acid into the food of the whole population.

Professor Louis Levy, head of nutrition science at Public Health England, said: ‘The vast majority of women between 16-49 have blood folate levels below global thresholds.

‘Evidence shows that mandatory fortification of flour would go a long way towards reducing the number of complications some experience during pregnancy as well as improving the folate status of the general population.’

The consultation will consider whether there are any risks to other members of the general public – for instance, whether it could hide other conditions like anaemia.

England’s chief medical officer Professor Dame Sally Davies added: ‘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.

‘I am pleased to see the Government taking action on this issue and hope to see the wider scientific community feed in their views to this important consultation which could benefit and improve the lives of many women and babies in this country.’


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