Scotland pushes for UK-wide mandatory fortification of flour with folic acid

Scotland's Minister for Public Health Maureen Watt has written to the UK government urging it to make a decision on fortification, which experts claim will help to prevent birth defects in children.

Although there is no requirement for UK flour to be fortified with folic acid, it is fortified with other nutrients including iron, calcium carbonate and thiamin (vitamin B1). Fortification with folic acid is mandatory in the US, but has not been introduced in Europe.

Support from food standards groups

UK groups including the Food Standard Agency in Scotland and Northern Ireland, and the Scientific Advisory Committee on Nutrition (SACN), which advises UK government agencies and departments on nutrition and health, have previously urged for mandatory fortification of flour with folic acid.

“You can see why flour would be chosen as a vehicle​,” Alex Waugh, director general of the National Association of British and Irish Flour Millers, told BakeryandSnacks. “It is widely used, but fortification is not completely straightforward to do, nor is it cost free​.”

“The Scottish government is looking to raise the debate and let’s have the discussion about what’s best for people and what’s the best way of doing that - within the constraints that all businesses operate in​,” added Waugh.

Unplanned pregnancies

Supporters of fortification have pointed out that half the pregnancies in the UK are unplanned, that many women don’t take folic acid supplements during pregnancy, and many others start taking them too late.

In October last year, SACN wrote to health ministers in England, Scotland, Wales and Northern Ireland, stating that 85.5% of UK women of reproductive age (16 to 49 years) were below the level of red cell folate concentration recommended by the World Health Organization to prevent the incidence of pregnancies affected by neural tube defects such as spina bifida.

“Low folate levels among pregnant women are one of the chief causes of neural tube defects​,” said health minister Watt in a statement this week. “This is a particular concern in some of our more deprived communities, where rates of unplanned pregnancy are higher​.

'No progress at UK level'

“We are disappointed that, despite repeated lobbying from a number of sources, there has been no progress at UK level on mandatory fortification of flour with folic acid​,” she added. “To maximize the impact of mandatory fortification, and in line with recommendations from SACN and Food Standards Scotland, we believe a UK-wide approach would be most effective​.”

Watt said that, should the UK government not make a decision, she would work with her counterparts in Wales and Northern Ireland to consider how to progress.

A spokesman for the UK Department of Health said it was considering the issue of folic acid fortification in flour following the submission from SACN in October.