May 03, 2016

03/05/2016: To fortify or not to fortify - Scotland’s big question

First published in Milling and Grain, March 2016

Discussions unfolding from the start of this year have revealed that Scotland is edging ever closer to a decision some 16 years in the making, whether or not to fortify flour with folic acid.

As concerns rise over the potential for an increase in birth defects, Scotland moves towards mandatory fortification, as Westminster continue to delay their decision.

The uncertainty surrounding the issue of fortification has led to a reduction of the amount of folic acid added to products by companies who voluntarily fortify their foods, in order to comply with regulations should fortification be implemented. This has led to mounting concerns of the level of folic acid intake across the UK.
Folate, from the family of B-Vitamins, occurs naturally in foods such as nuts and green vegetables. Folic acid is a synthetic form of folate, often used for food fortification and in dietary supplements; it plays a pivotal role in the prevention of birth defects, specifically neural tube defects (NTD) such as spina bifida.

Since 1992 advice to women UK wide has been to begin to take folic acid supplements while trying to get pregnant to reduce the risk of NTD, but studies have shown that as little as 28 percent of women take the correct dosage of 400 micrograms three months prior to pregnancy, following this through until the 12th week of pregnancy.

As the required amount of dietary folate intake does not appear possible through diet alone, women who have unplanned pregnancies, as well as the those who have not taken the required supplement at the correct time, are at greater risk of NTD. It is believed that as many as 50 percent of births in Scotland are unplanned, expounding the need for the addition of folic acid into diets.

A study published in December 2015 concluded that the failure to implement mandatory fortification at the same time as the US in 1998 led to an estimated 2000 children being born with NTD, and ignoring it further could lead to an additional 150 children born with NTD year on year; where the US has seen a decrease of children born with NTD of 28 percent.

Extensive research has been carried out by a plethora of scientific bodies including the Scientific Advisory Committee on Nutrition (SACN), who were looking into potential adverse effects of folic acid. The conclusion of this research culminated in a collective call for fortification.

In a report to UK health ministers last autumn, officials at SACN testified that where mandatory fortification has been implemented in nearly 80 countries worldwide, none had not reported any adverse health conditions as a result of fortification.

Milling and Grain spoke to the Scottish Health Minister Maureen Watt about Scotland’s push to fortify flour.

Read the interview in Milling and Grain HERE.  

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