Fortifying flour with folic acid could have major implications for bakers, according to Scottish Bakers.

Following the publication of a scientific paper claiming there is “overwhelming” evidence for mandatory fortification of flour with folic acid, the trade group said such a move would raise issues including the impact on exports and how it would affect production of baked goods.

There have been calls to fortify flour with folic acid because of its benefits for pregnant women, including preventing neural tube defects in babies (see below). Although the idea of fortification has been backed by health ministers in Wales, Scotland and Northern Ireland, the Department of Health has not done so.

Government advisory group the Scientific Committee on Nutrition has also supported the idea of mandatory fortification, but has warned that long-term intake of folic acid above 1mg/day should be avoided. Such a limit prevents flour fortification as this would cause some people to exceed the daily amount.

A scientific paper published yesterday (31 January) in Public Health Reviews (the journal of the Association of Schools of Public Health in the European Region) says the current 1mg/day upper limit for folic acid is unnecessary and should be removed.

“Fortification of flour with folic acid to prevent these defects has been implemented in 81 countries without public objection or indication of harm,” the report states.

“In the UK, flour is already mandatorily fortified with other B vitamins (thiamine and niacin), as well as with iron and calcium. Extending fortification to include folic acid would undoubtedly save many babies from the tragedy of being born with an neural tube defects.”

In response, Scottish Bakers CEO Alasdair Smith said a decision to add folic acid to flour could have major implications on the food and bakery sector.

“Since the Scottish Government backed the idea of mandatory fortification, we have consulted with the industry in Scotland on this and will continue to do so. We would welcome the opportunity to engage with the Health Minister on how this would be implemented should the decision be made.”

The main implications, according to the trade association, include consideration over whether the folic acid would be added to the flour at the mill or to bakery products themselves during production at a craft bakery and the potential impact on exports.

Scottish Bakers also questioned whether it would apply only to products made in the UK or imported products sold here, or both.


The debate: Why should folic acid be added to flour?

The debate for adding folic acid to flour has been ongoing for a long time. In 2006 and 2009, the Scientific Committee on Nutrition (SACN) recommended mandatory fortification of flour with folic acid alongside restrictions on the voluntary fortification of foods with it and guidance on supplement use.

In 2007, the Food Standards Agency (FSA) board agreed with the SACN’s recommendations after considering the risks and benefits to specific groups as well as the wider population.

Last year, the SACN reviewed the evidence that has been produced since these reports and continued with its previous recommendations.

The FSA said there was strong evidence that consuming a higher folic acid intake before pregnancy and in the first 12 weeks would reduce the risk of NTDs in babies.

Despite campaigning by various public health authorities about the benefits of taking folic acid supplements before and during pregnancy, one study showed that less than a third of women took it before getting pregnant and 62% took it after the pregnancy had been confirmed (but too late to prevent NTDs).

This was further exacerbated when taking into consideration that almost half of the pregnancies in the UK were unplanned.