Folic Acid Fortification Benefits Still Under Debate

Dr Siân Astley from IFR and Laura Read OBE, Policy Advisor, Association for Spina Bifida and Hydrocephalus, hosted a session at the annual British Science Festival in Birmingham in 2010 examining the issues surrounding potential mandatory fortification of UK bread flour and the benefits of folic acid in preventing neural tube defects (NTD) in pregnancy.

Sep 24 2010 --- A lack of folate can lead to neural tube defects while a diet rich in folates can help reduce the risk of cancer and cardiovascular disease. Mandatory fortification of bread flour with folic acid has been recommended in the UK. The science behind this decision is a fascinating insight into how what we eat and who we are affects our health. IFR has had a long and internationally recognised record in the area of folic acid research, contributing science-based advice to the regulatory bodies through the BBSRC's research portfolio on health.

Dr Siân Astley from IFR and Laura Read OBE, Policy Advisor, Association for Spina Bifida and Hydrocephalus, hosted a session at the annual British Science Festival in Birmingham in 2010 examining the issues surrounding potential mandatory fortification of UK bread flour and the benefits of folic acid in preventing neural tube defects (NTD) in pregnancy.

In two presentations, Siân described what food folates are, why we need them and how folic acid a synthetic pro-vitamin differs from the essential dietary vitamins. She also talked about the process the UK's Scientific Advisory Committee on Nutrition (SACN) and the Food Standards Agency (FSA) have undergone to recommend mandatory fortification to the Department of Health as well as the scientific controversies that mean some researchers are still doubtful about the appropriateness of this decision.

Sam Copeland, whose daughter was born with the most severe form of spina bifida, talked about her experience as a parent of a child diagnosed prenatally and the joy and difficulties of day-to-day living with a disabled child, and Carole Armour explained how living with these conditions, and the changing views on disability that can sometimes be prevented, have affected her.

Laura Read then explained the rationale behind previous campaigns to encourage pre- and early pregnancy folic acid supplementation and how the information provided for women is ambiguous and confusing, and does not reach many of those most at risk of a NTD-affected pregnancy.

The audience were asked on four occasions during the afternoon whether they though the UK should make fortification of bread flour with folic acid mandatory. Laura Read then facilitated the discussion at the end of the session exploring whether people’s views had changed during the session and, if so, why.

By and large the audience was equally divided on their opinion; some in favour, some against and some undecided. Some people who had voted one way or the other at the beginning found their views altered as the presentations provided information and highlighted complex social and medical issues. The most conclusive outcome was the clear dichotomy between young men and women and older generations; the latter saw the Government’s intervention as caring whilst young people felt decisions about their health and well-being were being subsumed by authorities without proper consultation.