Folic Acid in Flour
Expert government advisers have recommended that folic acid be put into all flour to achieve a major reduction in the number of babies who are affected by spina bifida during pregnancy.
The decision taken by Public Health Minister, Yvette Cooper, on 13 January 2000 to put the recommendation out to consultation was welcomed immediately by the Association for Spina Bifida and Hydrocephalus (ASBAH), which has been campaigning on this issue for several years.
The recommendation came from COMA (the Committee on Medical Aspects of Food and Nutrition).
COMA called on the government to require millers be required to put 240 micrograms of folic acid, a B-group vitamin, into every 100 grams of flour in order to reduce the number of spina bifida pregnancies by an estimated 41%.
ASBAH Executive Director Andrew Russell said: "COMA recommends a level of fortification, which its expert members consider is safe for the population as a whole.
"The government's present strategy encourages the voluntary use of folic acid as a diet supplement but it will always be limited in its effect because it will only ever reach women who plan their pregnancies. About 50% of pregnancies are not planned, and women who do not plan ahead don't take extra folic acid."
Mr Russell added: "We've waited an inordinately long time for COMA to report, but we now welcome the decision of the new Minister for Public Health to get to grips with it. A final decision must not become bogged down in arguments about allocation of responsibilities between the Department of Health, MAFF and the new Food Standards Agency, or we will be waiting another few years for action to be taken."
1998 figures, the latest available, show that almost 400 pregnancies were affected by spina bifida in England and Wales alone. This figure does not include the numbers of pregnancies affected in either Scotland or Northern Ireland.
Millers are already required to add two other B-group vitamins (thiamin and niacin), as well as iron and calcium to flour to replace material lost in the milling process Ð all of which are known to be beneficial to public health. At present, the additives are controlled by the Bread and Flour Regulations 1998, but wholemeal and some specialist flours are exempt.
Even if folic acid is added to all flour in future, women should still take a daily folic acid diet supplement to raise the folic acid level in their blood from well before conception until the end of the first 12 weeks of pregnancy - when their requirement for the vitamin is at its highest.
The supplement level recommended for women in general is 400 mcg a day; tablets containing this dose are found among the vitamin displays in high street chemists and health food shops. Women specially at risk - those with previously affected pregnancies or with family histories of spina bifida - should ask their doctors to prescribe 5mg of folic acid daily.
Helen Brinton, MP for Peterborough, has been working closely with ASBAH on our flour fortification campaign. Mrs Brinton has tabled a Commons' Early Day Motion urging the urgent implementation of the measure.
Information supplied by the:
Association for Spina Bifida and Hydrocephalus, 42 Park Road, Peterborough, PE1 2UQ, England
