Adding folic acid to flour: Have your say

The proposal has been put forward with the aim of helping to reduce neural tube defects (NTDs) in foetuses by raising the folate levels of women who could become pregnant.

Relevant information surrounding the issues and proposal has been published in a consultation document and impact assessment, both of which people are encouraged to read in full before responding.

Launched on 13 June 2019, this open consultation asks questions including:

• Do you agree or disagree with the proposal for mandatory addition of folic acid to flour produced by UK millers to help prevent neural tube defects?
• To which flour/products do you think mandatory addition of folic acid should apply?
• Are there any alternative ways of helping reduce the number of neural tube defects that you may prefer?
• Are there any particular groups or individuals that might be negatively affected by the proposed policy?
• Are there any businesses that might be negatively affected by the proposed policy?
• Do you think there are any other benefits, costs or wider impacts of this proposed policy that have not been mentioned?
• What are the practical issues that need to be thought about for this proposed policy? 

This consultation closes at 11.59pm on 9 September 2019.

While the Real Bread Campaign opposes the use of additives in general, it is unable to take a position of folic acid specifically.

The Real Bread Campaign’s notes and position on the so-called ‘fortification’ of flour.

Some key facts

The Real Bread Campaign urges anyone planning to respond to the consultation to read it, impact assessment, other supporting documents and as much other recent relevant research as possible before doing so.

• There are about 66 million people in the UK, of whom roughly 13 million are women aged between 15 and 45 (Typically, fewer than four per 1000 women under 15 or over 45 give birth each year)
• Around 1000 NTD-affected pregnancies are detected each year in the UK (ie 0.0015% of the population)
• The consultation estimates that adding folic acid to all non-wholemeal bread flour might reduce the incidence of NTDs by 5%-10%, while adding it to all flour might reduce the incidence by 15%-20%: ie the detected NTD incidence might be reduced from affecting around 1000 to around 800 - 950 pregnancies per year.

• The estimate used in the consultation is that around 90% of people consume products that contain flour.1
• An estimated 29% of women ‘consume very little bread’, so less than 10g of flour per day this way.2
• There are potential risks associated with ‘excess intakes’ of folic acid. Some are outlined in the consultation
• The consultation does not include specific alternatives to ‘fortification’ that might improve folate / folic acid uptake, eg improved cooking and healthy eating education, raising minimum levels of naturally-occurring folate (and other micronutrients) in flour, schemes to make healthier food more affordable and accessible, whilst curbing promotion of less healthy foods etc.

1 The documents don’t make clear how often or how much
2 We understand this to mean industrial loaf products as well as bread

Traditional mills

The Traditional Cornmillers Guild (TCMG) and Mills Section of the Society for the Protection of Ancient Buildings (SPAB) represent traditional wind and watermills. They have launched a petition calling for exemption for traditional wind and watermills that produce less than 1,000 tonnes of flour per year from any requirement to add folic acid to flour for reasons including:

• The impracticality for traditional mills to add folic acid in a consistent manner
• The threat to the integrity, historic character and sustainability of mill buildings of importance to national heritage from installing the necessary machinery

TCMG and SPAB Mills' notes and position on the issue