UK parliament approves mandatory folic acid fortification in wheat flour

UK – The UK Parliament has approved legislation mandating the fortification of non-wholemeal wheat flour with folic acid, a significant step to enhance public health.

This legislative change positions the UK alongside countries like the United States and Canada, which have mandated folic acid fortification since the late 1990s. The FFI views the UK’s decision as a major public health victory that may encourage other European nations to adopt similar measures.

According to the Department of Health and Social Care (DHSC), this measure aims to prevent approximately 200 cases of neural tube defects annually and improve the health of pregnant women.

The new law will take effect at the end of 2026, providing time for millers and flour producers to adjust their processes accordingly.

Folic acid, a synthetic form of vitamin B9, is essential for cell growth and the development of the brain and spinal cord in early pregnancy. Deficiency in this nutrient can lead to serious birth defects, including spina bifida.

While the NHS recommends that women planning a pregnancy take folic acid supplements before conception and during the first 12 weeks of pregnancy, up to 50% of UK pregnancies are unplanned, highlighting the need for a broader public health strategy.

The Food Fortification Initiative (FFI) has been instrumental in advocating for this policy change.

Since 2013, the FFI has provided guidance to the UK government and collaborated with various organizations, including The Queen’s Nursing Institute – Scotland, the International Federation for Spina Bifida and Hydrocephalus, and Shine, a UK charity supporting families affected by spina bifida and hydrocephalus.

“The mandatory addition of folic acid to fortified wheat flour is a major public health victory that will create a stronger future for the UK and may encourage other European countries to mandate fortification,” the FFI said. 

Their collective efforts have been pivotal in convincing policymakers of the importance of mandatory flour fortification.

Flour in the United Kingdom is already fortified with calcium, niacin, thiamine, and iron. The addition of folic acid is expected to reduce neural tube defects by 20% and deliver savings of around £20 million to the NHS over the next decade.

Additionally, it is projected to boost the economy by more than £90 million during the same period.

Professor Chris Whitty, England’s Chief Medical Officer, emphasized the simplicity and effectiveness of flour fortification in reducing neural tube defects. He also noted the importance of women who are pregnant or planning to become pregnant continuing to take folic acid supplements during the first 12 weeks of pregnancy.

“The fortification of flour is a simple and effective way to help to reduce cases of neural tube defects, although it is important that women who are pregnant or intending to become pregnant continue to take folic acid supplements before and during the first 12 weeks of pregnancy,” Whitty said.

As the UK prepares to implement this policy, the focus remains on ensuring a smooth transition for manufacturers and maintaining public awareness of the continued importance of folic acid supplementation during early pregnancy.

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