Folic acid is to be added to flour across the UK in a drive to reduce the risk of life-threatening spinal conditions in babies, the government has said.
It is thought that adding folic acid to non-wholemeal wheat flour will help to prevent around 200 cases of neural tube defects every year - around a fifth of the UK total.
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The new rules follow an agreement with the devolved administrations for Scotland, Wales and Northern Ireland and will only apply to non-wholemeal wheat flour, with gluten-free foods and wholemeal flour to be exempt.
What is folic acid?
Folic acid is the man-made version of the vitamin folate, also known as vitamin B9, which helps the body to make healthy red blood cells, which carry oxygen around the body.
Without enough folic acid, the body can make abnormally large red blood cells that do not work properly.
It is found in certain foods and is used to:
- treat or prevent folate deficiency anaemia
- help babies’ brain, skull and spinal cords develop properly and avoid neural tube defects, such as spina bifida
- help reduce side effects from methotrexate, a medicine used to treat severe arthritis, Crohn’s disease or psoriasis
It can also be combined with ferrous fumarate and ferrous sulphate to treat iron deficiency anaemia, along with other vitamins as a multivitamin and mineral supplement.
What foods is it found in?
Folate is found naturally in foods, while some foods have the vitamin added to.
Since the end of the Second World War, flour has been fortified with calcium, iron, niacin and thiamine during milling to support the nation’s health.
Good natural sources of folate include:
- spinach, kale, asparagus, brussels sprouts, cabbage and broccoli
- peas, lentils and beans, including chickpeas and black eyed beans
- yeast and beef extracts, including Marmite and Bovril
- oranges and orange juice
- wheat bran and other wholegrain foods
- poultry, pork, shellfish and liver
- some breakfast cereals that are fortified with added folic acid
What are the symptoms of folate deficiency?
Folate deficiency can cause a wide variety of symptoms, which can worsen if left untreated.
Anaemia is the most common effect, as this is caused by having fewer red blood cells than normal, or an abnormally low amount of a substance called haemoglobin in each red blood cell.
Common symptoms of anaemia include:
- extreme tiredness
- lack of energy
- feeling faint
- pale skin
- noticeable heartbeats (palpitations)
- loss of appetite and weight loss
If you have anaemia caused by a vitamin B12 deficiency, you may have other symptoms such as:
- a pale yellow tinge to your skin
- a sore and red tongue (glossitis)
- mouth ulcers
- pins and needles
- changes in the way that you walk and move around
- disturbed vision
- changes in the way you think, feel and behave
- a decline in your mental abilities, such as memory, understanding and judgement (dementia)
People with anaemia caused by a folate deficiency can also experience the following effects:
- reduced sense of taste
- numbness and tingling in the feet and hands
- muscle weakness
Why is folic acid important during pregnancy?
If a woman has a shortage of folate (vitamin B9) during the early stages of pregnancy, this can lead to neural tube defects in the foetus, which can result in spinal conditions such as spina bifida or anencephaly.
It has been found that adding folic acid flour - and so to bread - has resulted in a reduction in the number of neural tube defects in countries such as Australia, New Zealand and Canada, which are among around 80 nations to have adopted the practice.
While manufacturers already add folic acid to products such as breakfast cereals, the government has said that a higher intake is required during the first 12 weeks of pregnancy.
The NHS recommends that women who could become pregnant, or are planning a pregnancy, should take a folic acid tablet every day.
However, ministers want to increase the overall intake, particularly as around half of all pregnancies are unplanned, and said that the cost of adding folic acid to flour should be “minimal”.
Boris Johnson said: “Few things are as important as a baby’s health – and folic acid-fortified flour is a quick, simple win to enhance their development.
“This will give extra peace of mind to parents and families, as well as helping boost the health of adults across the country.”
Health Secretary, Sajid Javid added: “With the safe and taste-free folic acid baked into the national diet, hundreds more babies will be born healthy each year.
“Focusing on preventing life-threatening health issues such as spina bifida, will ensure fewer people will require hospital treatment, and more individuals and families are able to live healthier lives.”
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