Media headlines in October reported that fortification of flour with folic acid is to go ahead. The UK would be joining many other countries where the prevalence of neural tube defects (NTDs) such as spina bifida has fallen after the introduction of such measures.
However, this announcement was premature – the decision had not yet been taken – but a consultation in 2019 has since been confirmed.
Two babies a week are born with NTDs in Britain. Women are already advised to take folic acid daily, before and for the first 12 weeks of pregnancy – but many don’t.
Dip in folate intakes
Experts have been advocating fortification for many years. The justification has been strengthened by the dip in folate intakes and blood folate levels in women over the past eight years.
Pills and post-farmgate fortification of staple foods are strategies used to tackle low micronutrient intakes. Another approach being used in developing countries, where deficiencies in vitamin A, iron and zinc are rife, is biofortification.
In Britain, severe nutritional deficiencies are rare. Nevertheless, low intakes of a range of vitamins and minerals are widespread, especially in adolescents and young adults.
Worse rather than better
If anything, things are getting worse rather than better. A decade ago, 43% of adolescent girls had low intakes of iron, but this has now increased to 54%, with the mean intake being just 56% of the recommended amount.
Also in this age group, one in four girls has a low intake of iodine and zinc, one in five a low intake of calcium, and one in five adolescents and adults have a poor vitamin D status.
Two papers published this month (paper one) (paper two) discuss the evidence for biofortification and explore the relevance in a country such as the UK.
