Department of Health responds to calls for change to all white bread in UK
The government has responded to a major campaign calling on a big change to be made to anyone buying white bread in supermarkets or shops. Mandatory UK regulations require folic acid to be added to most non-wholemeal wheat flours. This public-health measure aims to boost dietary folate levels and reduce serious birth defects like spina bifida.
However, a petition on the Parliament website calling for politicians to end the mandatory fortification of white flour with folic acid ’immediately’. The petition, created by Dr Clare Craig, has been signed by 20,000 people and says: “We call on the Government to stop the fortification of flour with synthetic folic acid. Folic acid is a medicine not a food. We believe it is unethical to mass medicate the entire population without their knowledge or consent in the hope that a minority group of people might see a benefit.
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“The NHS website lists sections of the population (including people with cancer, a stent or low vitamin B12 levels) who should avoid folic acid exposure because of possible detrimental health impacts. Even if these people are aware of the issue, it is becoming harder to avoid as wholemeal and gluten-free products are voluntarily adding folic acid.”
Because the petition has passed 10,000 signups, the government has been forced to respond. If it gets to 100,000 signatures, it will be considered for a Parliamentary debate. The Department of Health, in reply, said that it was a public health measure, ‘not a medical intervention’ - and said it was thought to prevent around 200 babies being born with neural tube defects each year.
It said: “The policy applies to non-wholemeal flour, reflecting the flour-type already subject to fortification. The UK Government is mandating fortification of non-wholemeal wheat flour with folic acid with the primary objective to increase folic acid intake among women of childbearing age, thereby improving blood folate levels and reducing the risk of neural tube defects (NTDs) during pregnancy.
“The policy is projected to prevent around 200 NTD-affected pregnancies annually—approximately 20 per cent of UK cases. The population-level policy will have the wider benefit of increasing the intake of folic acid and improving folate status across the whole population. Folate, including folic acid, plays an important role in forming healthy red blood cells and maintaining brain health.
“Previous efforts through public health campaigns to promote supplementation, as well as voluntary fortification by manufacturers, have had limited success. Despite longstanding UK public health advice recommending a daily supplement of 400 micrograms of folic acid before conception and during early pregnancy, uptake remains suboptimal, particularly among younger women and those from lower socio-economic backgrounds.
"Since almost half of pregnancies in the UK are unplanned, many women may not take supplements during the critical early weeks of gestation.”
It explained that all products should have the ingredients, including folic acid, labelled.
It added: “The decision to fortify non-wholemeal wheat flour with folic acid has a long history and has been considered both by the Scientific Advisory Committee on Nutrition (SACN), which advises the four UK governments on nutrition-related matters, and its predecessor, the Committee on Medical Aspects of Food and Nutrition Policy.
"Folic acid fortification was recommended by the SACN in 2006, after an extensive review of the evidence on folate and health, which is available at the following link. Since then, there have been several further evidence reviews and modelling work (for example) to establish the level of folic acid to be added to flour, as well as to address concerns about potential adverse effects.”
It added that the NHS provides guidance for individuals who may need to avoid folic acid, for example, due to specific medical conditions or interactions with medication. It added: “People in this situation are advised to seek advice from a healthcare professional. Foods in the UK have been voluntarily fortified with folic acid for many years, including products such as breakfast cereals and spreads, without evidence of adverse health effects.”
To read the petiton and see the full response, click here.