The UK will fortify flour with 250 mcg of folic acid per 100 g of non-wholemeal wheat flour next year to help prevent neural tube defects (NTDs) in infants. The consumption of folic acid is especially important in the three months prior to and throughout the first trimester of pregnancy. Folate and folic acid are both forms of vitamin B9, but folate occurs naturally in foods while folic acid is synthetic. This change will have no adverse effects on men or children and is unlikely to negatively impact women past childbearing age, though rare overexposure to folic acid can mask a B12 deficiency, which is common in older adults and can cause neurological damage. This policy aims to prevent about 200 NTD cases a year in the UK, representing a 20% decrease in such birth defects. It has proved very successful in a number of countries.

In Australia, research shows the fortification of flour in 2009 led to more women meeting their folic acid needs in pregnancy and a statistically significant decrease in the number of infant NTD cases. Introduced in 1998 in Canada, a similar policy helped to cut the rate of spina bifida and other birth defects by 46% within a decade, according to a 2007 study. However, Unii feels it is crucial to highlight that you still need to take folic acid when trying to get pregnant or expecting a baby, no matter how many folic-acid-fortified or folate-rich foods you consume. It is very difficult to get as much vitamin B9 as you need in pregnancy from food. Even if you eat folate-rich meat and vegetables, for example, folate is heat sensitive, and preparation methods like boiling, frying, or baking reduce the content. Folic acid-fortified foods survive high temperatures with their vitamin reserve intact. However, pregnancy places an inordinate number of natural demands on your body that studies show decrease your vitamin levels generally, so supplementation remains essential.

What about methylated folate vs. folic acid?

Methylated folate and folic acid are not the same. There is more established evidence for folic acid, and while methylated folate is often touted as more bioavailable and potentially easier to digest for some women, as an evidence-based resource, Unii recommends you stick to taking as much folic acid as your doctor recommends.

Seek medical advice before taking anything when you are trying to conceive or expecting a baby, as even taking the NHS guidance amount may not be right for you if you have certain issues, such as epilepsy or a high BMI. In addition, folic acid is rightly dubbed the “queen of prenatal vitamins,” but there may be a number of supplements you need to consider for your own well-being as much as the baby’s. Prenatal vitamins may also help support you in the postpartum period, especially if you experience a lot of blood loss or low iron in pregnancy, so it’s important to be open with your healthcare team about what you’re eating and how you're feeling. Part of being the best mother and partner you can be is taking the best possible care of yourself.

For more advice on taking care of yourself in pregnancy, labour, and birth, check out Unii’s Ultimate Antenatal Classes, with prenatal video episodes taught by senior NHS midwives, an award-winning obstetrician and gynaecologist, and six other leading healthcare experts. Now available at unii.com.

Sources

British Dietetic Association. "Flour power and folic acid fortification."

Retrieved from: https://www.bda.uk.com/resource/flour-power-folic-acid-fortification.html

Ashbury Global. "Changes to England's Bread and Flour Regulations - What You Need to Know."

Retrieved from: https://ashbury.global/blog/changes-to-englands-bread-and-flour-regulations-what-you-need-to-know/

UK Government. "Folic acid added to flour to prevent spinal conditions in babies."

Retrieved from: https://www.gov.uk/government/news/folic-acid-added-to-flour-to-prevent-spinal-conditions-in-babies

UK Government. "Birth defects prevented by fortifying flour with folic acid."

Retrieved from: https://www.gov.uk/government/news/birth-defects-prevented-by-fortifying-flour-with-folic-acid

UK Flour Millers. "Bread and Flour Regulations."

Retrieved from: https://www.ukflourmillers.org/bread-and-flour-regulations

UK Government. "Folic acid added to flour to prevent brain and spinal conditions in foetuses."

Retrieved from: https://www.gov.uk/government/news/folic-acid-added-to-flour-to-prevent-brain-and-spinal-conditions-in-foetuses

BBC News. "Folic acid to be added to flour to help stop birth defects."

Retrieved from: https://www.bbc.co.uk/news/articles/c206d60xe7no

Folic Acid Will Be in UK Flour Next Year—But Don’t Stop Taking Prenatal Vitamins

Folic Acid Will Be in UK Flour Next Year—But Don’t Stop Taking Prenatal Vitamins