It was interesting to hear the news story from Scotland on the reported increase in babies being born with spina bifida. This links to work the Agency has done on this very issue, looking at ways of increasing the amount of folic acid in the diet in order to reduce the risk of pregnancies affected by neural tube defects, such as spina bifida. One public health measure the Agency has considered is fortification of flour or bread with folic acid to increase the folic acid intakes of women of child-bearing age. Evidence from other countries has demonstrated the positive impact this approach has had.
In May 2007, the Food Standards Agency Board recommended 'mandatory fortification' of bread or flour with folic acid, alongside controls on voluntary fortification and advice on the use of supplements. The Board’s decision on this issue was made after an extensive and scientifically robust process. This included analysis and advice from the Scientific Advisory Committee on Nutrition (SACN), which is an independent committee of scientific experts that advises the Government. All the scientific evidence considered by SACN is detailed in its report, Folate and Disease Prevention (December 2006).
In October 2007, SACN was asked by the Chief Medical Officer (CMO) to consider in depth two papers, which were published after the SACN report, suggesting that folic acid may increase the risk of colorectal cancer. SACN is expected to advise the CMO of its recommendation on mandatory folic acid fortification later this year and this will then be considered by UK Health Ministers.
If mandatory fortification is approved, the FSA will produce a plan of how it will be implemented, including details of the types of bread or flour that would be fortified and how the added folic acid would be labelled.