Call for UK-wide folic acid fortification

This would prove easier to implement than in Scotland and Northern Ireland (NI) proceeding – as they would like – alone, it has emerged. Neural tube defects such as spina bifida have not decreased significantly in the UK since the recommendations were originally made in 2007.

While the administrations in Scotland and NI are enthusiastic about adopting the folic acid fortification recommendations proposed by the Scientific Advisory Committee on Nutrition and endorsed by the Food Standards Agency (FSA), successive governments in Westminster, have dragged their feet in this area.

Pressure ​

Pressure to act is likely to rise now that a Bill to create a new body for Scotland – Food Standards Scotland – has begun its passage through the Scottish Parliament.

Since changes made by the government in 2010, the FSA no longer has responsibility for nutrition and health in England and Wales, which has been transferred to the Department of Health (DH). However, it does currently still retain responsibility in Scotland and NI.

At a meeting last month, the FSA’s board agreed to a paper recommending UK-wide fortification as the best way forward. The board was informed that problems would arise were Scotland and NI to proceed without the rest of the UK.

In particular, millers and plant bakers would be faced with the problem of supplying different products to the devolved nations. At the same time, introducing controls limiting the voluntary fortification of other products to prevent people consuming folic acid above recommended maximum intakes would also prove harder unless they were introduced pan-UK.

Difficulties ​

“Given the preference from the industry for a UK-wide approach and the potential difficulties associated with imposing voluntary controls in Scotland alone for products with a traditional UK-wide distribution pattern, it would be preferable if ministers across the UK could agree a uniform policy,”​ it stated in the report by FSA director for Scotland, Charles Milne.

The simplest way to introduce mandatory fortification would be to amend the existing UK Bread and Flour Regulations to extend the nutrients already covered (calcium, iron, niacin and thiamine) to include folic acid, it said.

The board heard that the DH was waiting for the latest figures on folate levels in the population from the National Diet and Nutrition Survey to become available in the summer before deciding whether to recommend mandatory fortification in England and Wales.