Pressure is mounting on the Government to halt the planned addition of synthetic folic acid to everyday items such as bread, pasta, and cakes. From December 13, it will be law for most non-wholemeal wheat flours to be fortified with folic acid, also known as synthetic vitamin B9, in a bid to reduce the number of cases of neural tube defects (NTDs) in pregnancy.
NTDs can cause several serious conditions to babies in the womb, including spina bifida, the Government says. Numerous everyday items like white bread, pasta, and baked goods are made with this flour and consumed in their millions across the UK every day.
But the move has attracted criticism in some quarters. A petition calling to 'end the mandatory fortification of white flour with folic acid immediately' has reached more than 133,000 signatures.
Petition calls fortification 'unethical'
The petition 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."
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.
In the UK, non-wholemeal wheat flour is already fortified by law with calcium, iron, niacin, and thiamin.
Petition timeline and Government response
Launched on June 8 by Dr Clare Craig, the petition surged past the 10,000 signatures required for a Government response after just four days. It reached the 100,000 signatures required for a parliamentary debate on October 8. It is set to be debated on December 14.
The Government said: "Folic acid fortification is an evidenced public health measure, not a medical intervention. 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."
"The policy has been carefully designed to be proportionate, targeting non-wholemeal wheat flour because it is widely consumed across the population and is the most effective vehicle for delivering the intended public health benefits. This approach is consistent with long-standing UK fortification requirements for wheat flour, including the mandatory addition of calcium, iron, niacin and thiamine, which also apply to non-wholemeal wheat flour produced to organic standards. Not fortifying wider than the type of flour that is presently fortified, means that individuals can avoid fortified flour if they choose to or need to. This includes wholemeal flour, gluten-free products and other flour types such as soya or spelt flour."
"To ensure people can easily identify products that are suitable for them, added vitamins and minerals, including folic acid, must be labelled in the product’s ingredients list. This must also be declared when fortified flour is used as an ingredient."
What is folic acid and is it safe?
Folic acid is the synthetic, man-made form of vitamin B9, whereas folate is the version found naturally in foods like leafy greens, beans, and citrus fruits. Although they are the same essential nutrient, food manufacturers and health authorities use synthetic folic acid for fortification because natural folate is fragile and easily destroyed by heat during baking and cooking.
Folic acid is far more stable, meaning it withstands high oven temperatures and long shelf lives, delivering a reliable, measurable dose of vitamin B9 in everyday staples like bread and pasta. While the body absorbs natural folate directly in the gut, synthetic folic acid requires the liver to convert it into its active form before it can be used.
There are undoubted health benefits of folic acid. Folate, also known as vitamin B9, is an essential vitamin found naturally in many foods. It is also available in fortified foods and supplements, most commonly as folic acid (the synthetic form of folate). Folate, including folic acid, plays an important role in forming healthy red blood cells and maintaining brain health. It is one of the most important vitamins in pregnancy. Folic acid helps a baby’s spine develop and reduces the risk of NTDs, such as spina bifida.
Government advice for women who are pregnant or trying for a baby is that they should take a folic acid supplement of 400 micrograms every day as soon as they start trying for a baby (ideally for three months before) and for at least the first 12 weeks of pregnancy. Even though pregnant women, or women trying for a baby, will be eating food fortified with folic acid, they should still take folic acid supplements. Folic acid fortification is intended to support, not replace, current advice on folic acid supplementation.
Adults need 200 micrograms of folate a day. A microgram is 1,000 times smaller than a milligram (mg). The word microgram is sometimes written with the Greek symbol μ followed by the letter g (μg). There are no long-term stores in the body, so you need to eat folate-containing foods frequently. Most people should be able to get the amount of folate they need by eating a varied and balanced diet.
Vitamin B12 is involved in helping the body make red blood cells and keeping the nervous system healthy, release energy from food, and use folate. A lack of vitamin B12 could lead to vitamin B12 deficiency anaemia.
However, not everyone is able to take much folic acid. The NHS says: "Most adults and children over 12 months can take folic acid tablets or liquid on their own. Multivitamins containing other vitamins combined with folic acid are not recommended for children under 12 years of age."
Folic acid tablets and liquid are not suitable for everyone. For example, they may not be suitable if you've had an allergic reaction to folic acid or another ingredient used in the medicine in the past, you have vitamin B12 deficiency anaemia or pernicious anaemia (a condition where your immune system attacks your body's healthy cells), you have a coronary stent (a small metal mesh tube inserted into the artery that leads to your heart), or you have cancer.
"Taking an extra dose of folic acid on its own is unlikely to cause problems, but taking too many multivitamin tablets or capsules can be dangerous." Independent bodies such as the Scientific Advisory Committee on Nutrition and the Food Standards Agency have reviewed decades of data from more than 60 countries that already fortify flour. It has found no evidence of allergic reactions or widespread harm.
Exemptions and scope of the law
Not all millers will have to add it. Small-scale millers producing less than 500 metric tonnes of flour per year are exempt, although many across the country have already started adding it. The UK is not the first to start doing this. Australia, Canada, and the US have been putting folic acid into flour for years and have seen a drop in birth defects.
The new requirement applies to non-wholemeal wheat flour. This includes white bread flours, brown flours, most general-purpose and cake flours, and specialist blends based on non-wholemeal wheat flour. The law does not apply to wholemeal flour and it does not apply to flours made from other grains (such as rye, spelt, buckwheat, einkorn, corn, or gluten-free blends), unless the miller chooses to add it voluntarily.
A number of sources say that the folic acid will not affect the taste or characteristics of the flour, and there is no need to adjust 'hydration, proofing, mixing times, or recipes'. The parliamentary debate on the petition is scheduled for December 14.
