UK ponders folic acid options

The institute’s Dr Sian Astley told NutraIngredients.com: “There are alternatives to the mandatory fortification of all bread flour with folic acid. Those include: Not fortifying all bread flour, using natural folates, co-fortifying with other B vitamins and using bio-fortificants from plants​.”

The FSA has advised government that mandatory fortification in Britain could prevent dozens of babies developing neural tube defects since the vitamin plays a key role in foetal growth.

Dr Astley said she would support the FSA’s advice if alternatives were considered first and if mandatory fortification was accompanied by a wide ranging campaign of public advice to ensure moderate folic acid intakes.

“If mandatory fortification were it introduced, it should be accompanied by the regulation of other commonly occurring folic acid sources in breakfast cereals and supplements​,” she said.

Not nature identical​

Unlike other vitamins, folic acid is not nature identical, continued Dr Astley. “There is evidence that folic acid is not easily metabolised by the liver leading it to become saturated leading to unmetabolised folic acid in the system​.”

After its introduction in the US 10 years ago, mandatory folic acid fortification has been linked with a number of potential heath risks. Those include the increased risk of certain types of bowl cancer, cognitive degeneration in older individuals who have depleted levels of B6 and B12, and cardio vascular disease, said Dr Astley.

“The concern is that the risks ​(associated with mandatory fortification) make take 10 to 20 years to emerge. So we may have to wait another 10 years to see its full effects​.”

But there was no conclusive evidence to support those fears, she stressed.

Moreover, folic acid supplements for women who are pregnant or who are trying to become so is “safe and beneficial​,” she said.

Focusing on the links made between folic acid and certain types of bowl cancer, Dr Astley said that “there was probably a risk for individuals with pre-existing malignant changes or a family history of the disease​.”

Uncertainties​

The Scientific Advisory Committee on Nutrition (SACN), which advises the FSA, has acknowledged that “there were still uncertainties regarding folic acid and cancer risk​.” It advised the FSA that there should be “precautionary advice on consumption of supplements containing folic acid by those at greater risk of developing colorectal adenomas and those with existing premalignant adenomas​.”

Meanwhile, a Department of Health spokesperson told BBC News: "We will now consider their (​FSA’s) recommendation for the introduction of mandatory fortification of flour with folic acid alongside controls on voluntary fortification​."