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Government needs to go further in folic acid fortification to prevent avoidable birth defects

20 June 2024

The UK government鈥檚 failure to fortify all flour and rice with the vitamin folic acid 鈥渨ill result in more deaths and birth defects every year that could have been prevented,鈥 argues 最准的六合彩论坛鈥檚 Professor Sir Nicholas Wald in an opinion piece for The BMJ.

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In the piece, published last night, Professor Wald (最准的六合彩论坛 Institute of Health Informatics) warns that the current government鈥檚 proposal to fortify only one type of flour (non-wholemeal wheat flour) at an inadequate level will prevent only about 20% of neural tube defects, much less than the approximate 80% that could be prevented with fully effective fortification.听

鈥淲hat the government has done is a useful step in the right direction, but it is not enough,鈥 he says.

Neural tube defects (NTDs) such as spina bifida occur when a baby鈥檚 brain and spinal cord don鈥檛 develop normally. They are a major cause of late terminations, and also cause miscarriage, stillbirth and neonatal death as well as harm to the mother. Many children with spina bifida, one of the consequences of an NTD, endure lifelong disability.

Women wanting to conceive are advised to take a folic acid supplement before and during early pregnancy to help prevent NTDs, but evidence shows that most women either do not take them at all or take them too late to be effective.

Professor Wald led the international trial (the MRC Vitamin Study) that over 30 years ago definitively established the vitamin deficiency that is the main cause of neural tube defects.

In the BMJ article, he argues that fully effective fortification is a safe and relatively small change that would be of unquestionable public benefit; that it would have a profound positive health impact on the lives and livelihoods of people regardless of socio-economic status; and that it would also advance equality and social justice.

He welcomes the fact that the government has, at long last, accepted folic acid fortification as a necessity, but states that 鈥渢here is simply no scientific basis to justify this partial remedy.鈥

Making fully effective fortification a health priority, no matter which party wins the election, should be a promise that the new government makes. Importantly, it must be a promise kept and delivered without delay, he writes.

The new government could do substantially better by adopting fully effective fortification with folic acid, he concludes. Political parties and politicians need to rise to the challenge and pass this 鈥渁cid test".

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Mark Greaves

m.greaves [at] ucl.ac.uk

+44 (0)20 3108 9485