Folic acid is making headlines with the government set to announce it will soon be added to UK flour to help prevent spinal birth defects in babies.
The NHS advises women to take the B vitamin before and during pregnancy. However, not all women do and not all pregnancies are planned, so adding folic acid to flour could prevent up to 200 birth defects a year, experts suggest.
The government launched a consultation on ‘mandatory fortification’ in 2019, which has led to this latest decision. Folic acid will only be added to non-wholemeal wheat flour, not wholemeal and gluten free foods.
But what is it and why do people – including men – need it?
What is folic acid?
Folic acid is the synthetic version of the folate, a B vitamin that’s vital for the formation of red blood cells. It also plays a part in helping the body’s nerves function properly. The vitamin is essential in helping DNA form within cells, “allowing each cell to replicate perfectly”, according to the BDA, the association of British dieticians.
If you don’t have enough folic acid in your body, it can cause a form of anaemia – where blood cells have reduced ability to carry oxygen around the body – which causes tiredness, weakness and fatigue. People with a deficiency might also suffer from diarrhoea, loss of appetite, weight loss, headaches, heart palpitations, a sore tongue and behavioural disorders.
Some expressed concerns that mandatory fortification could have unintended health effects, such as masking a vitamin B12 deficiency or increasing the risk of colon cancer. But the Scientific Advisory Committee on Nutrition, which advises the government, said the evidence does not support these concerns.
Why is it important for pregnant women?
Folic acid fortification – the process of folic acid being added to grain products – has already been adopted in more than 80 countries worldwide, including Australia, Canada and the US.
The government’s 12-week consultation in 2019 on whether folic acid should be added to flour followed years of campaigning by charities including Shine, which represents people with the birth defect spina bifida.
Pregnant women are advised to take a folic acid supplement before conceiving and for the first 12 weeks of pregnancy to cut the risk of birth defects. But some women forget to take the supplement, do not follow advice or do not discover they are pregnant until it is too late.
Neural tube defects (NTDs) – birth defects of the brain, spine or spinal cord – occur when an opening in the spinal cord or brain remains from early on in human development. “Folic acid can prevent NTDs, but only if taken very early in the pregnancy, and really before conception,” says Clare Murphy, director of external affairs at Bpas.
“Currently, women are advised to take folic acid supplements during the early stages of pregnancy, but around half of UK pregnancies are unplanned, which means that many women have already missed the window to take folic acid by the time they realise they are pregnant.”
Around 1,000 pregnancies are affected by NTDs each year in the UK and more than 40% of cases are fatal. Under plans to fortify flour, experts predict that around 200 birth defects a year could be prevented.
Public health minister Seema Kennedy said the move would also help women from the poorest areas who are less likely to take folic acid supplements. “It is right that we do all we can to protect the most vulnerable in society,” she added.
Do men need it too?
Folic acid is important for everyone, regardless of their sex. According to the BDA, men, children and women who are not likely to become pregnant should be able get sufficient amounts of folate (the form of folic acid occurring naturally in food) by eating a healthy diet.
It’s been reported that folic acid can help protect the heart and cardiovascular system, boost sperm count, and decrease the risk for certain cancers. Some evidence suggests it might even reduce the risk of mood disorders.
What food contain folate (folic acid)?
:: Spinach
:: Kale
:: Brussels sprouts
:: Cabbage
:: Broccoli
:: Beans and legumes (ie. peas, blackeye beans)
:: Yeast and beef extracts
:: Oranges and orange juice
:: Wheat bran and other whole grain foods
:: Poultry
:: Pork
:: Shellfish
:: Liver
:: Fortified foods (ie. some brands of breakfast cereals – check the label).
How much should you have?
Adults and children over 11 years old are recommended to have 200μg (micrograms) of folate daily, according to the BDA. You can get enough folic acid from food alone – many cereals have 100% of your recommended daily value of folic acid. Look on the outside of packets for the nutritional chart or the ‘contains folic acid’ symbol.
Women trying for a baby are advised to have 200μg plus a supplement. For pregnant women, the advice is to take 300μg plus a 400μg supplement during the first 12 weeks of pregnancy – but consult your doctor first, especially if you’ve had a pregnancy previously affected by neural tube defects or if you have diabetes.
Breastfeeding mothers are advised to make sure they’re having 260μg a day, to help their child’s development.
Should you take folic acid supplements?
While pregnant women are strongly advised to take folic acid supplements, the rest of the population should be able to get enough providing they eat a balanced, nutritious diet. BDA suggests those aged over 50, or those with a history of bowel cancer, should take no more than 200μg/day per day.
Potential side effects of taking additional supplements daily include nausea, loss of appetite, trapped wind or bloating – although the NHS notes these symptoms are usually mild and don’t last long.
If you have any of the following, you should speak to your doctor before having folic acid supplements:
:: An allergic reaction to folic acid or any other medicine
:: Low vitamin B12 levels or pernicious anaemia
:: Cancer
:: Kidney dialysis
:: A heart stent