Bread and Flour: Folic Acid

(asked on 7th July 2022) - View Source

Question to the Department of Health and Social Care:

To ask Her Majesty's Government, further to the answer by Lord Kamall on 6 July (HL Deb cols 1001–2) regarding the scientific evidence available regarding folic fortification, whether they will publish the science brief referred to by Lord Kamall referencing heliocentrism versus geocentrism.


Answered by
Lord Kamall Portrait
Lord Kamall
This question was answered on 20th July 2022

The scientific contestation referred to is summarised in the paper Folic acid and neural tube defects: Discovery, debate and the need for policy change by Professor Nicholas Wald. Professor Wald asserts that the United Kingdom should pursue a higher level of fortification than would be permitted by the UK’s Tolerable Upper Level (TUL). A copy of the paper is attached.

The Government and its independent scientific advisory bodies have agreed that fortification of non-wholemeal wheat flour with folic acid, at a level informed by the guidance for supplemental intake of folic acid intake advised by the UK Expert Group on Vitamins and Minerals, is a safe and effective measure to reduce the number of neural tube defects (NTDs).

This view is supported by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and by the Scientific Advisory Committee on Nutrition (SACN). In 2018 COT published Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment: COT position paper on the current upper level for folic acid intake in response to a previous paper by Professor Wald, addressing the technical points raised in objection to the TUL and continuing to recommend its use. A copy of this paper is attached.

Deaths associated with high levels of folic acid refers to potential unintended harms which may arise following the fortification of flour with folic acid, such as an increase in the potential masking of vitamin B12 deficiency or pernicious anaemia where the deficiency can cause permanent neurological damage which can lead to death if untreated.

No recent discussions have taken place with countries which have implemented folic acid fortification on unintended consequences of the policy. However, evidence from a number of countries, including those which have implemented folic acid fortification policies, was considered by the SACN and COT to establish the safety and efficacy of fortifying food with folic acid. Analysis by COT and the SACN found that there was insufficient evidence to discount a number of potential risks at very levels of fortification.

While there is no specific scientific briefing relating to the debate between heliocentrism versus geocentrism, as I stated in the debate, we will routinely review the policy post-implementation to ensure it meets the objective of reducing NTDs while avoiding any unintended consequences. The forthcoming consultation will outline the proposed fortification levels with the supporting scientific rationale.

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