What is it about?

Many countries have already introduced folic acid fortification of bread and flour with clear beneficial effects, especially reductions in neural tube defects causing severe congenital malformations. As part of our research on fertility and micronutrient intake involving 6 sub-fertile and 12 fertile women, we analysed their diet diaries for dietary folate intake. We used this data to also estimate dietary folate intake for another sample of 130 women in very early pregnancy. We collected data from all subjects on use of periconceptional supplements containing folic acid and estimated total intake of dietary folate plus supplementary folic acid. From this data we were able to predict how many UK women would achieve optimal intake of >700 microgram/day of folate for prevention of neural tube defects.

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Why is it important?

Our results indicated that after fortification of flour and bread in the UK should prevent approximately 226–343 conceptions a year from developing NTDs, but 45% of women will still have an inadequate total folate intake (<700 microgram/day), unless supplementation levels improve. Clearly women with pregnancies that are unplanned but not unwanted are at a disadvantage as folic acid needs to be taken starting 6 weeks before a planned pregnancy to be effective and these women can only benefit from general folic acid fortification. However, in our sample 26.6% of women with planned pregnancies had never taken a preconception folic acid supplement.


These finding and the reports of the Scientific Advisory Committee on Nutrition justify folic acid fortification of flour and bread in the UK. However, a leading politician has been quoted as saying "We have more urgent priorities" and that was before the Covid19 crisis!

Dr John Anthony Alvan Nichols
Royal Society of Medicine

Read the Original

This page is a summary of: Survey of total folate intake at conception and assessment of impact of fortification, Journal of Nutritional & Environmental Medicine, January 2008, Taylor & Francis, DOI: 10.1080/13590840801923952.
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