Folic acid should be added to both rice and flour to prevent hundreds of cases of “tragic” birth defects each year, experts said today.
Ministers have already announced that the nutrient will be baked into white and brown bread.
Officials estimate that 200 babies are born each year with neural tube defects, which are usually caused by folic acid deficiencies and can lead to lifelong disabilities.
But leading researchers are now criticizing the government’s “half-hearted” policy.
Up to 800 cases each year could be avoided if the nutrient were also added to rice and doses quadrupled, they claimed.
The government unveiled plans 18 months ago to add the nutritional flour to help prevent neural tube defects – a group of conditions affecting 1,000 babies in the UK each year – which are usually caused by a lack of folic acid
Folic acid, a synthetic version of the vitamin folate (B9), is found naturally in broccoli, peas and brown rice.
The NHS recommends that women take 400 micrograms of folic acid daily while trying to conceive and during the first trimester of pregnancy.
But coming off a diet on your own can be difficult. To get the recommended amount per day, a woman should eat at least four servings of foods high in folic acid, such as broccoli, kale and spinach, or eight servings of medium-content foods, such as kidney beans, zucchini or oranges.
A deficiency before or during pregnancy can lead to defects in a growing baby’s neural tube, which becomes the brain, spinal cord and central nervous system.
Defects can lead to lifelong disabilities, such as B. spina bifida, when a baby’s spine does not develop properly in the womb. This can lead to paralysis.
Others, such as anencephaly – when a baby is born without parts of the brain and skull – can be fatal.
Such defects, detected by routine screening, appear within the first month of pregnancy when the neural tube is fully formed.
Eight out of ten women choose to have an abortion after being discovered.
But experts say current NHS advice is not working, with half of pregnancies in the UK unplanned and only one in three pregnant women taking the supplement.
It was not until 2006 that British medical directors decided that fortifying flour with folic acid should be mandatory.
But it wasn’t until September 2021 that the government announced plans to add folic acid to non-wholemeal flour to reduce cases of neural tube defects.
The policy has been introduced in around 80 other countries, including the US, Australia and New Zealand.
These countries were prompted by a landmark 1991 study that found regular intake of adequate folic acid before pregnancy reduced the number of cases of neural tube defects by 80 percent.
Ministers apparently resigned because they were afraid of being accused of “mass medication” and acting like a “nanny state”.
They are still considering what amount should be mandatory, but have suggested 0.25 mg of folic acid per 100 g of non-whole wheat flour.
However, experts today warned that the approach is “too narrow”.
They said the plans would reduce the number of cases of neural tube defects by just 20 per cent a year, meaning around 200 fewer babies would be born with the disease.
However, increased fortification to 1mg per 100g of flour and rice would prevent 80 percent of cases and reduce the number of newborns with the condition by 800 annually.
Professor Sir Nicholas Wald, an expert in preventive medicine at University College London and author of the 1991 study on folic acid, said the government’s decision to make fortification compulsory was “welcome” but not at the right level to “ten to be fully effective”.
He said: “The Government’s proposals will create 600 preventable cases that will not be prevented.
“This must be rectified, and the fully effective settlement policy desired must be swiftly adopted.”
Professor Sir Nicholas Wald (left), an expert in preventive medicine at University College London and author of the 1991 study on folic acid, said the government’s decision to make fortification compulsory was “welcome” but not at the right level to be “complete”. . . Effective’. Professor Dame Lesley Regan (right), a former president of the Royal College of Obstetricians and Gynaecologists, has warned that the UK is ‘behind’ and that ‘there is no sense’ that folic acid fortification is ‘wrong’ or half-baked. ‘- sincerely’
He warned couples looking to terminate pregnancies that it was a “terrifying tragedy that could have been avoided in so many cases”.
Others have “hospitalized for life” children who may be paralyzed from the waist down and suffer from incontinence.
Professor Dame Lesley Regan, a gynecologist at Imperial College St Mary’s Hospital Campus, said there were scientific, medical, ethical and economic reasons for administering the “right dose” of folic acid for “maximum protection”.
The government’s women’s health tsar said: “I don’t think we can ignore the emotional and psychological trauma.”
Abortions due to neural tube defects detected by a scan at 20-22 weeks gestation require several days in the hospital.
And babies born with neural tube defects cost the NHS £30m over their lifetime, which Dame Lesley says is “unsustainable”.
Dame Lesley, who is also a former president of the Royal College of Obstetricians and Gynaecologists, warned that the UK was “behind” and there was “no point” getting folic acid fortification “wrong” or doing it “halfway”. not. from my heart out’.
Professor Neena Modi, expert in neonatal medicine at Imperial College London, said any pregnancy with neural tube defects was a “tragedy”.
Encouraging women to take folic acid supplements, along with the proposed “low” fortification, would leave “large sections” of the population behind, she said.
Women who avoid gluten or whose main carbohydrate source is rice will be disadvantaged, Sir Nicholas warned.
And ethnic minority mothers “who eat mostly rice and no flour” already have up to two-and-a-half times the risk of their baby developing neural tube defects, Professor Modi said.
“We have a huge problem with health inequalities and the current proposals will make it worse,” Professor Modi said.
The group said the government proposed low levels of folic acid based on advice from the Scientific Advisory Committee on Nutrition and the Committee on Toxicity.
Both committees expressed concern about a “theoretical risk” that high doses of folic acid could mask some symptoms of B12 deficiency and worsen neurological damage in people deficient in the vitamin.
Professor Modi said these concerns were “historical and baseless”.
She said: “It does not seem justified to base the policy on a theoretical risk versus a quantifiable risk to a baby.
“We think it would be wiser to move to a fully effective reinforcement strategy.”
Professor Peter Rothwell, a neurologist at the University of Oxford, said concerns about missed diagnoses of B12 deficiency were “not being taken seriously”.
The deficiency is “not common”, patients usually show symptoms early and can be easily detected by a blood test, he added.
According to current regulations, white and brown flour is already enriched with calcium, iron, thiamin (vitamin B1) and niacin (vitamin B3).
It takes about 500g of flour to make a loaf the same size as you buy in the store.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
