The UK government has officially announced the mandatory fortification of flour with folic acid, a transformative policy aimed at preventing neural tube defects (NTDs) in newborns. This decision comes after years of advocacy and mounting scientific evidence supporting the measure as a cost-effective way to improve public health.
The impact of neural tube defects
NTDs, including spina bifida, occur when a baby’s brain and spinal cord fail to develop properly during early pregnancy. These defects are a significant cause of miscarriage, stillbirth, and neonatal death, and they can lead to severe, lifelong disabilities.
Despite recommendations for women to take folic acid supplements when trying to conceive, many do not take them at all or start too late for the supplements to be effective. Fortifying flour ensures everyone benefits, regardless of awareness, access, or socio-economic status.
The role of advocacy and evidence
Experts like Professor Sir Nicholas Wald have been advocating for this policy. In a June 2024 opinion piece published in The BMJ, Wald argued that fully effective fortification could prevent up to 80% of NTDs, compared to the current approach of relying on individual supplementation, which reaches far fewer people.
This government announcement reflects the recommendations of numerous health experts and organisations, including the scientific consensus on the safety and efficacy of fortification.
“Around 80% of neural tube defects would be prevented by the simple measure of ensuring that women of child-bearing potential achieve the necessary intake of the vitamin folic acid before pregnancy. This cannot happen from a healthy diet alone.” –Nicholas Wald, professor of preventive medicine
What this means for the UK
The fortification policy will require the addition of folic acid to non-wholemeal wheat flour across the UK, helping to protect thousands of babies and families from preventable conditions. It represents a significant public health milestone, advancing equality by benefiting all segments of the population.
From advocacy to action
The decision underscores the power of evidence-based policy and the importance of collaboration between scientists, healthcare professionals, and policymakers. As this initiative is rolled out, its success will depend on meticulous implementation and ongoing monitoring to maximise its impact.
- Expert advocacy amplified by The BMJ
Professor Sir Nicholas Wald’s opinion piece in The BMJ highlighted the urgent need for mandatory folic acid fortification to prevent neural tube defects (NTDs). His authoritative analysis reinforced the scientific consensus and called for immediate government action, adding significant momentum to public health advocacy efforts. - Policy alignment with evidence based recommendations
The government’s decision to fortify flour with folic acid aligns closely with the evidence presented in The BMJ. Wald’s argument that full fortification could prevent up to 80% of NTDs was a key consideration, showcasing the critical role of science communication in shaping health policies. - Driving public and political awareness
By publishing Wald’s piece ahead of the election, The BMJ positioned folic acid fortification as a political and public health priority. This strategic timing helped ensure that the issue remained in the spotlight, influencing policymakers and paving the way for the government’s landmark decision.
This initiative demonstrates how robust evidence and persistent advocacy can lead to meaningful policy changes that safeguard public health for future generations.
Read more about Professor Wald’s perspective on folic acid fortification: Folic acid fortification: will the new UK government pass the “acid test”?
For the full government announcement, visit: Birth defects prevented by fortifying flour with folic acid.
