Ministers urged to make folic acid compulsory in flour

01 February 2018 08:42

A "statistical error" resulted in an upper limit being set for daily folic acid intake

A "statistical error" resulted in an upper limit being set for daily folic acid intake

Hundreds of children born with common birth defects may be partially due to a "statistical error" that resulted in an upper limit being set for daily folic acid intake, scientists say.

London-based researchers focused on anencephaly - where a baby is born without parts of the brain and skull - and spina bifida - where the bones of the spine do not form properly around part of the baby's spinal cord.

They believe around 3,000 cases of babies being born with the two defects could have been prevented in the UK in the last 20 years if the Government had approved a plan to make folic acid a compulsory ingredient in flour.

'Flawed analysis'

White flour is already fortified with iron, calcium and other B vitamins (niacin and thiamine) in the UK. But new studies suggest that the folic acid should be a necessary addition, and that the upper limit of 1mg a day is based on "flawed analysis".

The 1mg a day limit was adopted after the findings from the US Institute of Medicine suggested those with vitamin B12 deficiency are at an increased risk of damage to the central and peripheral nervous system when consuming higher doses of folic acid.

This has been seen as a barrier to introducing fortification of folic acid in the UK, according to study leader Professor Sir Nicholas Wald.

But Prof Wald and his team in London concluded that high doses of folic acid do not lead to neurological damage, therefore there is no need for the 1mg a day upper limit.

'Avoidable tragedy'

The researchers said this "flawed" NAM analysis from 1998 was a result of "misinterpreted data from 23 studies that they considered".

Prof Wald said at a press briefing, from the Wolfson Institute of Preventive Medicine at Queen Mary University of London: "The Government has been doing due diligence - insisting on eliminating every shred of evidence of harm.

"It is the advisory board that has failed here - it has failed because of the most extraordinarily simple statistical error."

It is estimated that one in every 500 - 1,000 pregnancies is affected by anencephaly and spina bifida, which are collectively referred to as neural tube defects (NTDs).

Previous studies, which included a randomised trial in 1991, have shown that increasing folic acid intake immediately before and early in pregnancy prevented NTDs by at least 80%.

Study co-author Professor Joan Morris, also from the Wolfson Institute, said: "It's a completely avoidable tragedy."

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