Food agency wants folic acid in bread or flour

Ministers should order the mandatory fortification of food with folic acid, the Food Standards Agency said yesterday.

The potential benefits of preventing between 77 and 162 babies a year from being born with severe disabilities outweighed any risk to the public, the agency said.

But it has not yet decided whether it will propose fortification of bread or of flour, after concerns that some people from ethnic minorities do not eat much processed bread, and from the organic flour industry, which is resisting any additives.

Should ministers decide to back the recommendation, it would amount to the first mandatory fortification of food since the second world war.

Folic acid is known to radically reduce neural tube defects (NTDs), including spina bifida, which can cause profound disabilities. But it needs to be taken for three months before conception to have the best effect.

Between 700 and 900 pregnancies are affected by NTDs every year, with most diagnosed women opting for abortions, and up to 162 could be prevented with mandatory fortification, scientists say.

Younger first-time mothers, particularly from poorer socio-economic backgrounds, are least likely to take supplements.

The FSA board has rejected the idea on several occasions amid a debate among health campaigners.

The decision was made at yesterday's board meeting in Nottingham after new scientific evidence concluded there was no proven risk to the public, and that levels of folic acid needed to mask vitamin B deficiency in older people, the greatest concern in the past, were higher than the effect that fortification of flour would have.

However, the agency recommended that ministers find a way of stopping the voluntary fortification of some margarines and cereals to prevent over-exposure to the drug, particularly in older people.

The Royal College of Paediatrics and Child Health welcomed the decision. "These conditions have profound implications for the children and parents or carers," said Patricia Hamilton, its president.

The Federation of Bakers said any fortification should be applied to flour rather than bread.

The Association for Spina Bifida and Hydrocephalus said about 85% of NTD-affected pregnancies in the UK resulted in abortions. Andrew Russell, its chief executive, called for the widest possible range of flours to be fortified. "Now that the science has been listened to, we look to health ministers to speedily implement this life-saving measure."