Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of impact on health inequalities of fortifying only non-wholemeal wheat flour with folic acid, including the impact on groups that are less likely to consume such flour; what estimate they have made of the number of birth defects that will be prevented by the introduction of folic acid fortification; and what consideration they have given to increasing fortification to a level similar to that deployed in the United States and Canada.

Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)

The Government laid legislation in England on 14 November 2024 to introduce the mandatory fortification of non-wholemeal wheat flour with folic acid. Similar legislation in Scotland, Wales, and Northern Ireland will be laid shortly. An impact assessment has been published to accompany this legislation. Fortifying non-wholemeal wheat flour with folic acid will help prevent approximately 200, or 20%, of Neural Tube Defects in the United Kingdom, such as spina bifida, in pregnancies.

We know that approximately 50% of pregnancies in the UK are unplanned, and folic acid intakes for women are lower than recommended, particularly amongst younger women and some lower socio-economic groups. The new regulations will help provide women with a higher baseline intake of folic acid, better protecting their babies in all scenarios. Importantly, fortification is intended to supplement, not replace, current advice on folic acid supplementation.

Non-wholemeal wheat flour is an established vehicle for mandatory fortification in the UK as it is already fortified with calcium, iron, niacin, and thiamine. By not requiring wider fortification of products, burdens and costs on businesses are minimised. Consumers are able to obtain folate, the non-synthetic form of folic acid, from other food sources, and some products are already voluntarily fortified with folic acid, such as breakfast cereals and spreads. Limiting folic acid fortification to non-wholemeal wheat flour enables individuals to choose not to consume fortified flour, if that is their choice.

Many countries have folic acid fortification policies, but each country fortifies different products, has different approaches, populations, and diets. Both Canada and the United States fortify at levels below the UK. There is a clear consensus from scientific committees that the proposed levels of fortification are appropriate, and provide a balanced approach to fortification.

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Found: raised the importance of holding the Regulator to account; a sentiment echoed by the Noble Lord, Lord Hampton