Asked by: Andrew Ranger (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential impact of the mandatory fortification of non-wholemeal wheat flour with folic acid on people with pernicious anaemia and other medical conditions for whom folic acid supplementation may not be appropriate.
Answered by Sharon Hodgson
Folic acid fortification was recommended by the Committee on Medical Aspects of Food and Nutrition Policy in 2000 and by its successor the Scientific Advisory Committee on Nutrition (SACN) in 2006, after an extensive review of the evidence on folate and health. The SACN has further considered the evidence in its 2009 report to the Chief Medical Officer on folic acid and colorectal cancer risk and its 2017 update on folic acid. The tolerable upper limit was also re-considered by the Committee on Toxicity (COT) in 2018.
In its 2006 report on folate and disease prevention, the SACN considered data from hospital discharge surveys in the United States of America, where mandatory fortification of enriched cereal grain products with folic acid was authorised in 1996 and fully implemented in 1998. The data suggested that the number of cases of pernicious anaemia or subacute combined degeneration of the spinal cord had not increased post-fortification. This suggests that mandatory fortification had not led to a delay in the detection of vitamin B12 deficiency by masking the diagnosis of pernicious anaemia.
In the SACN’s extensive review of the evidence on folate and health it considered other medical conditions for whom folic acid supplementation may not be appropriate including epileptic patients on phenytoin, an epileptic drug, pregnant women in the context of multiple births and embryo selection and anti-folate chemotherapy. For each, the SACN noted that there is no evidence or no substantive evidence to suggest that folic acid fortification would cause adverse health outcomes.
The policy was developed with Government’s public consultations on both the impact assessment and legislation. This issue was considered as part of the consultation and impact assessment process.
The level of folic acid chosen for fortification, 250 micro grams per 100 grams of flour, was based on modelling carried out by Food Standards Scotland. The level of fortification has been chosen in order to minimise the risk of the population exceeding the tolerable upper intake level and therefore the risk of masking the diagnosis of pernicious anaemia. COT concluded in 2018 that “Further work is needed to identify the maximum level of folic acid intake at which masking would not occur. However, it is very unlikely that this would be such that the [upper limit] for intake would be less than 1 mg/day, as at present.”
The Government is planning an evaluation on the impact of the policy to assess the effectiveness of the level of mandatory folic acid fortification for both the prevention of neural tube defect affected pregnancies but also to check that the population are not routinely exceeding a tolerable intake and identify any further unintended consequences.
Asked by: Andrew Ranger (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of the proposed changes to the Nutrient Profiling Model, including the adoption of a free sugars methodology, on (a) the availability of fortified breakfast cereals in schools and breakfast clubs, (b) levels of fibre and micronutrient intake among children and (c) UK food manufacturers that have invested in product reformulation to reduce sugar, salt and fat content.
Answered by Sharon Hodgson
In the 10-Year Health Plan, the Government committed to updating the standards behind the advertising and promotions restrictions on ‘less healthy’ food and drink products by applying the new Nutrient Profiling Model (NPM). The Government published the new NPM on 27 January. The new NPM is built on the latest science and has been updated in line with the latest dietary advice, especially on reducing children’s consumption of free sugars. Children are consuming twice the level of free sugars as recommended which can contribute to tooth decay and obesity.
Breakfast cereals can contribute to fibre and micronutrient intakes, but this needs to be balanced against their contribution to free sugars intake in children. Breakfast cereals are often fortified with micronutrients, and can make useful contributions to riboflavin, folate, vitamin D, and iron where intakes are low in older children aged 11 to 18 years old. However, the contribution made by breakfast cereals to children’s free sugars intake is similar to contributions from ‘sweet biscuits’, from ‘buns, cakes, pastries and fruit pies’ or from ‘sugars, preserves and sweet spreads’.
There are breakfast cereals that are higher in fibre and lower in free sugars that pass the new NPM.
The consultation on updating the school food standards, which includes standards for breakfast cereals, closed on 12 June. The Department for Education and the Department of Health and Social Care are currently considering the responses.
Like the current NPM, NPM 2004/5, the new NPM uses a scoring system in which points are allocated for nutrients or ingredients within a food or drink per 100 grams. The model balances the contribution made by ‘beneficial’ nutrients, that is, protein, fibre, fruit, vegetables, nuts and seeds, to a child’s diet, alongside the ‘negative’ contributions from nutrients, that is, energy, saturated fat, free sugars and salt, of which children’s intakes are higher than recommended. The protein component of the model acts as a marker for micronutrients. The new NPM also awards more positive points to fibre than the current model.
The NPM is not about restricting reformulation. The aim is to stop the targeting of ‘less healthy’ food and drink marketing to children and encourage further reformulation and the promotion of healthier options. While some products previously reformulated to meet the NPM 2004/05 may need to go further, the new NPM continues to incentivise reformulation and to support industry to deliver healthier products over time by allowing greater credit for fibre. A full public consultation on the proposed application of the new NPM to the advertising and promotions restrictions closed on 17 June. This consultation sought feedback on the impact and challenges of applying the new NPM.
We will use evidence from the consultation to inform final policy decisions and the final impact assessment which, subject to the outcome of the consultation, would be published ahead of any changes being made.
Asked by: Andrew Ranger (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, whether his Department plans to introduce a national screening programme for prostate cancer; and what steps his Department is taking to improve outcomes for people affected by the disease.
Answered by Ashley Dalton
The Department is guided on screening policy by the UK National Screening Committee (UK NSC). The UK NSC does not currently recommend a national screening programme for prostate cancer, as the current best test, the Prostate Specific Antigen test, lacks the necessary accuracy. It can lead to overdiagnosis and unnecessary treatment, as well as false reassurance for some men. This is particularly important given that many prostate cancers are slow-growing and may not cause harm during a man's lifetime.
However, the UK NSC has commissioned a university to carry out a high-quality review and cost effectiveness model of the evidence for a national prostate cancer screening programme. This includes targeted approaches to high-risk groups and an offer to all men defined by age. The UK NSC expects to receive the report later this year.
In addition, the Government has invested £16 million in the £42 million United Kingdom-wide TRANSFORM trial, led by Prostate Cancer UK, which aims to identify new ways of detecting prostate cancer at an earlier stage, including in men without symptoms. The trial will ensure that at least 10% of participants are Black men, reflecting their higher risk and the importance of ensuring new tests are effective across all groups.
The National Cancer Plan will include details on how we will improve outcomes for cancer patients, including for those living with prostate cancer.
Asked by: Andrew Ranger (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking to help improve (a) safety and (b) regulation in the non-surgical cosmetics sector.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government is committed to taking action to address longstanding concerns about the safety of the cosmetics sector, and is exploring options for further regulation in this area. We will set out the details of our approach in our response to the consultation on the licensing of non-surgical cosmetic procedures in England, which we will publish as soon as possible.
Asked by: Andrew Ranger (Labour - Wrexham)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is tacking to help tackle the socio-economic factors which contribute to ill health.
Answered by Ashley Dalton
I refer the Hon. Member to the answer I gave to the Hon. Member for Poole on 5 March 2025, to Question 33818.