Folic Acid

Folic acid fortification was recommended by the Committee on Medical Aspects of Food and Nutrition Policy (COMA) 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.

In SACN’s 2017 update on folic acid, the evidence on high folic acid intakes on cancer risk specifically in relation to prostate, breast, colorectal, and overall cancer risk was reviewed. The report concluded that the findings from the different types of studies were inconsistent but overall, the evidence was inconclusive in relation to prostate and colorectal cancer risk and did not suggest an adverse association with breast cancer or overall cancer risk.

The SACN’s risk assessments concluded that ‘conclusive evidence from randomised controlled trials (RCTs) has shown that folic acid supplementation during the early stages of pregnancy can reduce the risk of the fetus developing neural tube defects (NTDs)’.

Foetal death rates was not a health outcome specifically considered by the SACN.

The level of folic acid chosen for fortification was 250 micrograms per 100 grams flour, with a view to minimising the risk of the population exceeding the tolerable upper intake level, which was considered in the Governments impact assessment.

The Government is planning an evaluation on the impact of the policy.