The UK Government has announced that folic acid is to be added to flour in the UK to help prevent neural tube defects in pregnancy. Professor Ponnusamy Saravanan of Warwick Medical School comments on what the current research on folic acid supplementation tells us.
Professor Saravanan said: “While the folic acid supplementation has significant benefits in reducing NTD, this is based on old data (1980s and 1990s) with the assumption that folate deficiency is common. Folic acid is a synthetic chemical, not significantly present in natural foods and may have harmful effects. Our recent study in >4500 pregnant women in early pregnancy showed that folate deficiency is indeed rare and more than 30% of women had extremely high level of folate in the blood. This study also showed that higher levels of folate increases the risk of gestational diabetes (diabetes in pregnancy) by 11%.
"In addition, evidence from countries like the US that have had mandatory fortification since 1998 showed that elderly people exposed to high folic acid levels – in particular those with poor vitamin B12 status – have an increased risk of cognitive impairment.
"A public health decision of this magnitude should consider the risks as well as the benefits. It has been estimated that fortification may prevent about 96 NTD pregnancies each year in the UK, but in so doing some 670,000 pregnant women will be exposed to excess folic acid for each NTD prevented. Further work on harmful effects of synthetic folic acid not only on mothers but the unborn babies needs to be urgently carried out before the mandatory fortification is carried out."
21 September 2021