Folic Acid Action Raises Concerns Over The FSA's Line On Folic Acid Fortification And Supplementation

Main Category: Pregnancy / Obstetrics
Also Included In: Women's Health / Gynecology;  Complementary Medicine / Alternative Medicine
Article Date: 28 Feb 2008 - 1:00 PDT

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Folic Acid Action (FAA)[i] is challenging concerns raised by the Food Standards Agency (FSA) about the risk of excessive intake of folic acid, amid fears that it may stop women planning a pregnancy from supplementing their diet with this essential nutrient for the unborn child.

FAA is also highlighting how important it is that with or without fortification, women who are trying to conceive must take additional folic acid and says that current advice on this lacks clarity.

The FSA is calling for major food manufacturing companies to reduce the folic acid in their products so that people who eat bread fortified with folic acid - should the fortification plans go ahead - are not at risk of excessive intake. It claims that without a reduction of folic acid in fortified breakfast cereals and fat spreads, and a cap on the amount in supplements, up to 380,000 who ate bread fortified with folic acid could be consuming excessive quantities. 8,000 of these, the over 65s, could be at elevated risk of bowel cancer says the FSA, which also warns that certain types of anaemia in elderly patients may be masked by an elevated folic acid intake.

Andrew Russell, chair of FAA and CEO of ASBAH[ii] states: "Folic acid is an essential vitamin and people generally do not get enough of it! Most importantly, pregnant women need substantial extra folic acid and should not rely on flour fortification alone - and they should ideally start supplementation three months before conception and continue throughout the first 12 weeks of pregnancy."

"Concerns over 'excessive levels of folic acid' are unfounded," Russell continues. "No ill-effects or risks of folic acid have been proven. No link of folic acid to cancer has been shown, other than a possible preventative effect for some cancers. What's more, other evidence indicates benefits of folic acid in reducing dementia in older people, and preventing cardiovascular disease by reducing homocysteine levels.

"We really need to look at the bigger picture here to understand that increasing folic acid in the population as a whole is likely to have myriad benefits," Russell concludes.

Folic acid is a key nutrient in helping to prevent neural tube defects (NTD) such as spina bifida, where the spine fails to develop properly and leaves the spinal cord exposed. Spina bifida can lead to paralysis and, often, a tendency to another condition - hydrocephalus - where fluid builds up to dangerous levels in the brain and must be drained to prevent damage.

Both supplementation and flour fortification, as practised in the USA, are needed to raise the background level of folic acid in the population and prevent neural tube defect (NTD) pregnancies. Mandatory flour fortification alone would help prevent 350-400 NTD pregnancies of the 1,100 that occur in the UK each year but supplementation would prevent many more and also reduce elective terminations.

Further details of FAA and its campaign to ensure that all women of childbearing age have adequate levels of folic acid intake are available at http://www.microfolicacid.com/faa

References

[i] Folic Acid Action (FAA) is an expert panel of healthcare professionals and a patient organisations which was formed in 2004 to address some of the key issues regarding awareness on folic acid, to help reduce the incidence of babies born with birth defects

[ii] The Association for Spina Bifida and Hydrocephalus. http://www.asbah.org

http://www.microfolicacid.com/faa