What is folic acid?
Folate, which is one of the B vitamins, is essential for the formation of red and white blood cells in bone marrow. Medical research has shown that folate has a protective effect against conditions Neural Tube Defects (NTDs) such as spina bifida which causes severe disability in babies. It is estimated that taking folic acid (a synthetic version of folate) when trying to conceive a baby and in the early stages of pregnancy could prevent 1,000 cases of spina bifida a year, many of which result in termination of pregnancy. So it is important for every woman who might be thinking of having a baby to make sure she is getting enough folic acid in her diet.
How much folic acid do I need?
Adults need 200mcg of folic acid a day. Folic acid is water soluble and therefore cannot be stored in the body so needs to be consumed every day. Eating a varied and balanced diet should, for most people, provide the required amount of folate.
It is recommended that pregnant women and those trying for a baby take 400mcg of folic acid every day from the time of stopping using contraception until the 12th week of pregnancy. This is to help prevent NTDs.
How do I get folate into my diet?
There are three possible ways of getting extra folate in the diet:
- more folate-rich foods such as green vegetables
- foods fortified with folic acid such as some breakfast cereals
- take folic acid as a medicinal supplement
Bread is a source of folate. Other sources include leafy green vegetables, dried beans, legumes, oranges and orange juice.
- Four medium slices (140g) of malted grain (also sold as Granary®) bread provides 123 mcg of folate
- 4 slices of wholemeal bread delivers 56 mcg and
- 4 slices of white bread provides 35mcg
What happens if I have too much folic acid?
Doses of folic acid above 1000mcg a day can mask the symptoms of vitamin B12 deficiency, which if it’s not spotted and treated can eventually damage the nervous system. This is of particular concern for older people for whom it is more difficult to absorb vitamin B12.
What does the Department of Health recommend?
- women planning to conceive should take 400 micrograms of folic acid daily as a medicinal food supplement from when they begin trying to become pregnant until the 12th week of pregnancy.
- women who think they might be pregnant but have not been taking extra folic acid should start doing so immediately and continue until the 12th week of pregnancy.
- women who have had a previous child with spina bifida should take daily folic acid supplements of 5 milligrams (5000 micrograms) until the 12th week of pregnancy. You should only take this much folic acid under a doctor’s supervision.
Mandatory fortification of flour with folic acid
In October 2018 the Government announced plans to consult on the mandatory fortification of white flour with folic acid to decrease the incidence of neural tube defects during pregnancy. Such a move could also be of benefit for heart health, as poor folate status is associated with high homocysteine levels, which are an emerging risk factor for cardiovascular disease. However there are some concerns that there could also be adverse effects particulcarly the masking of vitamin B12 deficiency and worries about reduced freedom of choice. Nevertheless, the government’s Scientific Advisory Committee on Nutrition has recommended statutory fortification, as has the board of the Food Standards Agency.
Milling industry view on mandatory fortification
The milling industry has always maintained that it is for the government to decide upon matters relating to public health. Should the government wish to introduce mandatory fortification of flour with folic acid, the milling industry will work closely with government to determine the best method of achieving this.