Fortified foods are promoted as being good for us and helping to fill nutritional gaps that can lead to nutritional deficiencies and poor health.
However, the government’s recent decision to add folic acid to supermarket bread has become the center of a heated debate online.
From December this year, a new law will require food manufacturers to add synthetic nutrients to non-whole wheat flours, meaning some varieties of bread, cakes and other supermarket items will have extra fortifiers.
Once implemented, UK millers will be forced to add 0.25mg of folic acid per 100g of non-whole wheat flour.
But what exactly is folic acid? Why are people worried? Are the concerns circulating on social media true?
To better understand the conversation, we asked nutritionists to answer some of the most frequently asked questions.
Many of the breads you see in the supermarket soon contain folic acid.
(Drazan Zidgic via Getty Images)
What is folic acid?
Folic acid is the synthetic form of the vitamin folate, also known as B9.
Folic acid helps the body make healthy red blood cells and plays a role in how efficiently cells divide and grow. It’s found naturally in foods like leafy greens, chickpeas and cruciferous vegetables, and the NHS says most adults get all they need just by eating a healthy diet.
Having good folate levels becomes even more important in early pregnancy as it contributes to the normal development of the baby’s brain, skull and spinal cord.
During these weeks and months, it can be more challenging for women to get enough folate from their diet alone as their body’s needs increase significantly.
That’s why the NHS recommends that all pregnant women take 400 micrograms of folic acid every day from before pregnancy until their 12-week scan.
Why did the government introduce new regulations?
“The UK is adding folic acid to bread because folate intake among women of childbearing age is still too low and this has real, preventable consequences,” says Rob Hobson, nutritionist and author of Unprocess Your Life.
“About nine out of 10 neural tube defects, including spina bifida (a condition in which a baby’s spine and spinal cord do not fully develop in the womb), develop early in pregnancy – often before many women know they are pregnant.
“Although supplements have been recommended for many years, uptake in the UK is mixed, particularly among younger women and those from low-income backgrounds.”
In the UK, a study of nearly half a million women showed that only 31% took folic acid supplements before pregnancy.
“That’s why the fortifications are there,” Hobson said. “This follows years of review of the evidence, careful modeling of risks and benefits, and advice from independent scientific bodies.
“Countries that have fortified flour continue to see reductions in neural tube defects, but there is no clear evidence of harm to the wider population.”
A recent review looking at data from multiple countries found a clear link between the introduction of folic acid fortification and reductions in neural tube defects, with rates in Chile, South America, falling by 55% over a decade.
While the new rules are set to take effect later this year, some manufacturers have already begun voluntarily strengthening them.
(Lucy Lambrix via Getty Images)
Why is this decision controversial?
Much of the controversy online centers on a gene called “MTHFR,” which plays an important role in how your body metabolizes folate.
Some people worry that if you have a mutation in this specific gene, you may be less efficient at naturally processing synthetic folate, resulting in higher levels of the unmetabolized nutrient in your blood.
Online, panic has spread around folic acid “buildup,” with claims it may cause everything from immune problems to increased cancer risk to increased depression and fatigue.
However, Hobson believes these concerns are largely sensational and not based on strong scientific evidence.
“It is true that variations in the MTHFR gene are common and can slightly affect how folate is processed in the body,” he clarified. “However, the idea that people with these variants cannot safely consume folic acid, or that folic acid fortification is harmful in the population, is not supported by high-quality evidence.
“This argument often comes from unregulated online sources and often ignores the scale of the public health benefits.”
Concerns about folic acid fortification have been circulating on social media platforms.
(Maria Siltukova via Getty Images)
Does too much folate increase your risk of cancer?
Concerns about folic acid and cancer appear to stem from early research on high-dose supplements.
Some early research suggests that very high folate intake may be associated with an increased incidence of certain cancers. However, a 2013 meta-analysis of randomized trials examined these issues and found that folic acid supplementation did not significantly increase overall or site-specific cancer risk over a five-year follow-up period.
Hobson says when it comes to your weekly bread, it’s wise to increase fortification on a case-by-case basis.
“The amount of folate added to flour is small and strictly regulated,” he cautions. “Even with fortified bread, most people still consume far less than the upper limit of safe intake. This is very different from taking high-dose supplements.”
He added: “Claims on social media that fortified bread can ‘slow down body function’ or ‘promote cancer’ are not supported by strong human evidence from fortified bread.
“While it is theoretically possible that very high supplement doses could overwhelm certain pathways, there is insufficient evidence to suggest that the small amounts of supplements used in flour fortification would impair metabolism or cause harm in the general population.”
Of course, if you’re really anxious about the new laws and are meeting your daily folate needs through diet alone, you can always choose wholegrain varieties that aren’t affected by the rule, or try making your own wholegrain sourdough at home. Both are healthy and nutritious ways to increase your fiber intake.
However, if you’re all about eating white bread sani, Hobson sees no reason to panic. “The bottom line is that fortification is not about optimizing nutrition in people who are already eating well and taking supplements,” he points out.
“This is about reducing avoidable birth defects in the population. From a public health perspective, the benefits are clear, the risks have been carefully assessed, and the policy is based on decades of evidence.”
