Folic acid added to flour. What’s changing and how could it affect you?

Is white bread and pastry your guilty pleasure? You may have read that from the 13th December 2026, the UK government has made it law that white flour must be fortified with a vitamin called folic acid. There has been a mixed reception to this new policy, and many people have been up in arms about adding a synthetic vitamin to our everyday flour. This blog shares why the government have implemented this law, whether you should be worried or not and what this change actually means for you.

The UK is following around 80 other countries who have already adopted this initiative. The main reason for fortifying flour with folic acid is to prevent neural tube defects in babies such as spina bifida (a spinal cord defect) and anencephaly (a brain defect). This new regulation is estimated should prevent 200 neural tube defects each year in the UK.

It isn’t just the bread and croissants in the supermarkets and bakeries that will be affected by this fortification. If you grab a pastry or wrap at the train station, or your children are offered biscuits at school, these will all be made from fortified flour too.

What is folate and folic acid?

Folate is the vitamin that helps your body make healthy red blood cells which carry oxygen around your body and brain, and it makes your genetic DNA and supports cell division. Without enough folate, your cells can’t copy their DNA properly and so they can’t divide properly. Every time your body repairs itself or grows folate is a key part of the team of nutrients doing this work.

Folate (vitamin B9) is naturally found in a wide range of foods, including:

Dark leafy greens: kale, watercress, spinach, baby chard and romaine lettuce
Other vegetables: asparagus, broccoli, beetroot and peas
Beans and pulses: edamame beans, lentils, chickpeas as well as other beans and legumes
Fruit: avocado, bananas, pomegranate, oranges, papaya and cantaloupe melon
Animal sources: liver and eggs

Whole grains, such as those used to make wholemeal flour, naturally contain folate. However, when the outer layer of the grain is removed during the refining process to make white flour, much of this folate is lost. To help raise folate levels across the population, the government is introducing mandatory fortification of white flour with a synthetic form of folic acid. This fortified flour will then be used in many of our everyday baked goods.

It’s not just about the risk of birth defects. If you are folate deficient, you may experience symptoms such as ongoing tiredness, shortness of breath, headaches, dizziness, brain fog and sores in your mouth. You might feel irritable, experience a low mood and have poor stress tolerance. You could have brittle nails, thinning hair and premature greying hair.

Low folate levels, which affect your ability to methylate and can raise homocysteine levels, can in turn pose a higher risk for cognitive decline and dementia, depression, autism, bowel cancer and cardiovascular illness such as strokes. Low levels of folate may also lead to multiple miscarriage, pre-eclampsia, preterm birth and low birth weight during pregnancy.

Ask your GP for a simple blood test to check your folate levels if this sounds like you and work with a practitioner trained in nutrigenomics if you need guidance over long-term folate support.

Why are they fortifying flour and bread with folic acid?

The idea of fortifying flour isn’t a new concept to the UK. Flour in the UK is already required by law to be fortified with calcium, iron, vitamin B1 and vitamin B3. Iron, thiamine and niacin became mandatory fortifications in 1953 to replace the nutrients lost from milling to make white flour.

Since bread, buns, panini, wraps and pastries are daily staples, then fortifying the flour in these makes them an easy vehicle to ensure we are getting enough of these key nutrients.

As mentioned, eating enough dietary folate is especially important for women of childbearing age, to prevent neural tube defects in their babies. In the UK, as many as 83% of women of childbearing age have very low blood folate levels, posing a higher risk for these neural tube defects.

The folate requirements during pregnancy can be difficult for you to reach through diet alone, especially if you are suffering from pregnancy-related sickness, which is why folate supplementation is advised in the months leading up to pregnancy and during pregnancy.

Since many pregnancies are unplanned, a lot of women are not aware that they are pregnant for a while. They are therefore not intentionally supplementing or increasing their intake of folate-rich foods. As the first few weeks of foetal development are just so crucial to help prevent birth defects, fortifying white flour with folic acid may help overall to raise folate levels in women, helping support their baby’s development even before they know they are pregnant. It is important to note that this does not replace the advice for women to supplement with folate before pregnancy and during the first 12 weeks.

A national survey found that it isn’t only pregnant women who need to think about their folate intake. Around 17% of teenage girls and 7% of teenage boys showed deficient levels of folate in their blood test, so focusing on increasing natural sources of folate, such as greens, beans and eggs, can help to support them too.

What are the concerns around adding folic acid to flour?

There are a few concerns associated with consistent high intakes of synthetic man-made folic acid.

As vitamin B12 and folate work together in the body, there is a risk that high folic acid consumption could mask a B12 deficiency, in particular in those with pernicious anaemia (an autoimmune condition that attacks the parietal cells in your stomach to prevent you from absorbing B12 from food). If a vitamin B12 deficiency is masked for too long, it could result in neurological damage. Check with your GP if you suspect that your B12 levels may be low, especially if you are a vegan, as most vitamin B12 is found in animal produce. Usually, a blood test will check folate and B12 at the same time and always ask for them both to be done together.

Another key concern around synthetic folic acid is surrounding a system in the body called methylation which makes an internal antioxidant called glutathione. Glutathione protects us from cancers, autoimmune conditions, cardiovascular problems and neurological illness. Folate is the key vitamin that kick starts this methylation process and the type of folate able to do that job well really counts.

Some people genetically struggle to convert the synthetic folic acid found in fortified foods and mainstream vitamin preparations into the natural, bioavailable methylated form that aids this methylation process.

Variations in genes called SNPs such as MTHFR and DHFR are very common. The DHFR converts the synthetic folic acid and MTHFR works on all forms of folate. Around 40-50% of people carry at least one common variant of the MTHFR gene called C677T, and around 1 in 10 people carry two copies of this genetic SNP.

Whether MTHFR C677T is turned on or off is pivotal to how the folate you consume is synthesised and what type of folate your body needs. If you do hold this genetic variant, then synthetic folic acid from fortified white flour is not easily utilised. It then builds up in the bloodstream and does not get to work its methylation magic.

This genetic variation is different from person to person. You can read more about MTHFR genetic SNPs in this blog I wrote, and if you have any concerns or would like to run some in-depth tests to understand your specific nutrient needs and navigate this better, please get in touch with our clinical team at NatureDoc.

For our clients with this genetic profile, we often recommend that they avoid synthetic folic acid in fortified foods and choose folate supplements in the bioavailable forms such as methyl tetrahydrofolate, calcium folinate and folinic acid, as well as ensuring they are eating plenty of folate rich foods.

One puzzling pattern that we sometimes see in our NatureDoc clinics is that some people have high levels of folate in their blood, despite not taking supplements or eating a particularly folate-rich diet. Yet they still experience symptoms associated with low folate. Sometimes this is an indication that there is a methylation issue, and it would be prudent to explore whether you carry a variant of the DHFR or MTHFR genes that could be playing a role, and whether additional support might be needed.

We can also check a urinary folate marker called Formiminoglutamic acid (FIGLU) which can identify if the folate and its buddy vitamin B12 are being adequately utilised by the body, and that these are not just getting stuck in the blood.

Certain medications like the oral contraceptive pill, some seizure medications and methotrexate can deplete your folate levels. Folic acid can also interact with certain medications, so if you are taking one of these, it’s important to check with your GP or pharmacist before taking a supplement to make sure it’s suitable for you and if you need to avoid foods fortified with folic acid.

What can you do if you are concerned?

Even with a genetic blueprint which does not favour consuming synthetic folic acid, it is probably okay for you to still enjoy the occasional croissant from time to time and your primary concern will be the type of flour that you use to bake with all the time or that is sitting in your daily loaf. If you know that you have variations in the DHFR/MTHFR genetic SNPs or would prefer to avoid the folic acid being added, then here are some simple swaps that you can use instead so you can enjoy the flour-based products you love without the worry.

Organic flour is not exempt and so the flour from the larger organic flour mills now contains folic acid. Small mills that have produced less than 500 tonnes of flour in each of the last three years are exempt from having to add folic acid to their white flour, so do get in contact with a local mill near you to see if you can buy white non-fortified flour or bread from them. I anticipate a revival of several small flour mills over the coming years, a bit like the upsurge of microbreweries! Check out Ratton Pantry for a list of non-fortified white flours from small mills you can bake with.

Flours exempt from folic acid fortification include wholemeal flours, spelt, kamut, emmer or einkorn flour, which contain enough natural folate already, or you can try non-wheat alternatives such as:

• Oat
• Rye
• Barley
• Buckwheat
• Teff
• Sorghum
• Maize

There are also delicious bread recipes that don’t use grains at all, such as my incredible Vanilla and Honey Tahini Bread or Poppy’s Seeded Loaf. They are easy to make and a fun activity to get the kids involved with too.

If you don’t have the time to bake at home, brands that offer some great wholemeal loaves, and bread made from other grains like spelt and rye include:

• Jason’s sourdough
• Celtic Bakers
• Crosta & Mollica wholemeal wraps and durum wheat semolina bread
• Biona rye bread
• Waitrose No. 1 spelt sourdough bread

Always check the label for folic acid in the ingredients and check out my recipe finder for great recipes free-from white flour, as I usually use spelt or alternative flours in my recipes.

Round up

There are pros and cons to any public health initiative, and mandatory fortification can be a very tricky decision for governments to make, and partly why our government has stalled for years. Educating yourself on what’s changing can help you to make your own decision as to what feels right for you and your family.

The small mills, or white flour alternatives, provide a way for individuals like you to avoid folic acid if you choose. This isn’t about turning down every biscuit offered at a friend’s house, and it is more useful to look at your diet as a whole and see where you could add in more sources of natural folate like beans, greens and eggs instead.

The NHS guidance for women who are planning a pregnancy, or are already pregnant, remains the same. You are advised to take 400mcg of folic acid every day until 12 weeks pregnant, and you can speak to your GP or midwife if you need any advice on this. If you would like to discuss the most optimal form of folate for you, then our NatureDoc clinical team can provide testing and guidance to give you peace of mind.

If you sense that synthetic folate is not your friend and you want to explore your genetic blueprint and gain insight into how to live your best and healthiest life, book in with our NatureDoc clinical team, who can work with you to establish what your own individual nutrition road map looks like.

This is an updated version of my original blog on folic acid, first published on the 10th of March 2021.

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References

Responses

jude Tue, 5th Oct 2021

thank you for sharing this i did not know but i will now be contacting my local mp to register my opposition to this , this would not only affect women of childbearing age many of whom have had their children or not planning on having children but also the whole population, my menopausal supplements are not added to basic foods as they would not be appropriate, supplements should be appropriate to the individual age gender genetic dispositions etc and not disproportionately given to the masses