To think it's a disgrace that the UK still doesn't add folic acid to flour?

[LisaSimpsonsbff]

I'm a long-term obsessive user of the conception forums and I was a bit shocked this morning to see two separate posts in which it was clear that posters thought the advice to take folic acid before pregnancy was to help you conceive (and therefore not important if you weren't having problems there) rather than its actual purpose: to lower the risk of birth defects. That made me a bit curious about how many women take it, and I was shocked to find how few it is (fewer than a third): www.theguardian.com/uk-news/2014/feb/19/folic-acid-less-third-pre-pregnancy-guidelines-spina-bifida. The worst part, I think, is this:
The study also showed strong ethnic variations, with only 17% of Afro-Caribbean women, 20% of south Asian women and 25% of east Asian women taking folic acid, compared with 35% of white Caucasian women.

Just 6% of teenagers under 20 attending the antenatal clinics had taken the supplements, while 40% of older women aged 35 to 39 followed the guidelines.

Presumably a large part of that with the teenagers is the likelihood that their pregnancies were unplanned, but the health inequality here is really awful - it shouldn't be the case that some women and babies are so much more at risk of suffering these problems than others, whether through a lack of knowledge or through being less likely to plan their pregnancies.

I think we could do with a stepped-up public campaign on folic acid, but that obviously doesn't help women with unplanned pregnancies, and realistically no campaign is ever going to get across to everyone.

To me the argument for putting folic acid in flour, as they do in the US, is incredibly clear-cut. And yet the government decided against this: www.ifglobal.org/en/37-temp-news/4768-uk-government-says-no-to-mandatory-fortification-of-flour-with-folic-acid-2. So - and this is a genuine question - am I missing something? What's the argument against?

There are studies that say one thing and other studies that say another. But several studies saying it MAY be a problem is sufficient, in my opinion, to say that while the jury is still deliberating, it should NOT be added and it ain't disgraceful not to do it.

No idea crunchy. I think perhaps neurologists feel very strongly as they then treat the neural tube defects but most women don't go and see neurologists.

I may get this slightly wrong, but a few years ago, I remember reading something about artificial folic acid blocking the absorption of naturally occurring folates (they are different) in some people and causing developmental problems in some foetuses. I didn't follow it, so don't know if it still is thought, to be the case.

Nothing is ever clear cut. Not everybody reacts the same and a blanket approach is not always the solution

Crunchy I didn't know about the prematurity thing but when we started seeing our clinic at the very first appointment they asked if I was already taking folic acid (of course I was as we'd been TTC for two years by that point).

I think many cereals in this country are fortified with folic acid... not everyone eats bread regularly... Should it go in everything OP? Why not milk or coke?

So why isn't this advice widely publicised? Why have I never heard this? Despite being under a fertility clinic?

What do you mean? Taking folic acid pre-conception is standard NHS advice, but I agree that the message clearly hasn't got out as widely as it should have. According to the article I posted in my OP, the percentage of women taking folic acid preconception has actually been dropping, which is particularly concerning.

It would only work if 100% of women were eating enough flour/flour products to get a dose of folic acid.

The numbers are highest for white women, women who are in other groups may well either not be consuming flour or consuming different flours eg that from chickpeas or atta.

Added to that some people are recommended not to take folic acid or have an allergy to commercially produced folic acid, so you would be exposing virtually 100%of the population to something they may be allergic to.

I agree with Shatners and was just about to post the same link, but you beat me to it!

When I was pregnant, I chose to eat food that naturally contained folic acid, and took appropriate supplements. I would not have been happy then for other people to have to be forced to eat something that they had not chosen, and I would not now be happy with having that idea foisted upon me. I have read elsewhere that folic acid can 'feed' some existing cancers. And just because you have read, OP, that the US Health Dept say this is nonsense, does not exactly fill me with confidence, given the US's history on additives and injection of animals with antibiotics, etc, etc.

I like to put into my body what I choose, not what a Nanny-state (or another pregnant woman) tells me to.

The numbers are highest for white women, women who are in other groups may well either not be consuming flour or consuming different flours eg that from chickpeas or atta.

That's fair, but if you look at the figures in my OP the current policy is really disproportionately benefiting white women/ failing to benefit non-white women, so I think this would still go some way to address that inequality.

Unless they make all their own bread or don't eat oranges, many breakfast cereals, marmite, eggs, milk, peas, cauliflower and lettuce they will be getting folic acid n their diet. Combine that with the proportion of females between 16 and 45 ish who are falling pregnant by accident (I assume that those actively trying for a child I would be taking supplements) and make their own cakes and it becomes a small proportion of people who would benefit.

I like to put into my body what I choose, not what a Nanny-state (or another pregnant woman) tells me to.

So you don't eat flour at all anyway, then? Since by law all white is already fortified with a number of vitamins.

Vitamins that are not possibly cancer-feeding?

I assume that those actively trying for a child I would be taking supplements

Given that fewer than a third of women are taking folic acid before falling pregnant it would seem that you are assuming incorrectly.

I think more research is needed on the subject as there was a study last year that seemed to show a correlation between excess folic acid and increased risk of autism. Although I think that was only one study and I'm not sure of further developments. I think it's something that could need further investigation before adding it to food.

Has there been an increase in neural tube defects recently?

Meltor There was indeed a study suggesting that might be the case. Admittedly, it's a lot of MIGHTs and MAYs but still....

Have just taken a bag of Stoneground, Wholemeal Plain Flour from my cupboard.
List of Ingredients: Organic plain wholemeal wheat flour.
No additives, that I can see (and I've got my reading glasses on)

Just going to fish out the Spelt flour bag, see what that says.

Yes, it's just white flour that is fortified (as I said in my post)

Scottish spina bifida association has been campaigning for years to have flour fortified I am sure scottish government have been looking at it, however everywoman of child bearing age should take folic acid imo. I have a neurotube defect my dds take it

Er, no. What a weird idea. People who buy flour are people who cook from scratch...who are therefore far more likely to have their nutritional needs already met, given that folic acid is present elsewhere.

Stick it in ready meals, you'd get further.

And I am genuinely amazed people don't know about folic acid. I've never met anyone anywhere who wanted a kid/was pregnant and didn't know this. And my background is pretty rough.

Scottish spina bifida association has been campaigning for years to have flour fortified

It is also the official positions of the Royal College of Obstetricians and Gynaecologists and, most compellingly, the British Medical Association.

Ingredients of Spelt Flour bag: Spelt flour.

So, OP - in answer to your question, I do eat flour. Unadulterated, natural, additive-free flour.

Additives should not be automatically added to ingredients that someone may not necessarily know they are ingesting.

Actually, apologies evans, I was unclear on that. I said:

So you don't eat flour at all anyway, then? Since by law all white is already fortified with a number of vitamins.

but meant

So you don't eat white flour at all anyway, then? Since by law all white is already fortified with a number of vitamins.

First if all, the fortification of UK flour replaces what is lost from the wheat during the milling process. It isn't adding a new chemical that wasn't there originally. It is a completely unrelated issue to folic acid.

I don't want folic acid in my flour. It has the potential to have serious effects on people with existing medical conditions - those people aren't less important than the potential people yet to be conceived.

Those TTC can take supplements. Why should people with medical issues have to avoid all processed wheat? It's not hard to take a pill once a day. If the issue is people don't know they should be taking it then that needs communicating better. Although how anyone doesn't know that i don't quite understand - surely it's pretty basic knowledge?

I also don't want flouride added to my water, thanks.

I'd hate this to happen

I don't want to be forcibly medicated. I avoid heavily processed food and I like my flour to be unadulterated.

Those TTC can take supplements

And those who aren't TTC when they get pregnant?