News & Press Releases

Wednesday 23 November 2005

The Scientific Advisory Committee on Nutrition (SACN) today issued a draft report on folate and disease prevention. In the report the committee reviews and assesses the evidence on the health benefits and risks of dietary folate.

SACN is now, for eight weeks, inviting comments from interested parties on the scientific evidence basis for its assessment. The responses will be considered in full by the SACN Committee before they agree the final report, expected to be published in Spring 2006.

After SACN has submitted its final report to Government, the Food Standards Agency Board will consult on SACN's recommendations before considering whether flour should be fortified with folic acid (a synthetic form of folate) in the UK.

This is the second time that the evidence on folate and disease prevention has been reviewed. The first review was the Committee on Medical Aspects of Nutrition Policy (COMA) report on Folic Acid and the Prevention of Disease1, which was published in 2000. After the publication of the COMA report, the Food Standards Agency advised Health Ministers that at that stage they could not recommend the introduction of mandatory fortification of flour because of concerns about potential health risks to the elderly. ENDS

A full copy of the SACN draft report 'Folate and Disease Prevention' can be found at www.sacn.gov.uk and via the Food Standards Agency website www.food.gov.uk (reports section)

1Department of Health. Folic Acid and the Prevention of Disease. Report on health and social subjects 50. London: The Stationary Office, 2000.

Notes to editors

  1. Folic acid is a synthetic form of the B vitamin folate, which is found naturally in foods. Folic acid is used as in food fortification and supplements.
  2. Folate helps reduce the risk of neural tube defects (NTDs), such as Spina Bifida, in unborn babies. Fortification of flour with folic acid could significantly reduce the number of pregnancies affected by NTDs in the UK.
  3. It has, however, been suggested that mandatory fortification of flour with folic acid could lead to high folic acid intakes that might mask early symptoms and could delay the diagnosis of vitamin B12 deficiency and therefore delay treatment, which could potentially lead to irreversible neurological damage. In the UK vitamin B12 deficiency is relatively common in people aged 65 years and over and is usually caused by a failure by the gut to absorb vitamin B12.
  4. At its horizon-scanning meeting in September 2003, SACN requested an update on the evidence that had arisen since the COMA report, Folic Acid and the Prevention of Disease1. Health Ministers also requested this in 2004 particularly in relation to the elderly.
  5. A Subgroup was established in February 2004 to consider the evidence and make recommendations to the Committee. The Subgroup was requested to:
    • Consider the evidence that had arisen since the COMA report
    • Advise on any gaps in the evidence base, with particular reference to the issue of folic acid masking the diagnosis of vitamin B12 deficiency
    • Consider when and how to review the previous COMA risk assessment
  6. The Committee have considered evidence under the following headings:
    • Intake and status of folate and other B vitamins in the UK population and its subgroups
    • Uptake of folic acid (a synthetic form of the vitamin folate) supplements by women planning a pregnancy and pregnant women in the UK
    • Fortification policies in other countries and emerging evidence relating to neural tube defects
    • Risks associated with increasing folate intake (particularly the diagnosis of vitamin B12 deficiency)
    • The relationship between folate and other diseases (e.g. cardiovascular disease, neurodegenerative diseases and cancers)
  7. The draft report is open for stakeholder comment until 18 January 2006.
  8. In its report on Folic Acid and the Prevention of Disease1, COMA concluded that the universal folic acid fortification of flour would significantly reduce the number of conceptions and births complicated by neural tube defects. Following a formal public consultation in 2000, the Food Standards Agency and the Health Departments convened a stakeholder meeting in March 2002 to discuss issues relating to folic acid fortification.
  9. The Agency's Board considered the fortification of flour with folic acid at its May 2002 open meeting. In July 2002 the Agency provided its advice to the Health Ministers, who were responsible for making a decision on folic acid fortification. At that stage the Agency Board advised Government that they could not recommend mandatory fortification due to concerns over vitamin B12 deficiency and concluded that further evidence was needed on the wider impact of folic acid fortification, in particular the benefits and risks to older adults.
  10. The Health Ministers replied in June 2004 and agreed with the Agency's advice not to introduce mandatory fortification at present, due to outstanding concerns about vitamin B12 deficiency.
  11. SACN are a committee of independent experts who advise Government on matters relating to diet, nutrition and health. In 2001, SACN succeeded COMA. Details of the committee, including working procedures and membership, are found at www.sacn.gov.uk
  12. SACN is chaired by Professor Alan Jackson from Southampton University. A subgroup of SACN, Chaired by Professor Sheila Bingham, from the Medical Research Council Dunn Human Nutrition Unit, has worked on the draft report Folate and Health.

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