The United Kingdom Government has made no formal assessment of the impact of mandating the fortification of flour and flour-based products with folic acid or of informing pregnant women of the benefits of ingesting folic acid by other means.

Women who are trying to conceive or who are likely to become pregnant are advised to take a daily supplement of 400 micrograms of folic acid until the 12th week of pregnancy to help prevent neural tube defects in their unborn babies. They are also advised to increase their daily intake of folate by eating more folate-rich foods, for example spinach and broccoli, and foods voluntarily fortified with folic acid such a wide range of breakfast cereals. Health education messages on folic acid as part of a range of pregnancy advice are provided in various settings targeted at women of childbearing age such as family planning clinics and general practitioner surgeries. Additionally, NHS Choices provides information online on healthy lifestyle advice during pregnancy including the importance of folic acid supplementation. The NHS Start4life Information Service for Parents provides parents-to-be and new parents with advice and information about pregnancy and the first few months with a baby, using free emails, videos and text messages.

Plans are currently being developed to consult on a change to the Bread and Flour Regulations. The change would permit the production of unfortified flour in the UK under certain limited circumstances where the flour is destined for use as an ingredient in further processing. This consultation will not focus on the fundamental issue of fortification. It will consider options to ensure that UK produced flour used by manufacturers is not put at a disadvantage compared to unfortified flour produced in other Member States.

Health Ministers have yet to make a decision on mandatory fortification of flour with folic acid. They are awaiting data on the blood folate status of the population, which is expected in early 2015.

If the Government decided to proceed with mandatory fortification of flour with folic acid then views, including of those who object to the policy, would be sought through public consultation. Consumer choice would be one of the issues considered in reaching a final decision.

The extent of mandatory fortification of flour with folic acid, including any exemption for wholemeal flour, will be considered along with the effects of folic acid fortification of flour on the general population in coming to a final decision on whether to proceed with this policy or not.

The Government has yet to make a decision on introducing mandatory fortification of flour with folic acid. If a decision is made to proceed with fortification of flour with folic acid, following a full public consultation, it would probably be enacted through amendment of the Bread and Flour Regulations 1998 and would be subject to parliamentary scrutiny procedures for secondary legislation.

The scope of fortification of bread and flour with folic acid is one of the issues being considered by the Government. The Scientific Advisory Committee on Nutrition (SACN) considered the impact of exempting wholemeal flour from mandatory fortification with folic acid and concluded that it would have little effect on neural tube defect affected pregnancy risk but would reduce the numbers of people with intakes of folic acid above the upper limit per day.

The United Kingdom currently requires fortification of bread with calcium, iron, niacin and thiamin. European Union legislation permits the voluntary fortification of all foods other than unprocessed foods and alcoholic beverages (except tonic wine) and specifies the minimum permitted levels of fortificants that must be present as well as labelling requirements.