The UK government has announced new regulations mandating the addition of folic acid to non-wholemeal wheat flour, a measure expected to prevent approximately 200 cases of serious birth defects annually. Beginning in 2026, millers and flour producers will be required to incorporate this essential nutrient, which helps prevent neural tube defects (NTDs) such as spina bifida. This legislative move represents a significant step in addressing public health challenges associated with folic acid deficiency, particularly for expectant mothers.

Why is folic acid an essential nutrient?

NTDs are a leading cause of debilitating conditions in babies, with spina bifida being among the most severe. Folic acid, a type of B vitamin, is crucial for early fetal development, especially in preventing defects in the brain and spine. However, folic acid deficiency remains a concern in the UK, wher it contributes to a significant number of NTD cases each year.

Fortifying flour with folic acid, already a practice in countries like Australia and Canada, is expected to reduce these conditions by 20 percent across the UK.

The legislative change will see folic acid join a list of other mandatory nutrients in UK flour, including calcium, niacin, thiamine, and iron. This will not only help reduce birth defects but will also bring an estimated £20 million in healthcare savings and add £90 million to the economy over the next decade.

“Shifting care from sickness to prevention is one of the leading ambitions in our 10-Year Health Plan, as we work to make our NHS fit for the future,” commented Andrew Gwynne, Minister for Public Health and Prevention. “These measures are a simple and effective intervention to improve health outcomes in babies, giving them the best start in life.”

A review of the Bread and Flour Regulations 1998

The new regulations are part of a comprehensive review of the Bread and Flour Regulations 1998, undertaken by the Department for Environment, Food and Rural Affairs (Defra) in cooperation with devolved administrations and the Department of Health and Social Care.

These updated rules also include technical adjustments to ensure compliance, clearer requirements for nutrient levels, and exemptions for smaller millers producing less than 500 metric tonnes of flour annually. To further streamline compliance, the government is introducing improvement notices to address non-compliance, reducing the need for costly criminal proceedings.

Professor Chris Whitty, England’s Chief Medical Officer, reinforced the need for this measure while underscoring the continued importance of folic acid supplements for women planning pregnancies. “The fortification of flour is a simple and effective way to help to reduce cases of neural tube defects, although it is important that women who are pregnant or intending to become pregnant continue to take folic acid supplements before and during the first 12 weeks of pregnancy,” he said.

Currently, the NHS advises that women trying to conceive take folic acid supplements three months prior to conception and during the first trimester, a recommendation that will remain in place alongside the new flour regulations.

Making a difference

The initiative has garnered strong support from health advocacy groups. Kate Steele, CEO of Shine, a charity supporting people affected by spina bifida, celebrated the news. “After more than 30 years of campaigning, Shine can finally celebrate the introduction of this very important public health initiative,” Steele said.

“Mandatory fortification will reduce the number of babies affected by spina bifida…It will make such a difference to so many lives!”

The food industry is now preparing for the 24-month transition period, which will allow manufacturers to adjust their processes and comply with the new regulations.