The UK Government consulted on amending flour and bread regulations and introducing mandatory fortification of non-wholemeal wheat flour with folic acid. The RCPE is strongly in favour of mandatory fortification from a public health perspective. The academic evidence in favour is substantial and robust. The new fortification has the potential to raise levels of folic acid amongst women whose pregnancies are unplanned sufficiently to have a substantial impact on neural tube defects (NTD). The clinical consequences of NTD can be extremely serious and may lead to decisions to terminate pregnancy, requirement for neonatal surgery, physical disability, bowel and bladder dysfunction, recurrent catheter related UTIs, renal damage and the need for life long high tariff healthcare.
