Folic acid to be added to flour – should iodine be next?

There are 8 types of B vitamin, and each has its own function. Together these are known as the vitamin B complex. Some of these have a direct effect on our hormones

• Thiamin (B1) has been referred to as the “spark plug” which allows fuel (food) plus oxygen to convert into energy. This is sometimes depleted in alcohol excess and after bariatric surgery

• Riboflavin (B2) also helps the body convert energy from oxygen and steroid metabolism

• Niacin (B3) plays a key role in regulating the synthesis of fat-based sex hormones androgens, oestrogen, progestin and of stress hormones and improves cholesterol levels

• Pantothenic acid (B5) and Pyridoxine (B6) aid the production and distribution of melatonin. This is the hormone responsible for regulating your circadian rhythm.

• Biotin (B7) is involved in the digestion of carbohydrates and synthesis of fats. The American Thyroid Association has recommended that patients stop taking Biotin supplements for at least two days before thyroid testing as it has been shown to give falsely elevated levels of T4 and T3 and falsely low levels of TSH leading to the wrong diagnosis of hyperthyroidism or the conclusion that medication to treat hypothyroidism is at too high a dose. See here

• B12 (Cobalamin) is involved in fatty acid and amino acid metabolism and is important in the normal functioning of the nervous system and bone marrow

• Folate (B9) is required for the body to make DNA. As the body cannot make folate it is required in the diet and is considered an essential vitamin

It is B9 that I would like to write about today with the news that the Government has announced that they are to fortify non wholemeal flours with Folic acid or Folate.

You may feel slightly uncomfortable about this happening, but rest assured we’re not the only country to be doing this. In fact, more than 80 countries already fortify their bread flours including Australia, the United States and Canada.

What is already in our bread?

Folic acid is not the only vitamin or mineral added to flour for our nutritional benefit. In fact, since 1936 wheat flour mills in the UK have added thiamine, iron, and niacin to put back what is lost in the milling process.

Calcium carbonate was additionally added in 1943 to put more calcium into the diet. This was as a result of detecting high levels of rickets in women joining the Land Army during the war years

Current Bread and Flour Regulations state that the following must be added to all wheat flour (except wholemeal) at the milling process

Why is our bread fortified?

This is for health reasons and contributes towards our recommended daily allowance of essential vitamins and minerals.

• Calcium is essential for healthy teeth and bones as well as helping nerves and muscles to function. The recommended daily allowance (RDA) is 800 mg with people over 55 requiring 1200mg

• Iron is important for healthy blood, an effective immune system and helps with both energy and concentration. 8.7mg is recommended for men aged 18 or over and 14.8mg is recommended for women aged 19 to 50 and then 8.7mg per day over 50

• Thiamin (Vitamin B1) helps the body’s cells convert carbohydrates into energy for the body. This is particularly important for the brain and nervous system. It also plays a part in muscle contraction and the conduction of nerve signals. The RDA is 1mg for men and 0.8mg for women

• Nicotonic acid (Vitamin B3) helps in several areas including the metabolism of fats: the regulation of blood sugar and DNA synthesis. The recommended daily allowance is 16.5mg per day for man and 13.23mg a day for women.

The importance of folic acid in the first trimester of pregnancy

The NHS recommends that those who are planning pregnancy or pregnant should take 400 mcg of folic acid before and during pregnancy

However, around half of all pregnancies are unplanned and the most crucial time for an increased intake of folic acid – or Folate – is during the first 12 weeks. This is because it is essential in the building of an embryo’s neural tube which, within 4 weeks, has developed into the brain and spinal cord.

The cells in this structure are dependent on sufficient folic acid to grow properly because it is necessary for the synthesis of DNA, transfer RNA and the amino acids cysteine and methionine.

Without these the spine, skull and brain can be affected by the tube’s inability to close and this results in spinal bifida and anencephaly which are neural tube disorders of NCD’s

Why is folic acid being added now?

This is by no means a snap decision. Discussions about ensuring that the population had sufficient levels of Folic acid began in 1979. This was when the Medical Research Council lead a multinational study to see if supplements of folic acid could reduce the incident of children born with neural tube defects (mostly spina bifida). A strong link was proven, and, in fact, Australia saw such defects fell by 14% after folic acid was added to bread flour.

However, nothing moved forward until October 2018 announced their intention to have a public consultation on the subject. This consultation ended on September 2019, and it has now been announced that the addition of folic acid to UK flour will become mandatory.

Could Iodine be added into our food next?

There are certainly some medical experts – myself included - who would like to see this happen. This is not a new initiative; in fact, the UK Iodine Group was set up in 2012 with the aim of ensuring that iodine deficiency is eradicated in the UK.

It might surprise you to know that we are only one of 32 countries in the world where iodine deficiency is a widespread problem

Iodine helps make thyroid hormones and also plays a crucial role in the brain and nervous system of the foetus in the womb. In this respect evidence shows that iodine deficiency in pregnant women can cause significant mental impairment and delayed development in their children.

The results of research that I undertook in 2011 really shocked me. Having tested the urine of over 600 14/15-year-old girls from nine towns I discovered that 70% of them had iodine levels defined as mild deficiency. You can read about this research here 

Unfortunately, it’s likely that the problem has recently worsened with an increase in the population becoming vegan and the growing adoption of milk alternative drinks which removes the two primary sources of iodine – fish and milk – from the diet of millions.

You can read about the nutritional challenges of a vegan diet here and about milk alternative drinks here 

I hope this has been helpful

Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.

As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link