Public Release: 

Governments committing 'public health malpractice' over flour fortification

Editorial: Delaying folic acid fortification of flour, BMJ Volume 324, pp 1348-9


The failure of European governments, including the United Kingdom, to fortify flour with folic acid has allowed a continuing epidemic of preventable human illness, according to an editorial in this week's BMJ.

Fortification could save as many lives as are lost each year in vehicle crashes, writes Professor Godfrey Oakley of Emory University in the United States. Yet in Europe, fortification has been delayed because of erroneous speculation of possible harm for elderly people.

Recent evidence indicates that fortification improves the lives of adults, including elderly people, and that it is safe. In 1998 - the year in which fortification was made mandatory in the United States - deaths from stroke and heart attack declined by 3.4%.

Although fortification of flour is long overdue in the United Kingdom and the remainder of Europe, the UK board of the Food Standards Agency recently decided against mandatory folic acid fortification.

Ministers should not accept this recommendation, argues the author. Rather, they should follow the advice of the Department of Health committee on medical aspects of food and nutrition policy and require universal fortification of flour with folic acid. This prudent action would improve the health of children and adults.

Rare is the opportunity to implement a sustainable, inexpensive, and effective intervention to prevent major human diseases, says the author. Folic acid fortification of flour is one of those rare opportunities. Governments that do not ensure that flour is fortified with folic acid are committing public health malpractice, he concludes.


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