In September 2021, plans were announced to mandate the addition of folic acid to non-wholemeal wheat flour to reduce neural tube defects (NTDs) such as spina bifida and anencephaly in babies. As of November 2024, this initiative remains unimplemented, but new legislation will require millers and flour producers to fortify non-wholemeal flour with folic acid by the end of 2026. This move is expected to prevent 200 NTD cases annually.
While public health advocates celebrate this long-overdue step, the bakery industry faces questions about readiness. Smaller producers and artisan bakers may struggle with compliance costs and critics argue the exclusion of wholemeal and gluten-free products could deepen health inequities. The industry must now prepare for operational, regulatory and consumer challenges as it works toward implementation.
What does the additional fortification mean for bakers?
The decision to fortify non-wholemeal wheat flour with folic acid comes after decades of advocacy from scientists and public health experts. Research has consistently highlighted that folic acid deficiency is a leading cause of neural tube defects (NTDs) such as spina bifida and anencephaly, which can result in severe disabilities or even death.
While the NHS advises women to take folic acid supplements before and during pregnancy, nearly half of pregnancies in the UK are unplanned, leaving many women without sufficient folic acid during the crucial early weeks of foetal development. Fortification aims to bridge this gap and provide a safety net for all.
Currently, non-wholemeal flour in the UK is fortified with calcium, niacin, thiamine and iron. Adding folic acid expands these measures, targeting nutritional deficiencies among women of childbearing age. The Department of Health estimates this measure could reduce NTD cases by 20%, saving the NHS £20 million over the next decade and boosting the economy by over £90 million.
While described by England’s chief medical officer, Prof Chris Whitty, as “a simple and effective way” to improve health outcomes for babies, fortification brings complexities for the bakery sector.
Millers and flour producers will bear the immediate responsibility of implementing fortification, but the ripple effects will be felt throughout the supply chain. Artisan and smaller bakeries may face greater challenges, particularly around labelling, marketing and maintaining consumer trust.
Furthermore, some artisan bakeries that pride themselves on using minimally processed ingredients may face resistance from customers who view fortification as unnecessary or artificial. Communicating the public health rationale and benefits of folic acid fortification will be essential to winning consumer trust.
Calls for more comprehensive measures
Public health experts have lauded the Government’s decision but have also criticised its limited scope. Prof Sir Nicholas Wald of University College London – whose 1991 research first identified the link between folic acid deficiency and NTDs – welcomes the move but argues it doesn’t go far enough. He estimates that fortifying all flour and rice-based products could prevent 800 NTD cases annually instead of the projected 200.
Dr Jonathan Sher, former deputy director of Queen’s Nursing Institute Scotland, said the plans were “timid, unscientific and predictably insufficient”, warning they fail to address the full scope of preventable NTD cases. Similarly, Prof Neena Modi from the Imperial College London noted the measures could exacerbate existing health inequities, particularly among vulnerable populations.
The legislation only applies to non-wholemeal wheat flour, leaving wholemeal, gluten-free and rice-based products excluded. This has drawn criticism for potentially deepening health inequities, as consumers of these products – many of whom are from ethnic minority groups or have dietary restrictions – will not benefit from the fortification.
A collaborative approach
These criticisms highlight the need for a more inclusive approach that considers diverse dietary habits across the UK population.
However, Andrew Pyne, chief executive of the UK’s Federation of Bakers (FoB), told Bakery&Snacks, the association has been involved in the discussions on folic acid fortification with the government for many years.
In fact, he said there has been a collective of players from the flour and bread supply chain – including the FoB, the UK Flour Millers, the Food and Drink Federation (FDF) and the British Retail Consortium – working to develop an implementation strategy.
“We have supported Defra with the industry knowledge in order for them to develop clear and practical technical guidance,” Pyne told us.
“It’s important to remember that flour is already fortified with calcium, niacin, thiamine and iron as a means of improving public health. The addition of folate (folic acid) is another step in improving public health through flour (Bread and Flour Regulations) that date back to the 1940’s.”
He explained, “Whilst the principle of adding folic to non-wholemeal flour is relatively straight forward, understanding the consequences and impacts, plus the level of planning required, are detailed and nuanced. It’s estimated that flour is used in over 30% of UK foods, so it’s not just the obvious bakery and biscuits that are impacted by the changes.”
He emphasised that using folic acid fortified flour shouldn’t present any technical challenges for bakers, at least not for FoB members.
However, he admitted “the greatest challenge will be in timing. Alignment of a long complex supply chain that uses flour, requires co-ordination, collaboration and planning. It requires food manufacturers to be aligned with their suppliers, which includes a monumental task for the packaging industry to update all labelling of flour and food law labelling regulations.
“A key factor in the success of the whole implementation process will be clear and transparent communication with all stakeholders using non fortified wholemeal flour (which can be a complex and often long supply chain),” said Pyne.
“The government will be well advised to have a communication campaign that ensures that small and artisan bakers are aware of the pending changes, along with the milling industry informing their customers.
“Folic acid fortification is a public health policy, though to most of the UK population they will be neither aware nor concerned by these important but relatively minor changes.”
Grabbing the opportunity
The introduction of mandatory folic acid fortification brings challenges but also significant opportunities for the UK bakery sector.
Early adopters of the change can position themselves as leaders in health-conscious baking, appealing to a growing segment of consumers focused on nutrition. By innovating with fortified gluten-free, wholemeal and alternative flour products, producers have the chance to capture new market segments. Additionally, educating customers about the public health benefits of folic acid fortification could help build trust, enhance brand loyalty and align bakery brands with the broader agenda of improving societal health.
The readiness of the bakery industry hinges on effective collaboration between the government, millers and bakers. Clear guidelines, targeted financial support for smaller or artisan businesses and robust public education campaigns will be crucial for a smooth transition. The success of this initiative will not only be measured by the prevention of neural tube defects but also by the industry’s capacity to adapt and thrive under the new requirements.
While the policy marks progress, it also highlights larger questions about inclusivity and the role of public health interventions. The exclusion of wholemeal and gluten-free flours from the mandate could limit its overall impact, suggesting that additional measures may be needed.
Nevertheless, this legislation underscores the bakery sector’s pivotal role in tackling public health challenges. By embracing innovation and addressing gaps in nutritional access, the industry can play a key role in giving future generations the healthiest possible start in life.
