Why we need folic acid in our flour

If we are serious about our children deserving better, it also makes sense to give our baked goods a little extra goodness.

You could be forgiven for thinking that the recent report by the chief medical officer for England, Sally Davies, covered only one topic – improving child health. The press picked up on the argument that, given the upsurge in cases of rickets, the government should consider providing free vitamin supplements to all children, but there was much more in the report. Davies’s next point, that we should fortify our flour with folic acid, has been ignored for far too long.

This recommendation arguably has much greater potential impact. Boosting folic acid in foods eaten by pregnant women significantly decreases the occurrence of foetal “neural tube defects”, reducing cases of conditions such as spina bifida and anencephaly, in which large parts of a baby’s brain simply don’t form.

The neural tube, which eventually carries the spinal cord and the brain, starts as a groove that deepens and then closes off. A folic acid deficiency can prevent the closing process, leaving nerves exposed. Folic acid provides a “methyl group” – one carbon atom and three hydrogen atoms – that binds to foetal DNA and ensures the genetic instructions are carried out properly, fully closing the neural tube.

We’ve known about the importance of folic acid since a landmark paper was published in the Lancet in 1991. In an experiment involving 2,000 women known to be at higher risk of having babies with neural tube defects, supplements of folic acid prevented between 70 and 80 per cent of the defects. The benefits were so starkly obvious that the experiment was stopped early: it was deemed unethical to continue to withhold supplements from those in the control group.

The test results led more than 60 countries to mandate the fortification of flour with folic acid. The neural tube forms in the first four weeks of pregnancy, before many women know they are pregnant. For full protection, the foetus needs the folic acid right from conception, yet only 37 per cent of women in the UK are taking folic acid supplements when they fall pregnant.

In the US, the fortification of cereal products with folic acid prevents roughly 1,300 neural tube defects a year and forestalls 360 infant deaths. Every year in the UK, 1,000 children are born with a neural tube defect, one and a half times the number of such births in the entire United States. That’s because the UK government advises only that women who might get pregnant should take folic acid supplements – it has consistently ignored scientific advice to put folic acid in the nation’s flour.

Until early this year, the government was able to hide behind claims that folic acid fortification might increase rates of bowel cancer. Those claims were disproved in a Lancet paper in January. The only remaining fig leaf for the government’s current position is a vague concern that one shouldn’t impose medicines on the country.

There is also an economic case for fortifying flour with folic acid. Each spina bifida patient costs the NHS about half a million pounds over their lifetime. In the US, the financial benefits have been shown to outweigh the cost of fortifying flour by 40 to 1. A 2011 costbenefit analysis of fortifying flour with folic acid suggested it would save the UK several million to hundreds of millions of pounds per year.

By all means, let’s get children out into the sun, and taking Vitamin D supplements if necessary: rickets has no place in 21st-century society. But if we are serious about our children deserving better, it also makes sense to give our baked goods a little extra goodness.

One simple change could make a lot of difference to all of us, personally and financially. Image: Getty

Michael Brooks holds a PhD in quantum physics. He writes a weekly science column for the New Statesman, and his most recent book is At the Edge of Uncertainty: 11 Discoveries Taking Science by Surprise.

This article first appeared in the 06 November 2013 issue of the New Statesman, Are cities getting too big?

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How the Night Tube could give London’s mice that Friday feeling

London Underground’s smaller inhabitants might be affected by the off-squeak service – and learn when the weekend’s coming up.

What will the mice who live in the Tube network make of the new all-night service? Half a million of them are thought to have made the London Underground their home – and will be in for a surprise when the Victoria and Central lines keep running this weekend.

The Londonist is concerned the mice “are unlikely to get any sleep” with the new Night Tube, and may move to the District line instead. Yet a number of scientists point out to the New Statesman that mice are nocturnal creatures, most likely to sleep while the lights are on and the trains are running.

So will they get on board with the change – or make a run for different platforms on other lines?

The bad news:

“When the Tube’s away, the mice will play,” is how the rhyme (almost) goes. 

Many have come to know  and even love  the mischiefs of the mice who stream off the tracks and out of the tunnels as the stations close at night, in search of discarded morsels of Maccy D. And until now, they’ve had a good few hours to conduct such galavanting in peace. But the new system means they will have to re-structure their sleep and foraging cycles, or “circadian rhythms”. 

“The presence of night trains should upset several of these entrainment factors (or zeitgebers = time givers) leading to disturbances in their behaviours,” explains Professor Patrick Nolan, from MRC Harwell, an international centre for mouse genetics. 

“When you fly across the Atlantic, for example, it takes a few days to adapt, you feel a bit groggy, don't perform as well as you usually do, don't eat well, etc. You soon adapt to the change. But if there are constant disruptions like this, the effect may be more severe and long-lasting. And this is how the schedule changes in the Underground might affect the resident mice.” 

So it's the constant switching between the week and weekend schedules that could leave the mice  and Tube drivers  most cheesed off. Agoraphobia (fear of open spaces) and photophobia (sensitivity to light) are two possible effects of the resulting anxiety, and their mating patterns and liver functions are also likely to be disturbed.

The good news:

Yet it is unlikely mice will be leaving the Night Tubes for good. 

The more time we humans have to drop our dinners, the larger the menu becomes for the mice (researchers tell me that strawberry milk and Wheetos are particularly favoured fare).

“Mice are active most of the time – so more trains at night hours will not make such a difference to them,” say the RSPCA’s wildlife officers. “In fact, it may help as it may provide more foraging opportunities.”

They’ve also faced worse before. The London Transport Museum reminds us that, during the Second World War, cats were employed to counter vermin on the network (spot the cat in the 1940s TfL workers' canteen below).


Credit: London Transport Museum

For Dr Samuel Solomon at UCL, there is plenty to suggest the mice will successfully adapt. His study of mouse reflexes shows how they respond to various visual stimuli – and can start running within one-tenth of a second. “There might be cues they pick up – if people clean the station differently on Fridays, for instance.”

The tracks’ electric current may no longer be entirely switched off (if it ever was), but their whiskers’ sensitivity to vibrations could help them juggle their escapades to fit around the Night Tube’s less frequent service.

What Dr Soloman can’t yet predict is whether the mice will start to anticipate that Friday feeling: “It will be interesting to see whether they can learn that Friday is Friday”.

All in all, the Tube mice seem well set for the Night Tube’s new challenge. Who knows, they may soon gain the confidence of their 24/7 brothers in New York – and start ordering take-out...

India Bourke is the New Statesman's editorial assistant.