Conspiracy theories are spreading as to why folic acid is being added to bread

Fortified foods are marketed as being good for us, helping to plug nutrition gaps that can lead to weakness and poor health.

However, the government’s recent decision to add folic acid to supermarket bread has become the center of a heated online debate.

From December this year, new legislation will see food manufacturers add synthetic nutrients to non-wholemeal flour, meaning certain types of bread, cakes and other supermarket items will be fortified more.

Once this rule comes into force, UK millers will be required to add 0.25mg of folic acid per 100g of non-wholemeal wheat flour.

But what exactly is folic acid? Why are people worried, and is there any truth to the concerns circulating on social media?

To better understand the conversation, we asked a nutritionist to answer some common questions.

What is folic acid?

Folic acid is a synthetic form of the vitamin folate, also known as B9.

Folate helps the body build healthy red blood cells and plays a role in how our cells divide and grow. It is found naturally in foods such as leafy greens, chickpeas and cruciferous vegetables, the NHS says most adults can get all they need from a healthy diet alone.

In early pregnancy, having good levels of folate is especially important, as it helps in the proper development of the baby’s brain, skull and spine.

During these weeks and months, it can be more challenging for women to get enough folate from the diet alone, as the body’s needs increase significantly.

This is why the NHS recommends that all pregnant women take 400 micrograms of folic acid every day – from before they become pregnant until their 12-week scan.

Why did the government bring new rules?

“Folic acid is added to bread in the UK because folate intake is still very low among women of childbearing age, and this has real, preventable consequences,” says Rob Hobson, nutritionist and author of Unprocess Your Life.

“About nine in 10 neural tube defects, including spina bifida (a condition in which a baby’s spine and spinal cord do not fully develop in the womb), develop very early in pregnancy – often before many women know they are pregnant.

“Despite years of advice to take supplements, uptake has been low in the UK, particularly among young women and those from low-income backgrounds.”

In England, a study of nearly half a million women showed that only 31% took folic acid supplements before pregnancy.

“So reinforcement exists,” says Hobson. “It follows years of evidence review, careful modeling of risks and benefits, and advice from independent scientific bodies.

“Countries that have already fortified flour have seen consistent reductions in neural tube defects without clear evidence of harm to the wider population.”

A recent review that looked at data from several countries found a clear link between the introduction of folic acid fortification and a reduction in neural tube defects, with Chile in South America seeing a 55% drop in incidence over a decade.

Why dispute over the decision?

Much of the online controversy centers on a gene called “MTHFR,” which plays a role in how your body metabolizes folate.

Some people are concerned that, if you have a mutation of this particular gene, you may be less efficient at processing synthetic folic acid naturally, leading to higher levels of the catabolized nutrient in the bloodstream.

Online, panic has spread around this “build-up” of folic acid, with claims that it contributes to everything from immune problems and increased cancer risk to depression and fatigue.

However, Hobson believes these concerns are largely sensationalized, and not based on strong scientific evidence.

“It is true that variations in the MTHFR gene are common and may slightly affect how folate is processed in the body,” he explains. “However, good-quality evidence does not support the idea that people with these variations cannot safely handle folic acid, or that fortification is harmful at a population level.

“This argument often comes from random sources online, and it ignores the measure of public health benefit.”

Can too much folic acid increase the risk of cancer?

Fears surrounding folic acid and cancer appear to have stemmed from early research looking at high-dose supplementation.

Some early studies suggested that very high intakes of folic acid may be linked to a possible increase in some cancers. However, a 2013 meta-analysis of randomized trials addressed these concerns, and found that folic acid supplementation did not significantly increase overall or site-specific cancer risk over a five-year follow-up period.

When it comes to your weekly bread, Hobson says it’s sensible to keep more in terms of fortification levels.

“The level of folic acid added to flour is small and strictly regulated,” he recalls. “Even with fortified bread, many people will still consume folic acid below the upper safe intake level. This is very different from taking high-dose supplements.”

He adds: “Claims on social media that fortified bread ‘slows down bodily processes’ or ‘promotes cancer’ are not supported by robust human evidence at the levels used in fortification.

“While very high supplement doses could in theory overwhelm some pathways, there is no good evidence that the small amounts used in flour fortification affect metabolism or cause harm in the general population.”

Of course, if you’re really worried about the new law and you’re meeting your daily folate needs through diet alone, you can always choose whole wheat varieties not affected by the rule, or try making your own wholemeal sourdough at home. There are both healthy and nutritious ways to increase your fiber intake.

However, if you love nothing more than sticking white bread in a pan, Hobson believes there’s no immediate reason to panic. “The bottom line is that fortification is not about optimizing nutrition for people who are already eating well and taking supplements,” he notes.

“This is about public health reducing preventable birth defects. From a public health perspective, the benefits are clear, the risks are carefully assessed, and the policy is based on decades of evidence.”