A new call for the fortification of flour with folic acid has been made by doctors from St Bartholomew's and Royal London school of medicine, London. They suggest that fortification is needed to ensure that all pregnant women receive folic acid supplementation.
The doctors report that public education about the importance of folic acid has had some success in that in a 1998 survey, carried out in Stockport and St Bartholomew's, 45 per cent of women reported having taken a folic acid supplement before becoming pregnant (as recommended by the Department of Health). However, 40 per cent of women only started folic acid supplements once they knew they were pregnant and 15 per cent had taken no folic acid. "Over half of pregnancies occur in women who have not taken folic acid at the right time. The finding underlines the importance of a population approach in which flour is fortified with folic acid," the doctors say (British Medicial Journal 1999;319:1499).