Folic acid plus B12 recommended for grain fortification

Fortification of food with folic acid to prevent neural-tube defects in babies also lowers plasma total homocysteine, a risk factor for vascular disease, claim researchers from Ireland this week.

Scientists from Trinity College, Dublin published an open letter in the January 19th issue of The Lancet claiming that a fortification policy based on folic acid and vitamin B12, rather than just folic acid alone, is likely to be much more effective at lowering of homocysteine concentrations, with potential benefits for reduction of risk of vascular disease. Their conclusions follow an extensive investigation into the effect of folate and vitamin B12 on homocysteine concentrations

Mandatory fortification of grain foods with folic acid has been in place in the USA since 1998. In the UK, mandatory folic-acid fortification is now a prospect after it was proposed by the Government's Committee on Medical Aspects of Food and Nutrition Policy (COMA). The COMA report is currently undergoing consultation with the four UK Health Departments and the Food Standards Agency.

If the report is approved, new legislature for compulsory fortification of wheat flour with folic acid will have to be drawn up. Although the COMA report focused mainly on the role of folic acid in prevention of neural-tube defects, the potential benefit of folic acid in reduction of risk of cardiovascular disease by lowering of concentration of homocysteine3 was also addressed, and undoubtedly contributed to the conclusions of the report, the scientists write.

Homocysteine is a compound formed in the body when protein is metabolised. Folic acid, a B vitamin, is known to lower blood levels of homocysteine.

Visit The Lancet​ to read the full findings.