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Fortifying flour with folic acid: leveling the playing field for all pregnant women


Folic acid isn’t anything new. We know that it’s important for pregnant women to consume an adequate amount of folic acid, so as to minimize the chances of their babies being born with birth defects. But is there a difference in taking tablets, as opposed to getting your intake from flour that’s fortified with folic acid? Plus, why are some governments making it mandatory for flour to be fortified with folic acid? In this article, we answer all that, and more!

Folic acid: a brief history

Gynaecologists and doctors first discovered the importance of folic acid around 1991, when studies linked folic acid supplements with a reduction in the rate of neural tube defects. Since then, governments and medical professionals alike have been trying to get pregnant women to consume it. Whilst women in Britain and Europe are simply advised by their doctors to take supplements, US and Canadian governments have actually passed laws which make it mandatory for flour to be fortified with folic acid.

Folic acid in flour vs supplements

Supplements, on paper, look pretty good. They’re packaged nicely. They’re convenient to consume. What more could you ask for?


When you dive a little deeper, though, these supplements may be a wee bit lacking. More specifically, a study by the US Centers for Disease Control and Prevention showed that encouraging pregnant women to consume these supplements made zero difference to neural tube defect rates in Europe. According to this study, over-the-counter supplements are typically taken by those who least need them (meaning: women who are already getting plenty of folic acid in their diet). On the flip side, those who do need them are the least likely to purchase and consume supplements.

Then there’s fortified flour, which seems to be a lot more effective. After US and Canada’s governments implemented new legislation requiring flour to be fortified as such, neural tube defects in the US and Canada fell by 25-50%. More than 70 countries have followed suit, and passed similar laws. (Singapore, unfortunately, is not one of those countries!)

Fortified flour and the element of surprise

For maximum impact, folic acid needs to be taken before (or immediately after) conception. And because 40% of pregnancies worldwide are unplanned, it goes without saying that the window of opportunity is lost for the majority of these women.


Fortifying folic acid in something as widely consumed as flour, on the other hand, is a great way of sidestepping the element of surprise and ensuring that pregnant women (regardless of whether it’s a planned or unplanned pregnancy!) do get the folic acid that they need.

Fertility consultation with BeNatural’s fertility coach, Marie Otsuka

If you and your partner would like to learn more about conceiving, come down for a 45-minute consultation with Marie Otsuka, BeNatural’s fertility coach. In this session, Marie will seek to understand the couple’s situation, and offer insights she’s gained through her 10 years of experience in working with infertile Singaporeans. Slots are limited and on a first come first serve basis; contact us here to schedule an appointment!

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