Folic Acid and Human Health; Monitoring Folate Status in the UK

Published on 3 February 2013 in Food, health and wellbeing

Key Challenges

Folates play a crucial role in the development of human diseases including heart disease, cancer and dementia in adults and birth defects in the babies. The evidence for a protective effect of folic acid against neural tube defects (NTDs) prompted the Government to consider introducing mandatory folate fortification in the UK. The impact that this may have on other aspects of human health is unknown. We critically assessed methods for quantifying folate status in people and recommended which methods should be employed for future population monitoring in the UK.

Key Benefits

The work described here has impacted directly on UK public health policy by changing the way in which folate status is currently evaluated. Moreover, this work provides the evidence base for effectively measuring the impact of mandatory folic acid supplementation if introduced by the UK Government in line with advisory committee recommendations.

Folates are critical for human health and wellbeing. It has been suggested that folate deficiency is the most common vitamin deficiency in the world, with 40% of adolescents in the UK exhibiting marginal folate status and folate deficiency common in people over 65 years of age. Severe folate deficiency results in congenital defects such as neural tube defects (NTD) in the newborn. More than 80% of women who could become pregnant do not achieve the recommended folate intake for women. Low folate intake is a risk factor for dementia in the elderly and is also linked with the development of cancer and heart disease, two of the biggest killers in Scotland.

Research at RINH has led to the UK Food Standards Agency (FSA UK) changing the way that folate status is evaluated in the UK population.

Blood concentrations of folate are an important marker of nutritional status and have been measured in many large-scale national population-based surveys including the Scottish Dietary targets and the UK-wide National Diet and Nutrition Survey (NDNS). Given the negative impact that low dietary folate has on human health, a precise, accurate and standardised population-based analytical method for monitoring folate status in people is vital.

Working with the UK Food Standards Agency (FSA UK), scientists at RINH assessed the methodology for best measuring folate status in the UK population in consultation with National and International experts in the scientific area and with experts in the standardisation and optimising of clinical sample analysis.

RINH provided the UK government with a series of recommendations on the best method and sampling regime to use in future human population monitoring. The recommendations generated by this work had a direct and immediate impact on how the UK government assess blood folate. Decisions by the NDNS and Department of Health (DoH) on how best to assess the folate status of the UK population have been informed by this research.

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