Miller Magazine Issue 146 February 2022

69 COVER STORY MILLER / FEBRUARY 2022 deficiency in expectant mothers. 5 The universal fortification of a staple food product – like wheat flour – with folic acid can therefore help to plug the gap and reduce the number of un- born babies at risk of developing life-threatening conditions. FORTIFICATION AND THE GLOBAL STAGE Historically, the results of mandatory fortification initiatives have been extremely positive. Since the addition of folic acid to flour became US policy in 1998, there has been a 28% decrease in the prevalence of NTDs in babies. 6 New Zea- land has also recently announced that, by 2023, millers must incorporate between 2 and 3mg/kg of folic acid into their flour. 7 This follows on from a 2014 Code of Practise where the New Zealand Association of Bakers agreed to fortify 25-50% of bread with folic acid. 9 In 2021, the UK became the most re- cent country to introduce a mandate that requires folic acid fortification in all non-wholemeal flour. 10 This aims to reduce the number of babies born with NTDs by around 200 each year – around 20% of the UK annual total. 11 Flour has been fortified in the UK for over 80 years with the addition of calcium, niacin, iron and thiamin – nutrients typically lost during the milling process. 12 This means that the addition of folic acid is neither a logistical nor a financial challenge. Beyond an initial investment, the cost of incorporating folic acid is far outweighed by the total healthcare costs that are saved by do- ing so, with the benefit to cost ratios typically sitting at 12-48:1. 13 SEEING THE OPPORTUNITY TO PROVIDE BETTER FUTURES FOR ALL Similar steps are being taken in lower-income countries, with major flour and milling companies in India agreeing in 2017 to introduce fortified flour into their flagship brands. Around 50% of the Indian population lives with some form of health deficiency due to malnutrition. 14 Even more crucially, between 4-8 in 1000 babies here are born with spina bifida – four times the global average. 15 By taking these steps to forti- fy a staple food like flour, the numbers of infants with this po- tentially life-threatening condition can begin to be reduced. It is vital that millers, brand owners, private sector partners, governments, donors and NGOs work together to find and im- plement long-term solutions to combat folate deficiency and subsequently improve pre-natal health – allowing even the most vulnerable across the globe access to a brighter future. As the leading expert in flour fortification, DSM’s knowl- edge and experience ensures the correct concentration, distribution, and stability of micronutrients to meet specific regulatory requirements and quality standards. With a com- plete portfolio of high-quality ingredients, alongside spe- cialized fortification technologies and customized solutions including micronutrient blends, DSM is the ideal end-to-end partner – bringing expertise and passion at every stage of the development process. DSM has also set ambitious en- vironmental, social, and governance (ESG) targets. This mis- sion is reflected in measurable and transparent Food System Commitments, designed to deliver Health for People, Health for Planet, and Health for Livelihoods. By 2030, DSM aims to have played a tangible role in helping to close the micronu- trient gap for 800 million people, and through our partner- ships in both the public and private sectors we are constantly innovating for affordable, accessible, and aspirational solu- tions to keep the world’s growing population healthy. For more information about how partnering with DSM can help you to innovate in the fortification market, visit www.nu - tritionimprovement.com. 1 Morris JK et al, Prevention of neural tube defects in the UK: a missed opportunity, Archives of Disease in Childhood, 2016. 2 University of Maryland Medical Centre. “Vitamin B9 (Folic acid)” 5 August 2015. 3 NDNS Supplementary Folate Report – a summary of findings, British Nutrition Foundation. 4 UK National Health Service, Vitamins, supplements and nutrition in pregnancy, last reviewed 14 February 2020. 5 Public Health England, Health Matters: Reproductive health and pregnancy planning, 2018. 6 UK Government, Department for Health and Social Care, Folic acid added to flour to prevent spinal conditions in babies, 20 September 2021. 7 https://www.mpi.govt.nz/food-business/bakery-and-grain-based-products/folic-acid-fortification-of-bread 8 Government of New Zealand, Fortification of flour with the B vitamin folic acid, 8 July 2021 9 Government of New Zealand, Fortification of flour with the B vitamin folic acid, 8 July 2021. 10 Ibid., Folic acid added to flour to prevent spinal conditions in babies. 11 Ibid., Folic acid added to flour to prevent spinal conditions in babies. 12 Ibid., Folic acid added to flour to prevent spinal conditions in babies. 13 H. Pachon et al., Folic acid fortification in wheat flour: A cost-effective public health intervention to prevent birth defects in Europe, 2015. 14 Global Fortified Flour Market Analysis – Forecast to 2026. 15 ‘Doctors call for more awareness of spina bifida. References: