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Benefits and Risks of Fortifying Flour with Folic Acid to Reduce the Risk of Neural Tube Defects

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SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

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Published: Report no: 183

SBU’s Conclusions

The primary objective of the project was to systematically examine the scientific evidence for the benefits and risks of fortifying flour with folic acid. Benefits refer to the possibility that the incidence of neural tube defects (NTDs) is lower with fortification than without fortification. Risks refer to the possibility that a higher intake of folic acid increases the likelihood of twin pregnancy.

Other possible effects of fortification were not included in the examination.The main conclusion of the Swedish Council on Technology Assessment in Health Care is that mandatory fortification of flour with folic acid cannot be unequivocally recommended based on the scientific evidence in this report.

How to cite this report: SBU. Benefits and risks of fortifying flour with folic acid to reduce the risk of neural tube defects. Stockholm: Swedish Council on Health Technology Assessment in Health Care (SBU); 2007. SBU report no 183 (in Swedish).

Project group

  • Claes Sundelin (Chair)
  • Göran Annerén
  • Bengt Brorsson (Project Director)
  • Sven Cnattingius
  • Christina Engström (Project Assistant)
  • Gunilla Malm
  • Nina Rehnqvist
  • Hanna Sara Strandler
  • Alicja Wolk
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