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Conclusive evidence has existed for nearly 30 years that folic acid supplementation before and in early pregnancy prevents neural tube defects (NTD) in the developing foetus, leading to clear recommendations for women of reproductive age worldwide.

Policy in this area is however problematic because, despite a proven benefit in NTD, there are concerns that folic acid could be harmful at high levels of exposure.

Research by Ulster on folic acid (aka folate, a B vitamin) has:

  • Directly impacted international health policy for women of reproductive age aimed at preventing major birth defects in their babies
  • Provided the necessary scientific opinion to set new dietary recommendations across age and sex-groups to benefit populations worldwide.
  • Informed the risk-benefit assessment underpinning food policy for folic acid fortification in the UK, Ireland and New Zealand.
  • Contributed to translating the scientific evidence into practice for policy makers and health professionals globally, ultimately to benefit patients and consumers.
  • Research Context 

    Supported by significant external funding (> GBP5M; 2000-2020) from the Food Standards Agency, the European Commission, UKRI and industry, we have a built a dedicated, and internationally recognised, research programme focused on folate in health and disease.

    Our landmark findings showed important stability and bioavailability differences between naturally-occurring food sources of folate and the synthetic vitamin form, folic acid.

    We showed that, compared with folic acid (present only in fortified foods and supplements), the naturally-occurring (polyglutamylated) forms of folate in food have poor stability under normal conditions of cooking and limited bioavailability once ingested by the body.

    These findings, in turn, greatly limit a person’s ability to achieve optimal nutritional status of folate from natural food sources alone. We showed that the addition of a low-dose folic acid supplement to the diet can greatly enhance folate status in the blood, and in turn substantially lower homocysteine, a metabolite linked with adverse health outcomes throughout life from pregnancy to older age. Furthermore, we demonstrated that regular consumers of folic acid-fortified foods had significantly higher blood concentrations of folate, and lower homocysteine, compared with non-consumers.

  • Sources To Corroborate 
    • C1 = Food Safety Authority of Ireland, FSAI (2016) Update report on folic acid and the prevention of birth defects in Ireland.
    • C2 = Scientific Advisory Committee on Nutrition (SACN, UK) Folate and Disease Prevention Report; SACN Update on folic acid (2017).
    • C3 = Office of the Prime Minister’s Chief Science Advisor (New Zealand) and the Royal Society Te Apārangi (2018) The health benefits and risks of folic acid fortification of food.
    • C4 = European Food Safety Authority (2014) Scientific opinion on dietary reference values for folate.
    • C5 = Canadian Paediatric Society (2016) Position Statement. Folate and neural tube defects: The role of supplements and food fortification.
    • C6 = Office of Dietary Supplements, National Institutes of Health USA (2019) Folate – Health professional fact sheet.
  • Dissemination Activities 
    • Research Blog by H McNulty for the ‘Members Research Series’ of The Royal Irish Academy

      Background: The RIA is an all-island academy to support scholarship and promote awareness of how science and the humanities enrich our lives and benefit society.

      In this ‘Members Research Series’ series, RIA Members talk about their research fields to raise awareness of their work, to facilitate collaboration within the wider academic community and to inform the public