The role of food fortification: The example of folic acid

Food fortification is the process of adding essential micronutrients to food. This chapter considers the role of folic acid-fortified foods in impacting folate status and in maintaining better health in populations worldwide. The evidence linking low, but not necessarily deficient, folate status with neural tube defects (NTDs) is conclusive and beyond debate: therefore achieving optimal folate status is an important public health goal for populations worldwide. However, despite the known and emerging health benefits of optimal folate status, achieving this at a population level presents significant challenges, particularly for countries that lack policies of mandatory folic acid fortification of food. This chapter explores whether fortified foods can provide a sustainable source of folic acid and deliver improved folate status and better health outcomes while presenting a minimal risk to health. It concludes that there is a very strong case for folic acid fortification and indicates that the proven benefits would more than outweigh any potential risks.