Did you know that the neural tube, which goes on to form a baby's brain and spinal cord, has usually finished developing by around six weeks into pregnancy, often before many people even realise they are pregnant at all? It is one of the reasons folate has become such a significant focus of UK public health policy, and why the UK government has legislated for mandatory fortification of non-wholemeal wheat flour with folic acid, due to come into force in the coming months (many mills have already adopted it ahead of the deadline). In my practice, this is a topic that comes up often with clients who are trying to conceive, and understandably, it raises a lot of questions about what it actually means for them. I want to break this down clearly: what fortification is, why it matters so much in those very early weeks, and what it does and does not change about your own diet.
What is folic acid fortification, and why now?
Fortification means adding a nutrient to a food during production, so that people consuming that food regularly get a reliable additional source of it, without having to change their shopping or cooking habits. The UK government has legislated for mandatory fortification of non-wholemeal wheat flour, the type used in white bread and many everyday flour-based products, with folic acid, the synthetic form of folate, due to come into force in the coming months. This follows the lead of many other countries, including the United States, which have fortified flour with folic acid for a considerable time, and reflects a strong and long-standing body of evidence linking adequate folate intake around conception with a reduced risk of neural tube defects, such as spina bifida. This is a population-level public health measure rather than a personal recommendation, and it sits alongside, rather than replaces, the existing NHS advice around folic acid supplementation for anyone trying to conceive.
Why folate matters so much in early pregnancy
The reason fortification matters so much comes down to timing. The neural tube forms in the earliest weeks of pregnancy, often before a positive test, which means relying solely on increasing your folate intake after you find out you are pregnant can genuinely be too late for this particular window. A significant proportion of pregnancies in the UK are unplanned, so a fortification approach that reaches the whole population, rather than only those actively planning a pregnancy and taking a supplement in advance, is a meaningful shift in reducing risk more broadly.
This is exactly why folic acid fortification has been described as such an important public health step. It does not rely on someone already knowing they need extra folate, it simply raises the baseline folate intake across the population through a food that is already eaten regularly by most people.
What foods will be fortified, and what this does and does not change for you
Fortification will apply to non-wholemeal wheat flour, meaning products such as white bread, and many baked goods and flour-based foods made using it, will contain added folic acid. It is worth being clear about what this does not mean, though. It does not mean you can rely on fortified bread alone to meet your folate needs if you are pregnant or trying to conceive, and it certainly does not remove the value of eating a varied, folate-rich diet more broadly. Wholemeal flour itself is not included in this particular fortification, though it already offers more fibre and other nutrients from the whole grain.
Think of fortification as raising the floor for the population as a whole, a helpful background layer of protection, rather than a replacement for a genuinely balanced diet or for medical guidance around supplementation if you are planning a pregnancy.
It is also worth remembering that folate is only one part of the nutritional picture around preconception and early pregnancy. Iron, vitamin D and, for some, omega-3 intake are all commonly discussed alongside folate, and each has its own guidance around whether and how to supplement. This is exactly the kind of area where I would encourage anyone planning a pregnancy to have a conversation with their GP or midwife about a full picture of their needs, rather than focusing on folic acid in isolation.
Practical food sources of folate beyond fortified flour
Whether or not you are planning a pregnancy, folate is a nutrient worth having consistently in your diet, and there are plenty of accessible, everyday sources beyond fortified flour:
- Leafy greens such as spinach, kale and broccoli, ideally lightly cooked to help preserve their folate content
- Lentils, chickpeas and other pulses, which are genuinely rich sources and easy to add to soups, curries and salads
- Fortified breakfast cereals, which often carry added folic acid alongside other B vitamins
- Oranges and orange juice, a useful everyday source alongside their vitamin C content
- Avocado, and eggs, both of which contribute smaller but still meaningful amounts
Building a handful of these into your usual weekly meals is a straightforward way to support your folate intake as part of everyday eating, well beyond what fortification alone provides.
If you are trying to conceive or in early pregnancy
If you are pregnant, trying to conceive, or think you might be, I would always recommend discussing folic acid supplementation directly with your GP, midwife or pharmacist. Specific supplementation, including dosage and how long to continue taking it, particularly for anyone with a higher individual risk of neural tube defects, is genuinely clinical guidance that needs to come from your GP or midwife, not from a nutritionist, and it can differ from person to person.
My role as a registered nutritionist sits alongside that clinical advice, helping with the broader picture, building folate-rich meals you will actually enjoy, supporting balanced nutrition through preconception and pregnancy more generally, and answering the everyday food questions that come up between midwife appointments. Good early nutrition also sets a helpful foundation for the years that follow, and it is something I return to often when supporting families with children's nutrition from those very first months onward.
Folic acid fortification is a genuinely positive step for public health, but it works best alongside, not instead of, personalised guidance and a varied diet, particularly during the window when it matters most.
If you would like personalised support with nutrition around folic acid and preconception health, I offer one-to-one online consultations. View my consultation packages or book a free discovery call to discuss how I can help.