Folic Acid vs Folate: Flour Fortification

Folic acid is being added to flour, but what happened to the folate that was naturally there?

If you like bullet point summaries, then here is the skinny on this blog:

• From 13 December 2026, non-wholemeal common wheat flour in the UK will have folic acid added to help reduce neural tube defects.
• BUT to make white flour, wheat is refined by removing much of the bran and germ and, with them, a substantial amount of its naturally occurring folate.
• The folic acid being added back is not the same as the naturally occurring folates that were removed.
• Folic acid is a synthetic, fully oxidised form that has to be converted before it can be used within our folate pathways.
• One of the enzymes involved in that conversion is DHFR, and human DHFR activity is relatively slow.
• This raises questions around unmetabolised folic acid (UMFA), particularly when folic acid exposure is high.
• There are also important questions around Vitamin B12 status, pregnancy, methylationMethylation is one of the body's most important ‘behind-the-scenes’ processes. Happening millions of times every second, it helps regulate everything from energy production and hormone balance to detoxification, neurotransmitters, DNA repair, and how we respond to stress. Yes, it is literally involves in every reaction in your body. At its heart, methylation is the process of transferring tiny chemical tags, called methyl groups (one carbon with 3 hydrogens if you like a bit of chemistry), from one molecule to another. To do this efficiently, the body relies on nutrients such as folate, vitamin B12, vitamin B6, zinc, choline, methionine and more. Together, these nutrients help produce a molecule called SAMe, which acts as one of the body's main methyl donors.Referenced in 14 articlesClick to read more →, immune function and cancer that make this conversation far more nuanced than simply: “folic acid prevents neural tube defects, therefore more is better.”
• And if you personally don’t want added folic acid? You don’t need to avoid folate and you don’t necessarily need to give up flour or bread either.

If you like the full-fat version… keep reading.

You may have seen the recent headlines that, from 13 December 2026, non-wholemeal common wheat flour in the UK will be fortified with folic acid. Although folic acid has been added to foods previously, this is more extensive and a potential long-term concern.

Folate is essential during the earliest stages of pregnancy, when the neural tube is developing into the baby’s brain and spinal cord. Inadequate folate status increases the risk of neural tube defects, including spina bifida and anencephaly.

The UK Government estimates that mandatory folic acid fortification could prevent around 200 neural tube defects every year. But there is another part of the story. Before we talk about adding folic acid to flour, let’s talk about what happened to the wheat in the first place.

We also need to ask a question that the headlines don’t address: Are folate and folic acid actually the same thing?

BTW, you may want to read the Methylation Blog HERE. We will be coming back to it in the follow-up blog to this one.

Let’s start with the wheat grain

A whole wheat grain contains three main parts (see the image below):

1. Bran: The fibre-rich outer layers, containing fibre, minerals, B vitamins and numerous phytochemicals.
2. Germ: The part capable of developing into a new plant. It contains healthy fats, vitamin E, B vitamins, and minerals.
3. Endosperm: The largest part of the grain, containing predominantly starch and proteinProtein is one of the three main macronutrients, alongside fats and carbohydrates, yet for many years it was often the forgotten member of the trio. More recently, protein has become something of a celebrity in the nutrition world, appearing in everything from snack bars and cereals to coffee and desserts. Whilst the marketing can sometimes get a little carried away, the truth is that protein is essential for human health. Every cell in the body relies on it. Protein helps build and repair tissues, supports immune function, forms enzymes and hormones, transports nutrients, and helps maintain muscle mass, particularly as we age.Referenced in 35 articlesClick to read more →, including the proteins involved in gluten formation.

If we eat the whole grain, we retain all three. But white flour does not contain the whole grain. The refining process removes some of the fibre, vitamins, antioxidants, healthy fats, and minerals.

Firstly, to produce flour, the grain has to be milled

Milling means processing wheat grain to produce flour. Milling produces wholemeal flour, in which the components of the whole grain are retained, but milling is not the same as refining. The refining process produces refined white flour, in which much of the bran and germ-rich fractions are separated, leaving flour consisting predominantly of the endosperm.

In summary, all wheat flour is milled but not all milled wheat flour is refined. Refined wheat flour is the white flour used in white bread, cakes, pastries, bagels and many packaged baked foods.

Why do we refine wheat?

There are practical reasons. However, removing the bran and germ produces flour that is:

• lighter
• finer
• softer
• more consistent for baking
• more shelf-stable

The germ contains unsaturated fats, including omega-6s and omega-9s and, to a lesser extent, omega-3s. Those oils are nutritionally valuable, but once the grain has been milled, they are also susceptible to oxidation and rancidity. By removing the germ, you extend the shelf life of the flour. Removing the fibrous bran also changes texture and baking characteristics, producing the soft white flour used in everything from white bread and bagels to cakes, pastries, and croissants.

However, there is a nutritional trade-off: when parts of the grain are removed, we remove key nutrients, including naturally occurring folate.

Refining wheat substantially reduces its naturally occurring folate.

Studies comparing refined wheat flour with whole-grain flour have reported folate levels that are 21–89.5% lower (Siatka T et al., 2025). Another study showed that refining wheat resulted in a 71% loss of folate (Liang Q et al., 2020).

These studies demonstrate that producing refined flour can substantially reduce the naturally occurring folate in wheat. And this brings us to December 2026.

Folic acid is going to be added to flour

From 13 December 2026, UK regulations require non-wholemeal common wheat flour to contain 250 micrograms of folic acid per 100 g of flour. This isn’t technically being done to restore the naturally occurring folate removed during refining.

The Government explicitly states that folic acid is being added to supplement the diet rather than replenish the folate naturally found in flour. The amount added is also not calculated according to how much natural folate was lost.

It is a fixed amount of folic acid, regardless of the natural folate concentration remaining in the flour. Why? You may ask…because this is a population-level public-health intervention designed primarily to reduce neural tube defects.

However, folic acid is not the same molecule as the folates naturally present in food (check our blog on methylation)

Folic acid is not folate that is removed during the refining process

Folic acid also known as pteroylmonoglutamic acid is the synthetic, fully oxidised form commonly used in supplements and fortified foods. It is used as it is relatively inexpensive, stable and survives storage and food processing considerably better than many naturally occurring reduced folates.

There is evidence that folic acid supplementation around conception reduces the risk of neural tube defects (NTDs). But folic acid itself isn’t doing the work inside the body. It first has to be converted to the active form (biologically usable form).

This is where the complications come in and why nutritional therapists, functional medicine practitioners and anyone well-versed in nutrition medicine have some concerns.

In order to convert folic acid to a biologically active form, it requires the ‘help’ of an enzyme, DHFR (see image below). However, the activity of this enzyme in humans has been shown to be 56 times lower than that of rat liver tissue (Bailey, SW and Ayling JE, 2009). The original experiments establishing folic acid supplementation were done in rodents whose exceptional DHFR capacity allowed them to rapidly reduce large doses of synthetic folic acid without difficulty. Early nutritional guidelines mistakenly assumed human liver tissue processed the synthetic compound at this same high rate, they overlooked the human enzymatic bottleneck. Consequently, consuming synthetic folic acid easily saturates human DHFR, allowing unmetabolized folic acid (UMFA) to spill directly into systemic circulation, a metabolicMetabolism is not a calorie-burning furnace that sits somewhere near your belly button, deciding whether you can fit into last year's jeans. Metabolism is the set of chemical processes taking place inside your body every second of every day, keeping you alive.Referenced in 35 articlesClick to read more → anomaly that does not occur in rodent models or with natural food folates.

What happens when we have unmetabolised folic acid (UMFA) in our system? Here is  some of the science

1. UMFA and our Natural Killer (NK) cells

Natural Killer (NK) cells are part of our immune defence, helping identify and destroy virus-infected and abnormal cells. In a study of 105 postmenopausal women, higher circulating UMFA was associated with lower NK-cell cytotoxicity (Troen AM et al., 2006). Animal research has subsequently reported reduced NK cell activity with high folic acid intake as well (Sawaengsri H et al., 2026).

This is a cause for concern and needs more research.

2. Folate and Vitamin B12

A study by Morris et al. (2007) analyzed National Health and Nutrition Examination Survey (NHANES) data from over 1,300 older American adults following mandatory national folic acid fortification, demonstrating that high circulating folate combined with low Vitamin B12 status significantly exacerbated adverse clinical outcomes. The researchers found that individuals with low B12 concentrations and high serum folate levels were nearly five times as likely to exhibit cognitive impairment and more than three times as likely to develop anaemia compared with subjects with normal B12 and normal folate levels. These findings indicated that flooding the human system with excess synthetic folic acid does not merely mask the haematological warning signs of an underlying B12 deficiency, but actively worsens its neurological and metabolic manifestations.

A later follow-up study by Selhub et al. (2007) evaluated 1,459 adults aged 60 and older from the post-fortification NHANES (1999–2002) dataset, measuring serum folate, Vitamin B12, total homocysteine, and methylmalonic acid (MMA) to determine how widespread exposure to synthetic folic acid impacts cellular metabolism.

In clinical biochemistry, high levels of both MMA and homocysteine serve as the definitive ‘smoke alarm’ for a severe, functional B12 deficiency. Homocysteine accumulation can contribute to oxidative stress and blood vessel dysfunction, while high MMA levels can lead to impaired energy production and progressive nerve demyelination. By stratifying participants into normal versus low B12 status, the researchers demonstrated that while higher serum folate helped clear metabolic waste in subjects with adequate B12, subjects with low B12 who were exposed to high circulating levels of unmetabolized synthetic folic acid experienced a dose-dependent, compounding increase in both MMA and homocysteine. This proved that excess synthetic folic acid does not merely mask B12 deficiency in blood counts, but actively worsens cellular B12 dysfunction and accelerates metabolic and neurological impairment.

It remains very important to question why refined white flour is being fortified with folic acid.

3. Can UMFA interfere with our natural folates?

Some key studies in mice

As mentioned, folic acid is chemically different from naturally occurring reduced folates such as 5-methyl-THF (methylfolate). Christensen et al. (2015) showed that high folic acid intake impacts both MTHFR enzyme expression and its overall activity, thereby creating an artificial (‘pseudo’) MTHFR deficiency that slows down the processing of natural folates.

Later research (Bahous RH et al., 2017) on maternal exposure during pregnancy (in mice) revealed that this synthetic folic acid-induced ‘pseudo-MTHFR deficiency’ suppresses embryonic and placental MTHFR levels, impairs placental transport, and reduces foetal methyl-folate availability. Consequently, this maternal overload resulted in embryonic growth delay, altered cortical brain development, and memory deficits in the offspring.

Research in humans

Raghavan et al. (2018) at the Johns Hopkins Bloomberg School of Public Health highlighted potential risks associated with extreme maternal synthetic folate and B12 blood levels.

They evaluated 1,257 mother-child pairs and reported that extremely high maternal plasma folate concentrations at delivery (>59 nmol/L}, predominantly driven by high synthetic intake, were associated with a 2.5-times higher risk of Autism Spectrum Disorder (ASD) in the child. If the mother had both extremely high folate and extremely high B12, the risk of ASD increased over 17-fold.

Such studies highlight that the specific form, dosage, and underlying maternal genetics dictate whether supplementation is protective or harmful.

4. Folate and cancer

Folate is essential for making and repairing DNA. But rapidly dividing abnormal cells also need folate to make new DNA. This has led to the ‘dual role of folate’ hypothesis, where adequate folate may be protective before abnormal cells develop, while high folate exposure once pre-cancerous cells exist could potentially encourage their growth.

In one randomised trial (Cole BF, et al., 2007) using 1 mg of folic acid daily, overall adenoma recurrence was not significantly increased, but researchers found a concerning later signal for advanced and multiple colorectal adenomas. Note: this doesn’t mean folate causes cancer, but it raises questions about the form of folate, the dose, timing, etc.

If you don’t want added folic acid:

• Choose genuinely wholegrain foods: oats, brown rice, quinoa, buckwheat, millet and whole rye are useful alternatives to refined wheat flour.
• Look for 100% wholemeal wheat flour rather than simply ‘wheat flour’ or ‘white flour’.
• Check the ingredients list: If you specifically want to avoid added folic acid, look for ‘folic acid’ in the ingredients rather than assuming a product does or doesn’t contain it.
• Don’t assume gluten-free means folic-acid-free: Gluten-free products can still have vitamins added, so check the label.
• Think beyond bread: Breakfast doesn’t have to mean toast or cereal. Eggs, yoghourt, oats, nuts, seeds and fruit can all form part of breakfast.
• Use naturally folate-rich foods: Leafy greens, broccoli, asparagus, avocado, beans, lentils, chickpeas, eggs, and liver provide naturally occurring folate rather than added folic acid.
• Bake differently: Oat, buckwheat, rye and other flours can reduce reliance on refined white wheat flour, but again, check the individual product label.
• Avoid supplements that contain folic acid 

Don’t want added folic acid, but still want flour?

If you would prefer to avoid foods containing added folic acid, it doesn’t necessarily mean giving up bread, flour or grains. It does, however, mean becoming a little more label-savvy. Look for:

• 100% wholemeal wheat flour and breads made from 100% wholemeal flour, rather than simply looking for the word ‘wholegrain’
• Alternative wheat species, such as spelt, einkorn, emmer and khorasan
• Non-wheat flours and grains, such as rye, oats, buckwheat, rice, quinoa and maize
• Flour produced by small mills that are exempt from mandatory fortification
• Bread from independent or artisan bakeries that can confirm they use unfortified flour
• Or make your own bread using flour you have verified does not contain added folic acid

Don’t be fooled by the packaging. Organic, artisan, and sourdough do not automatically mean folic acid-free. A beautiful organic sourdough can still be made from fortified non-wholemeal wheat flour.

So, if avoiding added folic acid matters to you, check the ingredients rather than the marketing on the front of the packet.

And if you want to read more, Prior’s Flour explains the changes to UK flour fortification, why some small traditional mills are exempt, and how they continue to produce flour without added folic acid.  Read more HERE

If you are aware of more small traditional mills that do not use folic acid, do drop us a line HERE so we can add them to this newsletter.

Remember, ‘folate’ and ‘folic acid‘ are NOT interchangeable on a label. If your aim is specifically to avoid synthetic folic acid, that’s the ingredient to avoid.

Avoiding folic acid doesn’t mean avoiding folate. Folate is an essential B vitamin, and the aim should be to maintain a folate-rich diet even if you personally choose not to consume foods fortified with folic acid.

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