From Portugal to Russia, Europe is often viewed as a more developed part of the world where the clinical signs of vitamin and mineral deficiencies are not prevalent. In reality, however, certain countries in this region are still characterized by deficiencies at a level of public health significance which deserve attention.
Wheat is the most commonly consumed grain in this region. Using wheat flour as the main food vehicle for fortification is especially appropriate for Europe given high regional consumption of bread and pasta. In addition, common fortification challenges in other regions, such as an abundance of small mills and an underdeveloped transportation infrastructure, are not evident here.
About 4500 pregnancies in the European Union are affected by a neural tube defect every year. A paper published in 2015 said, 'Europe has an epidemic of spina bifida and anencephaly (two types of neural tube defects) compared with countries with mandatory folic acid fortification policy.'
In the European Union, an estimated 72% of affected pregnancies are terminated. For more information on how fortifying flour could be used to prevent these birth defects see the following three documents:
In Switzerland, about 250 food products are voluntarily fortified with folic acid said, Erich P. Meyer, one of the founders of a national campaign to increase awareness about the need for folic acid intake. The campaign is focused on a website and an annual magazine. In 1999, 38% of the Swiss population said they were aware of the importance of folic acid; that had increased to 75% by 2011.
“We are well aware of the fact that we will never be able to reach the same level of results with our campaign as any mandatory fortification would achieve,” Meyer said. “However we believe that what we do is the best we could do.”
In Europe, we frequently collaborate with two key partners - the International Federation for Spina Bifida and Hydrocephalus (IF) and UNICEF. Both entities have significant experience and knowledge related to country-specific flour fortification efforts in the region.