A study has shown that high levels of vitamin B3, which is added to breads and cereals and is a requirement by the UK government to be added to white and brown bread, is associated with a greater risk of strokes and heart attacks. Also known as niacin, this vitamin is used to fortify many breakfast cereal products and has previously been recommended to lower cholesterol, although some health experts dispute whether lowering cholesterol is beneficial to health.
The main takeaway is not that we should cut out our entire intake of niacin, but a discussion over whether a continued mandate of flour and cereal fortification with niacin could be warranted.
The Bread and Flour Regulations of 1988 lay down labelling and compositional standards for bread and flour, and specify that four vitamins and minerals must be added to all white and brown flour—calcium, iron, thiamine (Vitamin B1) and niacin, with folic acid set to be added soon. Wholemeal flour is exempt from these regulations as the wheatgerm and bran from the grain included in the final flour are natural sources of vitamins and minerals. There is no legal requirement to bolster breakfast cereals with vitamins and minerals, but makers can voluntarily do this in line with government guidelines, and manufacturers often market their products as being “fortified.”
It is a legal requirement to fortify all white flour sold in the UK with niacin, and the amount that must be added was increased by the government in 2022, with the policy expected to come into effect later this year, once the formal process of notifying the World Trade Organisation and EU Commission has been completed.
Many countries other than the UK mandate the supplementation of niacin in certain foods, as well as the addition of other vitamins and folic acid, which is said to prevent birth defects, although some studies have suggested there could be risks to high folate levels. However, niacin deficiency is rarely seen in developed countries, and it is generally associated with poverty, malnutrition, or malnutrition secondary to chronic alcoholism.
It’s thought that everyone’s tolerance for niacin is slightly different and that excess niacin can be expelled in the urine, but overdoses can also cause flushing and liver damage. Niacin used to be prescribed in high doses to individuals with high cholesterol levels, but even though it lowered cholesterol, it didn’t lower the risk of heart attack or stroke.