Food fortification isn’t new. We’ve all been eating bread fortified with iron, calcium, and vitamins B1 and B3 for decades.

Margarines are fortified with vitamins A and D, to make them closer nutritionally to butter. And baby milk is also fortified with the same two vitamins.

These are simply the mandatory fortifications. Many other foods have goodies added by manufacturers voluntarily because they believe that they enhance their value.

So anybody arguing that mandatory fortification of food is a breach of human rights has to acknowledge that it is a breach long established by tradition.

There are also some fortunate areas whose water is fortified by fluoride, protecting local children’s teeth. Rotten teeth are inversely correllated with the presence of fluoride.

The Government has refused to become engaged in the debate. This is a pity, because fortification and fluoridation are the simplest and cheapest ways of improving the health of the very people the Government is most anxious to help.

Healthy eating messages tend not to reach the poor. But water and white bread do. So fortifying them with additives that improve health works as no other measure can. But there is still a conflict between personal autonomy and social responsibility, as a report carried out for the FSA by the Institute for Science and Society at Nottingham University makes clear.

Fortification – and, even more strongly, fluoridation – is an attack on autonomy. It diminishes an individual’s right to retain control over decisions about his own health. So a balance has to be struck. The FSA voted yesterday for mandatory fortification. Ministers will now have to decide whether to follow this advice.

Ten years after the US began fortifying its food with folic acid, we have yet to make up our minds. Sometimes temporising can be justified, but in this case it is simply evidence of indecision and lack of leadership.

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