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Nutrition and Health
Series Editor: Adrianne Bendich

Victor R. Preedy
Rajaventhan Srirajaskanthan
Vinood B. Patel Editors

Handbook of Food
Fortification and
Health
From Concepts to Public Health Applications
Volume 2
 Nutrition and Health Series
Adrianne Bendich, PhD, FACN, FASN, Series Editor

For further volumes:

http://www.springer.com/series/7659
Victor R. Preedy • Rajaventhan Srirajaskanthan
Vinood B. Patel
Editors

Handbook of Food Fortification

and Health
From Concepts to Public Health Applications
Volume 2
Editors
Victor R. Preedy, PhD Rajaventhan Srirajaskanthan, MD
Department of Nutrition and Dietetics Department of Gastroenterology
Diabetes and Nutritional Sciences University Hospital Lewisham
School of Medicine London, UK
King’s College London
Department of Gastroenterology
London, UK
King’s College Hospital
London, UK
Vinood B. Patel, BSc (Hons), PhD
Department of Biomedical Sciences
School of Life Sciences
University of Westminster
London, UK

ISBN 978-1-4614-7109-7 ISBN 978-1-4614-7110-3 (eBook)

DOI 10.1007/978-1-4614-7110-3
Springer New York Heidelberg Dordrecht London

Library of Congress Control Number: 2013940062

© Springer Science+Business Media New York 2013

This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned,
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The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even
in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and
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While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors
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Printed on acid-free paper

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Springer is part of Springer Science+Business Media (www.springer.com)
Preface

In this book the Editors aim to disseminate important material pertaining to the fortification of foods
from strategic initiatives to public health applications. It covers (in two volumes) policy, preclinical
studies, clinical investigations, and the impact of fortification on the individual and whole communi-
ties. The importance of food fortification relates to the fact that optimal nutritional intake is an essen-
tial component of health and well-being. Unfortunately, situations arise on a local or national scale
when nutrient supply or intake is deemed to be suboptimal. As a consequence, ill health occurs, for
example, neural tube defects in the developing fetus, organ damage in adults, or increased rates of
premature deaths. In terms of public health, malnutrition due to micronutrient deficiency can be quite
profound, imposing economic and social burdens on individuals and whole communities. The com-
plex inter-relationship between poor health outcomes and nutrient delivery can, however, be modu-
lated by appropriate food fortification. Thereafter issues arise as to the efficacy of food fortification,
what strategies should be employed and what nutrients to add. The food carrier is also important, as
well as its stability. Ethical issues also arise, and the concept of potential harm also needs to be
addressed in terms of cost-benefits. All of these aspects, and many others, are covered in The Handbook
of Food Fortification: From Concepts to Public Health Applications.
This comprehensive text examines the broad spectrum of food fortification in all its
manifestations.
The term fortification has multiple meanings and is often used synonymously in relation to the addi-
tion of any component to food to facilitate a nutritional advantage. In this book we cover fortification not
only in terms of its more strict definitions, in terms of the addition of micronutrients, i.e., minerals and
vitamins, but also within the context of its wider and holistic applicability. The book thus recognizes the
international differences in definitions and usage of fortification. At the same time we also include chap-
ters on novel fortificants that are contained within more complex food matrices. However, whilst some
micronutrients are permitted fortificants in one country, their inclusion in some foods may be prohibited
or at the “discussion” or pre-legislative stage in another country. These complexities in terminology are
recognized by the Editors. In all there are two volumes with eight main parts, namely:

Volume 1

Part I: Introductory Chapters and Perspectives of Fortification

Part II: Iron Fortification
Part III: Fortified Foods and Beverages
Part IV: Biofortification: Biological Modes of Enhancing Nutrient Intake

v
vi Preface

Volume 2

Part I: Novel Food Vehicles and Agents for Fortificants

Part II: Impact on Individuals
Part III: Public Health, Concepts and Issues
Part IV: International Perspectives
Key features within each chapter include key points and, where relevant, guidance on safe levels
and recommendations.
The Handbook of Food Fortification: From Concepts to Public Health Applications represents a
multidisciplinary approach to food fortification and is written by many authoritative individuals, from
centers and institutions around the world. It is designed for nutritionists, dietitians, medical practitio-
ners, educationalists, health experts, epidemiologists, and other health-related professionals. It is also
suitable for students, graduates, postgraduates, researchers, lecturers, teachers, and professors.

London, UK Victor R. Preedy, PhD

Rajaventhan Srirajaskanthan, MD
Vinood B. Patel, BSc (Hons), PhD
Series Editor Page

The great success of the Nutrition and Health Series is the result of the consistent overriding mission
of providing health professionals with texts that are essential because each includes (1) a synthesis of
the state of the science, (2) timely, in-depth reviews by the leading researchers in their respective
fields, (3) extensive, up-to-date fully annotated reference lists, (4) a detailed index, (5) relevant tables
and figures, (6) identification of paradigm shifts and the consequences, (7) virtually no overlap of
information between chapters, but targeted, inter-chapter referrals, (8) suggestions of areas for future
research, and (9) balanced, data-driven answers to patient as well as health professionals’ questions
which are based upon the totality of evidence rather than the findings of any single study.
The Series volumes are not the outcome of a symposium. Rather, each editor has the potential to
examine a chosen area with a broad perspective, both in subject matter as well as in the choice of
chapter authors. The editor(s), whose training(s) is (are) both research and practice oriented, have the
opportunity to develop a primary objective for their book, define the scope and focus, and then invite
the leading authorities to be part of their initiative. The authors are encouraged to provide an overview
of the field, discuss their own research, and relate the research findings to potential human health
consequences. Because each book is developed de novo, the chapters are coordinated so that the
resulting volume imparts greater knowledge than the sum of the information contained in the indi-
vidual chapters.
The Handbook of Food Fortification: From Concepts to Public Health Applications edited by
Professor Victor R. Preedy, PhD, DSc, FRIPH, FRSH, FIBiol, FRCPath, Professor Rajaventhan
Srirajaskanthan, BSc (Hons), MD (Res), MRCP, and Vinood B. Patel, PhD, clearly exemplifies the
goals of the Nutrition and Health Series. The major objective of this comprehensive two volume text
is to review the growing evidence that food fortification has a major role in assuring adequate intake
of the essential nutrients. Fortification also serves as an important vehicle for introducing newer bio-
active components of food, such as carotenoids, into the diet of a population. This volume includes 63
up-to-date informative reviews of the current major fortification programs underway around the world
and examines the consequences of the programs. Practicing health professionals, researchers, and
academicians can rely on the chapters in this volume for objective data-driven sources about essential
vitamins and minerals, proteins and fats as well as other dietary components that have been included
in basic food sources. This new comprehensive review of the science behind the fortification strate-
gies that help to assure the health of the populations at risk by providing essential nutrients is of great
importance to the nutrition community as well as for health professionals who have to answer patient,
client, or graduate student questions about the newest clinical research in the nutritional effects of
food fortification.
The Handbook of Food Fortification: From Concepts to Public Health Applications represents
the most comprehensive compilation of the recent data on the actions of specific essential nutrients

vii
viii Series Editor Page

and bioactive dietary components in at risk populations around the globe. It is to the credit of
Drs. Preedy, Srirajaskanthan, and Patel that they have organized this volume so that it provides an
in-depth overview of the critical issues involved in the determination of the best fortification strate-
gies for infants, toddlers, school-age children, and adult populations, whether they were born in
developing nations or in developed nations. The volumes’ editors provide their in-depth knowledge
and expertise to help the reader to understand the value of food fortification. Professor Preedy is a
senior member of King’s College London where he is a Professor of Nutritional Biochemistry and is
also a Professor of Clinical Biochemistry at King’s College Hospital. He is also Director of the
Genomics Centre and a member of the School of Medicine. He is a member of The Royal College of
Pathologists, a Fellow to The Institute of Biology, The Royal College of Pathologists, The Royal
Society for the Promotion of Health, The Royal Institute of Public Health, The Royal Society for
Public Health, and in 2012 a Fellow of The Royal Society of Chemistry. Professor Srirajaskanthan
is a consultant gastroenterologist at University Hospital Lewisham and Kings College Hospital,
London. He trained at the prestigious Guy’s, King’s and St. Thomas’ Medical School where he
obtained his MD (MBBS) and a B.Sc. in Neuroscience. He is a member of the Royal College of
Physicians. His specialist training includes Gastroenterology, Hepatology, and Internal Medicine.
Dr. Patel is a Senior Lecturer in Clinical Biochemistry at the University of Westminster and honorary
fellow at King’s College London. Dr. Patel obtained his degree in Pharmacology from the University
of Portsmouth, his PhD in protein metabolism from King’s College London and completed postdoc-
toral research at Wake Forest University School of Medicine.
Each of the two volumes contains about 30 comprehensive chapters. The first volume contains four
related parts. The first part provides an overview and perspective on national and international
fortification strategies and policies. Five chapters examine the complexities of developing fortification
initiatives and use examples of successful and not so successful fortification programs. The first chap-
ter presents a new attempt to provide blueprint for global flour fortification with essential nutrients for
countries with major population groups at risk for micronutrient deficiencies. The Flour Fortification
Initiative (FFI) goal is to provide a flour fortification standard milling practice throughout the world.
The focus is wheat and maize flours. The FFI model is based upon engaging partners in the public,
private, and civic sectors. The chapter uses the example of how countries began fortifying flour with
folic acid to prevent birth defects to illustrate the public-private-civic sector collaboration involved in
flour fortification.
Micronutrient fortification of staple foods had been in place for decades before the understanding
of the role of folic acid in birth defect prevention was confirmed in clinical trials. The historic perspec-
tive and current fortification programs in both developing and developed nations are examined in the
next chapter. Clear definitions of terms, tables that include the countries with mandatory fortification
programs, details concerning the concentration of micronutrients used in fortification, as well as a
review of the positives and negatives of using food fortification to improve nutrient status are included.
The following chapter examines the critical need for fortification of foods provided to the neediest
populations that are consuming foods provided for humanitarian relief. Humanitarian food aid involv-
ing global food assistance utilizes organizations including the United Nations Food and Agricultural
Organization (FAO), World Food Program (WFP), and the Food for Peace Act (FFP). WFP reported
that over 5,000,000 metric tons of food aid was distributed to humanitarian relief efforts in 2010. The
chapter includes data on diverse foods provided and the micronutrients included in the major humani-
tarian food programs. Food fortification programs in the Middle East are described in the next chapter
that examines the vast diversity in the economic status of the 20+ countries included in the term
“Middle East.” The chapter examines the difficulties in reaching relatively small populations within
wealthy nations that may benefit from foods fortified with micronutrients and uses national programs
of flour fortification with iron as an example. Currently, ten countries in the Middle East do not have
a mandatory flour fortification program in place. The last chapter in this part describes the historic
development of fortification practices in Canada and begins with the establishment of mandatory
Series Editor Page ix

uniform iodine fortification in 1949 after more than 2 decades of voluntary fortification initiatives
across the country that used different concentrations of iodine. In contrast to the United States that
mandated flour fortification with certain B vitamins and Iron in the early 1940s, Canada did not have
mandatory flour fortification until 1976. Canada continues to examine its fortification policies espe-
cially with regard to voluntary food fortification initiatives.
The second part contains six chapters on national programs to implement iron fortification of sta-
ple foods and water. The chapter authors remind us that there may not be one mechanism that can
provide iron to all populations at risk. Food fortification is a major source of iron for millions of ane-
mic infants, children, and women worldwide. The six chapters are devoted to reviewing the multiple
foods and iron compounds that have been used to enhance iron status in at risk populations. Iron has
a complex chemistry as well as metabolism and reactions are dependent upon pH, potential oxidation,
competition for other minerals, and presence of food components that can block or enhance its absorp-
tion. Because of these issues, and the fact that population groups consume different staple foods,
many foods have been considered for iron fortification. For example, soy sauce in China, tonyu in
Japan, and Nuoc-mâm (fish sauce) in Vietnam has been successfully used to reduce iron deficiency.
As dairy products are widely consumed in Europe and North America, the next chapter considers the
pros and cons of fortifying dairy products and milk with a number of potential iron fortificants.
Another chapter describes the use of parboiled rice to deliver both iron and zinc. Fortification of
iron and zinc in the parboiling process increased iron and zinc concentrations, especially in polished
rice where most of iron and zinc is usually removed during milling. Parboiled rice is produced on
industrial scale and traded globally. It is commonly consumed in South Asia and Africa where iron
and zinc deficiencies are widespread. Iron and zinc deficiencies have been estimated to affect 70–95 %
of the population in Asia. There is also a chapter that describes the benefits of fortifying millets with
iron and zinc. Millets are used chiefly as food grains in Africa, Eastern Europe, China, India, and other
Asiatic countries. Finger millet, sorghum, and pearl millet are widely grown and consumed as the
staple in several parts of India. The beneficial effects of fortifying millets for Indian populations are
described. There is also a chapter on the clinical finding from experiments with iron fortification of
drinking water that seem quite promising.
Many iron compounds are used as food fortificants. These must meet the requirements of high iron
bioavailability, inertness in relation to the sensorial properties of the fortified food, absence of toxicity,
resistance during storing or processing of the fortified food, and have a bioavailability similar to that
found with naturally occurring iron in food. Two chapters describe specific sources of iron. One of the
possible newer salts of iron that has been used to fortify food is ferric pyrophosphate and is described
in the next chapter. Ferric pyrophosphate is a poorly soluble iron compound that does not change orga-
noleptic properties of foods even when used in many difficult-to-fortify food vehicles. Reduction in the
particle size of this iron salt has greatly increased its bioavailability. The second chapter describes the
benefits of heme iron. Heme is a biologically important source of dietary iron because of its significantly
greater bioavailability compared to non-heme iron sources. Dietary heme sources include foods con-
taining myoglobin and hemoglobin such as meats, fish, and poultry. The positives and negatives of
using heme iron as a food fortificant are described. Several studies have evaluated fortification with
heme iron in different foods using biscuits, cookie fillings, weaning foods, flour, and black beans.
The third part of this volume contains 11 chapters that describe fat-soluble and water-soluble
essential nutrients that are used in a number of food matrices to enhance the dietary intakes of these
nutrients. Fats used as vehicles for fortification include margarine, fat spreads, cooking oils, eggs, and
dairy products. Dairy products are also used as vehicles for minerals and other water-soluble nutri-
ents. Both cow milk and soy milk products are described; commonly used fortificants include cal-
cium, zinc, iron, iodine, and selenium. The critical issues of maintaining safe doses of minerals and at
the same time assuring the palatability of the fortified milk products are discussed in each chapter.
Other dairy-based foods that have been fortified with fat-soluble vitamins and certain minerals include
cheeses, yogurt, fermented milk products, butter, and cream.
x Series Editor Page

Additionally, corn, rice, noodles, water, and salt are reviewed as sources of added nutrients for at
risk populations. Corn fortification is reviewed and indicates that it is an excellent vehicle for deliver-
ing iron, folic acid, zinc, copper, vitamins B1 and B2, and calcium. Rice, flours, and noodles have also
been used to fortify their levels of folic acid and other B vitamins, and at times, vitamin C. Salt has
been used as a carrier for iodine for almost 100 years and continues to be a well-accepted food source
for reducing iodine deficiency disorders in at risk nations. Two detailed chapters review the biological
effects of deficiencies, the choices of each fortificant and types of salts used for fortification, the com-
plexities of maintaining the concentrations of this fortificant, assessment of bioavailability, and clini-
cal studies of efficacy.
Margarines and fat spreads have delivered vitamins A and D in certain developed nations for more
than 50 years and have also been used successfully in underdeveloped countries. Vegetable oils are
also suitable vehicles for fortification with the fat-soluble vitamins A, D, and E. The fat-soluble vita-
mins form a true solution and are uniformly distributed in vegetable oils. The stability of vitamin A is
greater in oils than in any other food, and oil facilitates the absorption of vitamin A by the body. There
is a separate chapter devoted to the value of fortifying vegetable oils with vitamin A and the other fat-
soluble vitamins. Newer fortificants in fats include n-3 fatty acids, plant sterols, vitamin E, vitamin C,
and carotenes as well as iodine. A new potential fortificant is also described in a separate chapter.
Conjugated linoleic acid (CLA) is a mixture of isomers of the essential fatty acid, linoleic acid. CLA
is mainly found in food products from ruminants such as dairy products and beef. CLA is a major fat
in milk fat. The reason that CLA is considered as a fortificant for nondairy sources is that recent
research studies have reported anticarcinogenic, antiatherogenic, antioxidative, and immune system
enhancement as well as reduction of body fat. Preliminary clinical studies are reviewed.
Enhancing the efficiency of plants to concentrate nutrients essential for human life through selec-
tive breeding is called biofortification. The uptake of certain minerals by plants is usually controlled
by several genes. Choosing plants that contain higher than normal levels of the desired mineral and
using the seeds of these plants for cultivation of the next generation can result in more uniform higher
levels of this mineral in subsequent generations. Biofortification through genetic engineering of staple
foods is a new and important avenue for fortifying staple foods. Rice, corn, and carrots have been
successfully enriched with essential nutrients and carotenes. Biofortification studies of the enhance-
ment of selenium levels in lentils are described specifically in a unique chapter. A second unique
chapter describes the biofortification of eggs with tocotrienol and tocopherol, vitamin E sources, by
feeding the egg laying hens with a diet high in tocotrienols and tocopherols in rice bran oil.
The fourth part, entitled Biofortification: Biological Modes of Enhancing Nutrient Intake, con-
tains seven chapters that include discussions of genetic modifications to rice, corn, wheat, and sweet
potatoes. Traditional breeding methods alone may not be a valid option for grain biofortification due
to low levels of genetic variability for mineral uptake into the edible portions of the plant. Gene
technology can enhance micronutrient concentrations in many grains. These chapters include detailed
descriptions of the genetic vectors used to deliver new codings for mineral binding proteins, trans-
porters, and other mechanisms to significantly enhance the concentration as well as the bioavailabil-
ity of the essential nutrient. Examples reviewed include the successful biofortification of rice with
vitamin A, iron, zinc, folic acid. Unlike minerals that are available in the soil, plants must synthesize
vitamins, and several genes are involved in the synthesis of any vitamin. Thus, the complexity of
inserting all of the genes required for the synthesis of folate, as an example, and assuring that the
biochemical reactions occur in the right order and in the right place within the plant cell, is monu-
mental. Plant scientists have, in fact, been able to biofortify rice so that its concentration of folate is
significantly greater than seen with traditional breeding programs. Biofortification of corn, using
genetic engineering, has resulted in significantly increased concentrations of beta carotene (provita-
min A), folate, vitamin E, and ascorbic acid (vitamin C) as described in another chapter. The chapter
includes a detailed description of the newest genetically engineered multivitamin corn. Another
chapter describes the processes used to affect the selenium content of wheat agronomic biofortification
Series Editor Page xi

which involves fertilizing the growing crop with the micronutrient, which the plant converts to sev-
eral organic Se forms, notably selenomethionine, which are more suitable for human consumption.
As exciting as the new genetic engineering research is to the scientific community, there may be
many barriers to consumer and national acceptance of these new fortified products. The chapter on
the potential benefits and risks of adopting folate fortified rice in Chinese communities is explored
in a fully tabulated chapter. In a complementary chapter, there is an insightful discussion of the
introduction of orange sweet potatoes in sub-Saharan Africa where the usual sweet potato was white
and lacked any carotenoid content. The linking of agriculture to nutritional content of a staple food
is reviewed. This part also contains a unique chapter that reviews the nutritional content of gluten-
free foods and tabulates the essential micronutrient levels in many gluten-free products. The chapter
includes a detailed discussion of the importance of biofortification in enhancing the micronutrient
content of grains used in these products.
The second volume of The Handbook of Food Fortification: From Concepts to Public Health
Application emphasizes the clinical and public health consequences of fortification programs. The
four parts in this volume include chapters devoted to novel food vehicles and agents for fortification;
the impact of fortification on different population groups and individuals; public health concepts and
issues and finally, a critical part on international perspectives. The first part contains ten chapters that
explore the potential for fortifying staple foods and commonly consumed foods including eggs, meats,
yogurt, cheese, fish and fish sauces, and drink products with essential micronutrients as well as fiber
and n-3 fatty acids. There is a strong rationale presented for using eggs as vehicles for fortification.
Fortified eggs combine an important animal food that naturally contains high quality protein and
amino acids, fats and essential fatty acids, and certain vitamins and minerals, with a unique capacity
to be fortified with added essential nutrients and phytonutrients and effectively deliver these with high
bioavailability. Nutrients discussed included iodine, selenium, zinc, iron, copper, manganese, chro-
mium, fat and water-soluble vitamins and carotenoids, choline, and long chain n-3 fatty acids that are
provided to the hens for transfer to the eggs. New fortificants for cheeses and new technologies to
incorporate these into cheese products are included in another chapter. Microencapsulation, emul-
sions and gel particles, and immobilization on polymeric complexes have permitted the addition of
probiotics, essential micronutrients, polyphenols, and carotenoids to be incorporated into cheeses.
Other commonly consumed foods consumed daily (mainly in Asia) include fish sauce and soy sauce.
In certain nations, there is mandatory fortification of these sauces with iodine. Currently, incentives
are underway to also fortify with iron compounds to further enhance the nutritive value of these
sauces as described in a separate chapter.
Ocean fish are an important source of long chain n-3 fatty acids; however farmed fish require
sources of n-3 fatty acids in their diets to be able to incorporate these oils into their muscle tissues.
New sources of n-3 fatty acids for farmed fish and enhanced production practices to assure decreased
risk of oxidation are reviewed. Enhancement of long chain n-3 fatty acids in feeds has been under-
taken with ruminants including beef cattle and lambs, pork, and poultry. The risks and benefits of
these fortification strategies are discussed in a separate chapter. Another opportunity to deliver long
chain n-3 fatty acids to the diet, especially for individuals who do not consume fish, is the develop-
ment of n-3 fortified beverages. The technological issues as well as the clinical evidence of efficacy
are discussed in a new meta-analysis of published data found in systematic review included in this
part. Beverages that were fortified include cow and soy milks, fruit and vegetable juices, and drinks.
Four chapters describe the use of waste and/or by-products from commercial production of pro-
cessed foods for the development of excellent sources of missing nutrients in relevant populations.
Examples of novel source of nutrients, polyphenols, and fiber are discussed. The term “apple pomace”
refers to the left-over solid biomass after extraction of juice from fresh apple fruits and this product is
being used in baked goods and other applications. Bovine lung is the second example of a waste product
from cattle slaughtering that is being used to successfully fortify iron levels in processed ready-to-eat
foods for anemic children. Date fiber is a by-product of date syrup production and this has been
xii Series Editor Page

incorporated into yogurt to add further value to this important staple food. Evaporated sugarcane
juice, unlike refined sugar, is an important source of bioavailable iron. This by-product has been used
as a natural sweetener for fruit juices and preliminary clinical studies reviewed in the chapter suggest
that this fortificant is beneficial in anemic children.
The second part in this volume contains seven chapters that examine the effects of fortified food in
specific populations including pregnant and lactating women, preterm infants, preschool and school-
age children, postmenopausal women, and elderly living in nursing homes. A well-referenced litera-
ture review confirms that micronutrient fortified foods and beverages provided during pregnancy
improved micronutrient status and reduced anemia rates in women. Also, micronutrient fortified
foods, when combined with energy and essential fatty acids, resulted in improved pregnancy out-
comes including increased birth weight and length. In addition, multiple micronutrient fortified foods
combined with additional calories and essential fatty acids modestly improved the growth of infants
and improved iron and vitamin A, but not zinc status. The effects on child development were incon-
sistent. One study reported an unexpected negative impact of fortification on morbidity. Malnutrition
is often seen in school-age children in undeveloped communities. Two controlled studies are reviewed
and confirm that intervention with a fortified lunch meal can improve iron and riboflavin blood levels
in one study, and improved blood levels of many micronutrients when a multiple micronutrient pow-
der was mixed with the food before cooking. Iodine deficiency is associated with significant declines
in cognitive function in growing children. Fortification of foods with iodine and other micronutrients
including iron was shown to enhance cognitive functions and school testing results in studies reviewed
in another chapter in this part.
An even more at risk population for inadequate nutrient intake than young children are those that
are born preterm. Moreover, human milk is an inadequate source of protein and minerals for the grow-
ing preterm infant. Neither human milk from a woman who has given birth prematurely nor human
milk from a woman who has had an infant born at term is sufficient to provide all the nutritional needs
of the preterm infant. Thus, human milk for the preterm infant is usually supplemented or fortified
with additional protein, sodium, phosphate, calcium, magnesium, copper, zinc, and many vitamins
(B2, B6, C, D, E, K, folic acid).
Another population group at risk for malnutrition is the elderly who are hospitalized or in nursing
homes. Fortified foods and beverages are helpful in providing opportunities to enhance the nutritional
status of these populations who are capable of consuming oral diets. One of the key nutrients that is
often low in serum of immobile elderly is vitamin D. With lack of exposure to sunlight, there is a
reduced ability to produce cutaneous vitamin D. This chapter reviews the other factors that can result
in low vitamin D status including limited dietary intake, intestinal absorption, and kidney capacity to
convert vitamin D to its active form. Fortification of bread with calcium and vitamin D enhanced
blood levels of vitamin D and improved markers of bone health. Similarly, in a separate study reviewed
in the next chapter, fortification of milk with calcium and vitamin D significantly enhanced bone
mineral densities in elderly women.
The third part in the second volume examines the rationales used to implement food fortification
strategies as public health interventions. Six chapters examine global as well as recent national initia-
tives to fortify foods with folic acid, vitamin B12, vitamin D, and other key nutrients. The first chapter
in this part provides a broad overview of the requirements for consideration of beginning a new
fortification program and also includes an in-depth analysis of potential barriers to adopting a food
fortification program nationally. There is a unique chapter that examines the complexities involved
with development and monitoring of a fortification program from regulatory perspective. There is a
comprehensive explanation of the risk analysis process. One chapter reviews the overall use of folic
acid fortification globally: 66 countries (one-third of the world’s nations) have recommended manda-
tory folic acid fortification. Wheat or maize flour, and/or flour products such as noodles or pasta, are
the food vehicles of choice used by all countries. Additional vehicles include rice and milk. Two
chapters discuss the national strategies undertaken to fortify flour and/or other grains and foods with
Series Editor Page xiii

folic acid for prevention of neural tube birth defects. In Canada, the fortification program resulted in
significant decreases in these birth defects as well as other benefits to infants as well as adults. It is
well recognized that higher than normal folate status can block certain of the signs and symptoms of
vitamin B12 deficiency. The chapter on vitamin B12 provides cogent, well-referenced arguments for
consideration of food fortification with vitamin B12 in addition to folic acid fortification.
The final part of the second volume examines the current international perspectives concerning
fortification and its consequences. Of great importance is the consistent lack of essential vitamins and
minerals in infants, and young children under 2 years of age, women of childbearing potential and
elderly populations. The following chapters provide perspectives of ways that nations cope with mal-
nutrition and the timeframe of adoption of mandatory food fortification programs in developed as well
as developing nations. Country programs from Oman, Vietnam, Pakistan, Australia, India, Brazil, and
Nigeria are included. There is also a concluding chapter that summarizes the current state of food
fortification programs. It is important to note, as described in the chapter, that Oman was the first
country in the Middle East to make fortification of flour with folic acid a national compulsory legisla-
tion in 1996. Iron was also added to flour. Although there was an 80 % decrease in neural tube birth
defects following fortification, anemia levels in preschool children remained above 10 %. However,
a partial explanation may be that 9.5 % of the children suffered genetic hemoglobinopathies associ-
ated with anemia. Anemia is a serious problem for Brazilian children. In Brazil, mandatory addition
of iron (30 % recommended nutritional intake (RNI) or 4.2 mg/100 g) and folic acid (70 % RNI or
150 mg) to milled wheat and corn flour was implemented in 2001. The core objective of increasing the
accessibility of milled cereal grains with iron and folic acid is to reduce the prevalence of iron-
deficiency and neural tube defects in Brazil. Iron-fortified water and orange juice are being explored
as alternative vehicles to reduce iron deficiency in Brazil. Nigeria also has a significant issue of child-
hood anemia. Nigeria is one of ten countries in the world with the largest number of underweight
children, with an estimated six million children under five who are underweight. Micronutrient
deficiency is a direct cause of child morbidity and mortality. Micronutrients such as iron, iodine, vita-
min A are missing in children’s diets and 40 % of Nigerian pregnant mothers did not take any iron
tablets, a recommended supplementation during pregnancy. It appears that a number of processed
foods voluntarily add iron and other essential nutrients whereas mandatory programs do not appear to
be in place.
A number of countries continue to have relatively high levels of childhood malnutrition. A recent
survey on nutritional status of women and young children carried out in 2010 in randomly selected
provinces in Vietnam confirmed that about 30 % of children under 2 years of age were stunted, 10 %
were underweight, 2 % were wasted. In addition, about 15 % of children under 2 years of age had
anemia. Moreover, 3 % had zinc deficiency, 12 % had vitamin A deficiency, and 50 % had marginal
vitamin A status, almost 60 % had vitamin D deficiency and over 98 % had mild hypocalcaemia.
Programs undertaken to provide a micronutrient fortified cereal as a complementary food for young
children has resulted in a decrease in the number of malnourished children as well as increases in
growth. Pakistan also has a significant number of children that suffer from iron and vitamin A
deficiency. However, due to its geographical position, there is also a very high incidence of iodine
deficiency and folate deficiency seen in women of childbearing potential. Salt fortification with iodine
has increased over the past years and the hope is that 100 % of salt in Pakistan will contain iodine by
2013. New programs are being initiated with the primary goal of reducing the prevalence of iron-
deficiency anemia among preschool children from 30 to 10 %, and in women of reproductive age
from 50 to 18 %, and half the occurrence of neural tube defects among newborns from 0.4 to 0.2 %
of live birth, through universal fortification of wheat flour with iron and folic acid. Indonesia also has
a significant number of children with micronutrient deficiencies. Food fortification in Indonesia was
initiated in 1994 with mandatory fortification of iodized salt. In 1997 trials on wheat flour fortification
with iron, zinc, folate, vitamins B1 and B2 were started and as a result wheat flour fortification
became mandatory in 2001. In 2011, vitamin A fortification in cooking oil was encouraged as a
voluntary fortification.
xiv Series Editor Page

Since 2001, India has implemented a school feeding program in all public primary schools. Under
this program, commonly known as the “midday meal” scheme, primary schoolchildren receive free
lunch meals, cooked and served at school for at least 200 days in a school year. In most States, the
program has a standardized menu that consists mainly of rice and dhal (sauce prepared using pulse/
lentils) or vegetables. A micronutrient intervention study in Himalayan villages in India was imple-
mented and described in a separate chapter. The 8 month study of the intake of the micronutrient
fortified food by schoolchildren was associated with significant improvements in vitamin A, folate,
and vitamin B12 status as well as significant improvements in iron status but not hemoglobin levels
or reductions in anemia. Although India is a sun-rich country, vitamin D deficiency has been reported
in all age groups from pregnancy to late adolescence. Vitamin D deficiency is often accompanied by
low calcium intakes. Reasons for this deficiency include cultural as well as genetic issues. Very few
foods are fortified with vitamin D in the Indian market, and these are not commonly consumed. As
there is very little vitamin D in Indian children’s diet, providing vitamin D through supplementation
or fortification to vulnerable groups may be the strategy of choice.
The historical account of the move from voluntary folic acid fortification of flour to mandatory
fortification in 2007 in Australia is very informative, especially as Australian researchers provided
seminal data showing the value of folic acid for neural tube birth defect prevention. The range of
programs, initiatives, and resources available to nations and communities to help implement
fortification programs is vast. The last chapter in the second volume provides readers with web
addresses to hundreds of resources.
The logical sequence of the parts in each volume as well as the chapters within each part enhances
the understanding of the latest information on the current standards of practice in food fortification in
different countries around the world. This comprehensive two volume resource has great value for
academicians involved in the education of graduate students and postdoctoral fellows, medical stu-
dents, and allied health professionals and public health nutritionists who plan to interact with popula-
tions at risk for macro and/or micronutrient deficiencies.
The volume contains over 400 detailed tables and figures that assist the reader in comprehending
the complexities of food technology, biological mechanisms of metabolism of essential nutrients,
composition of human breast milk compared to the needs of the preterm infant, sources of infant and
childhood nutrition as well as nutrition requirements through the lifespan for males and females.
There are in-depth discussions of the biological significance of the microbiome and its importance in
maintaining growth and health. The overriding goal of this volume is to provide the health profes-
sional with balanced documentation and awareness of the newest research and fortification approaches
including an appreciation of the complexity of the interactions between genetics, maternal health, the
critical role in term and preterm infants of nutrient deficiencies and new issues of bioavailability in
this relatively new field of investigation. Hallmarks of the 63 chapters include key words and bulleted
key points at the beginning of each chapter, complete definitions of terms with the abbreviations fully
defined for the reader and consistent use of terms between chapters. There are over 2,600 up-to-date
references; all chapters include a conclusion to highlight major findings. The volume also contains a
highly annotated index.
This unique text provides practical, data-driven resources based upon the totality of the evidence
to help the reader understand the basics of the effects of nutritional deficiencies, complexities involved
in the fortification of foods with single as well as multiple micronutrients, new research using the
novel sources of nutrients as well as new foods for fortification, and preventive strategies that are
being implemented in the most at risk populations in developing nations across the world. Explanations
are provided for the role dietary components may play in the early development of infants and the role
of genetics, metabolic, or other effectors. Of equal importance, critical issues that involve, such as
food preferences, nutrient interactions that affect absorption and regulatory and public health perspec-
tives in developing and developed nations are included in well-referenced, informative chapters. The
overarching goal of the editors is to provide fully referenced information to health professionals so
Series Editor Page xv

they may have a balanced perspective on the value of various food fortification options that are
available today as well as in the foreseeable future.
In conclusion, The Handbook of Food Fortification: From Concepts to Public Health
Applications edited by Professor Victor R. Preedy, PhD, DSc, FRIPH, FRSH, FIBiol, FRCPath,
Professor Rajaventhan Srirajaskanthan, BSc (Hons), MD (Res), MRCP, and Vinood B. Patel, PhD
provides health professionals in many areas of research and practice with the most up-to-date,
well-referenced and comprehensive volume on the current state of the science and medical prac-
tice guidelines with regard to the value of food fortification programs. This volume will serve the
reader as the most authoritative resource in the field to date and is a very welcome addition to the
Nutrition and Health Series.

Morristown, NJ, USA Adrianne Bendich, PhD, FACN, FASN

Series Editor
About Series Editor

Dr. Adrianne Bendich, Ph.D., FACN, FASN. has successfully served as Series Editor for the Nutrition
and Health book series for 15 years and continues to identify key areas of clinical nutrition research that
can benefit from the development of targeted, objective volumes edited by the leading researchers in their
fields of investigation.
Prior to retiring in September, 2010, Dr. Bendich held the position of Director of Medical Affairs
at GlaxoSmithKline Consumer Healthcare where she was responsible for the Medical leadership for
the Venture Group, and provided Medical support for well-known Brands including TUMS,
FiberChoice, Os-Cal, Geritol and Citrucel. Additionally, she served as a member of GSK’s successful
Advisory Committee team in support of FDA’s Rx to OTC switch of alli®.
Dr. Bendich is internationally recognized as an expert in Women’s Health, calcium and vitamin D
in bone health, folic acid and pregnancy outcomes, antioxidants and carotenoid effects on immune
functions. She served as the GSK corporate representative to the Women’s Health Initiative (WHI)
for 9 years as GSK Consumer Healthcare provided all calcium and vitamin D supplements for the
WHI study.
She has held memberships and professional positions (ongoing and former): Editorial Board,
Journal of Nutrition in Gerontology and Geriatrics, Antioxidants, an e-journal, Journal of Women’s
Health and Gender-based Medicine; Associate Editor for Nutrition, the International Journal; Chair,
Corporate Advisory Committee, Society for Women’s Health Research; Member of the Program
Advisory Committee for Helen Keller International; Advisor to the Nutrition Department, Montclair
State University; Member: Advisory Board, Current Topics in Nutraceutical Research; member
ASN’s Industry Board and several RIS groups.

xvii
xviii About Series Editor

Dr. Bendich was a recipient of the Burroughs-Wellcome Fund Professorship and Roche Research
Award; she is listed in Who’s Who of American Women Scientists and many other Who’s Who
volumes; she is a recipient of the CRN Apple Award for contributions to the science of vitamin and
mineral supplements. In 2012, Dr. Bendich was elected a Fellow of the American Society for
Nutrition, the highest honor of the Society.
Dr. Bendich is the author of more than 100 peer-reviewed publications; Series Editor of “Nutrition
and Health” for Springer/Humana Press which includes 48 volumes such as Preventive Nutrition,
Handbook of Clinical Nutrition and Aging, Diet and Human Immune Functions, Handbook of
Drug-Nutrient Interactions and other reference volumes for health professionals as outlined at
www.springer.com/series/7659.
About Volume Editors

Dr. Vinood B. Patel, PhD is currently a Senior Lecturer in Clinical Biochemistry at the University of
Westminster and honorary fellow at King’s College London. Dr. Patel obtained his degree in
Pharmacology from the University of Portsmouth, his PhD in protein metabolism from King’s College
London in 1997 and carried out postdoctoral research at Wake Forest University School of Medicine,
USA where he developed novel biophysical techniques to characterize mitochondrial ribosomes. He
presently directs studies on metabolic pathways involved in fatty liver disease, focusing on mitochon-
drial energy regulation and cell death. Dr. Patel has published over 150 articles, including books in the
area of nutrition and health prevention.

Victor R. Preedy BSc, PhD, DSc, FSB, FRCPath, FRSPH, FRSC is a senior member of King’s
College London (Professor of Nutritional Biochemistry) and King’s College Hospital (Professor of
Clinical Biochemistry). He is attached to both the Diabetes and Nutritional Sciences Division and the
Department of Nutrition and Dietetics. He is also Director of the Genomics Centre and a member of
the School of Medicine. Professor Preedy graduated in 1974 with an Honors Degree in Biology and
Physiology with Pharmacology. He gained his University of London PhD in 1981. In 1992, he received
his Membership of the Royal College of Pathologists and in 1993 he gained his second doctoral
degree, for his outstanding contribution to protein metabolism in health and disease. Professor Preedy
was elected as a Fellow to the Institute of Biology in 1995 and to the Royal College of Pathologists in
2000. Since then he has been elected as a Fellow to the Royal Society for the Promotion of Health
(2004) and The Royal Institute of Public Health (2004). In 2009, Professor Preedy became a Fellow
of the Royal Society for Public Health and in 2012 a Fellow of the Royal Society of Chemistry. In his

xix
xx About Volume Editors

career Professor Preedy has carried out research at the National Heart Hospital (part of Imperial
College London) and the MRC Centre at Northwick Park Hospital. He has collaborated with research
groups in Finland, Japan, Australia, USA, and Germany. He is a leading expert on the science of
health. He has lectured nationally and internationally. To his credit, Professor Preedy has published
over 570 articles, which includes 165 peer-reviewed manuscripts based on original research, 100
reviews, and over 50 books and volumes.

Rajaventhan Srirajaskanthan BSc(Hons), MD (Res), MRCP is a consultant gastroenterologist at

University Hospital Lewisham and Kings College Hospital, London. He trained at the prestigious
Guy’s, King’s and St. Thomas’ Medical School where he obtained his MD (MBBS) and a BSc in
Neuroscience with a specialist focus in pain pathways. He has a postgraduate research degree
MD(Res) was awarded by University College London. His postgraduate training was undertaken at a
variety of university teaching hospitals including the John Radcliffe Hospital, Oxford, Royal Free
Hospital and Kings College Hospital, London. During this time he was elected as a member to the
Royal College of Physicians. His specialist training has included Gastroenterology, Hepatology and
Internal Medicine. His academic and practical fields of interests include neuroendocrine tumours,
nutrition in liver disease, non-alcoholic steatohepatitis (NASH) and viral hepatitis. He has published
more than 30 peer review articles, 60 abstracts and written 6 book chapters plus co-edited 3 books.
Acknowledgments

The development of this book is built upon the foundation of the excellent work provided by the staff
of Humana and we are very thankful to them. In particular we wish to acknowledge the outstanding
support, advice, and patience of the Series Editor, Dr. Adrianne Bendich, Developmental Editor,
Michael Griffin, and Editor, Amanda Quinn.

xxi
Contents

Part I Novel Food Vehicles and Agents for Fortificants

1 Multiple Fortified Egg for Comprehensive Nutritional

and Health Support............................................................................................................. 3
Niva Shapira and Ossie Sharon
2 Apple Pomace: Source of Dietary Fibre and Antioxidant
for Food Fortification.......................................................................................................... 21
Shashi Bhushan and Mahesh Gupta
3 Fortified Food Made from Animal Products: From Product
Design to Nutritional Intervention .................................................................................... 29
José A.G. Arêas, Raquel de Andrade Cardoso-Santiago,
and Regilda Saraiva dos Reis Moreira-Araújo
4 Dietary Lipid Sources as a Means of Changing Fatty Acid
Composition in Fish: Implications for Food Fortification .............................................. 41
Jaume Pérez-Sánchez, Laura Benedito-Palos, and Gabriel F. Ballester-Lozano
5 Meat and Meat Products Enriched with n-3 Fatty Acids ................................................ 55
María Teresa Díaz Díaz-Chirón, Ana Rivas-Cañedo, Jesús De La Fuente Vázquez,
Concepción Pérez Marcos, and Sara Lauzurica Gómez
6 Cheese Fortification ............................................................................................................ 71
Monique Lacroix, Jaejoon Han, Michel Britten, Claude P. Champagne,
and Patrick Fustier
7 Yogurt Fortified with Date Fiber ....................................................................................... 87
Isameldin B. Hashim, Ali. H. Khalil, and Hanan S. Afifi
8 Convenience Drinks Fortified with n-3 Fatty Acids: A Systematic Review ................... 95
Clemens von Schacky
9 Evaporated Sugarcane Juice as a Food Fortificant ......................................................... 105
Francisco Plácido Nogueira Arcanjo, Olga Maria Silverio Amancio,
and Josefina Aparecida Pellegrini Braga

xxiii
xxiv Contents

10 Fortification of Fish Sauce and Soy Sauce ........................................................................ 113

Visith Chavasit, Siriporn Tuntipopipat, and Ratana Watanapaisantrakul

Part II Impact on Individuals

11 Targeting Pregnant and Lactating Women and Young Children

with Fortified Foods ............................................................................................................ 129
Saskia J.M. Osendarp and Lynnette M. Neufeld
12 Fortification of Human Milk for Preterm Infants ........................................................... 147
Luigi Corvaglia, Elena Legnani, Arianna Aceti, Elisa Mariani,
and Giacomo Faldella
13 Fortification of School Meals ............................................................................................. 159
Malavika Vinod Kumar
14 Food Fortification and Frail Elderly Nursing Home Residents...................................... 171
Kristina Norman and Matthias Pirlich
15 Bread as a Vehicle Vitamin D Fortification: Application to Nursing
Home Residents ................................................................................................................... 179
Veronica Mocanu, Corina Galesanu, and Reinhold Vieth
16 Learnings from the Postmenopausal Health Study
for the Effect of Dairy Products Fortified with Calcium
and Vitamin D on Bone Metabolism ................................................................................. 195
George Moschonis, Angeliki Giannopoulou, and Yannis Manios
17 Cognition and Multiple-Micronutrient Fortification of Salt .......................................... 205
Malavika Vinod Kumar

Part III Public Health, Concepts and Issues

18 Food Fortification as a Global Public Health Intervention:

Strategies to Deal with Barriers to Adoption, Application
and Impact Assessment....................................................................................................... 223
Lada Timotijevic, Arnold Timmer, and Adebayo Ogunlade
19 Why Food Fortification with Vitamin B12 Is Needed?.................................................... 237
Ilia Volkov and Victor R. Preedy
20 Folic Acid to Prevent Neural Tube Defects: Success and Controversies ........................ 247
Philippe De Wals
21 Vitamin D Fortification in North America: Current Status
and Future Considerations................................................................................................. 259
Mona S. Calvo and Susan J. Whiting
22 Profiling National Mandatory Folic Acid Fortification Policy
Around the World ............................................................................................................... 277
Mark A. Lawrence and Karishma Kripalani
23 In-Home Fortification of Complementary Feedings: Chinese Perspectives .................. 291
Chunming Chen, Yuying Wang, Wu He, Suying Chang, and Victor R. Preedy
Contents xxv

24 Food Fortification: A Regulator’s Perspective ................................................................. 305

Dorothy Mackerras, Dennis Thomas, Jason March, and Jenny Hazelton

Part IV International Perspectives

25 Fortification of Flour and Outcomes: Oman’s Perspective—Contextual

Considerations and Outcome ............................................................................................. 321
Deena Alasfoor and Medhat K. ElSayed
26 Strategies to Improve Micronutrient Status of Infants
and Young Children with Special Attention to Complementary
Foods Fortified with Micronutrients: Perspectives from Vietnam ................................. 335
Jacques Berger, Frank T. Wieringa, Arnaud Laillou, Phu Pham Van,
and Marjoleine A. Dijkhuizen
27 Food Fortification Programmes in Pakistan .................................................................... 347
Salim-ur-Rehman, Javaid Aziz Awan, Faqir Muhammad Anjum, and Nuzhat Huma
28 Neural Tube Defects in Australia and Food Fortification with Folic Acid..................... 361
Carol Bower and Jane Halliday
29 Vitamin D Supplementation in Children: Indian Perspectives ...................................... 373
Anuradha V. Khadilkar and Shashi A. Chiplonkar
30 Use of Fortified Foods for Indonesian Infants .................................................................. 383
Umi Fahmida
31 Micronutrient Fortification of School Lunch Meals in Himalayan Villages ................. 395
Akoto K. Osei, Irwin H. Rosenberg, Robert F. Houser, Minnie Mathews,
and Davidson H. Hamer
32 Iron Fortification Strategies in Brazil ............................................................................... 411
Joel Alves Lamounier, Flávio Diniz Capanema, José Eduardo Dutra de Oliveira,
Daniela da Silva Rocha, and Carlos Alberto Nogueira de Almeida
33 Iron-Fortified and Unfortified Nigerian Foods ................................................................ 427
Osaretin Albert Taiwo Ebuehi
34 Food Fortification: What More Is There to Know? ......................................................... 445
Rajkumar Rajendram, Roshanna Rajendram, Vinood B. Patel,
and Victor R. Preedy

Index ............................................................................................................................................. 453

Contributors

Arianna Aceti Neonatology and Intensive Care Unit-Sant’Orsola-Malpighi Hospital, University of

Bologna, Bologna, Italy
Hanan S. Afifi Department of Food Science, United Arab Emirates University, Al Ain, Abu Dhabi,
United Arab Emirates
Deena Alasfoor Department of Nutrition, Ministry of Health, Al Ghubra, Muscat, Oman
Carlos Alberto Nogueira de Almeida University of Ribeirão Preto (UNAERP), Ribeirão Preto,
SP, Brazil
Olga Maria Silverio Amancio Department of Pediatrics, Paulista Medicine School, Federal
University of Sao Paulo, Sao Paulo, SP, Brazil
Faqir Muhammad Anjum National Institute of Food Science and Technology, University of
Agriculture, Faisalabad, Pakistan
Francisco Plácido Nogueira Arcanjo Department of Pediatrics, Federal University of Ceara, Sobral,
CE, Brazil
José A.G. Áreas Department of Nutrition, University of São Paulo, São Paulo, Brazil
Javaid Aziz Awan National Institute of Food Science and Technology, University of Agriculture,
Faisalabad, Pakistan
Gabriel F. Ballester-Lozano Fish Nutrition and Growth Endocrinology Group, Department of
Biology, Culture and Pathology of Marine Species, Instituto de Acuicultura de Torre la Sal (IATS-
CSIC), Castellón, Spain
Laura Benedito-Palos Fish Nutrition and Growth Endocrinology Group, Department of Biology,
Culture and Pathology of Marine Species, Instituto de Acuicultura de Torre la Sal (IATS-CSIC),
Castellón, Spain
Jacques Berger Institute of Research for Development (IRD), UMR Nutripass IRD-UM2-UM1,
Centre de Montpellier, Montpellier, France
Shashi Bhushan Division of Biotechnology, CSIR-Institute of Himalayan Bioresource Technology,
Kangra, Himachal Pradesh, India
Carol Bower Department of Population Science, Telethon Institute for Child Health Research,
Subiaco, WA, Australia

xxvii
xxviii Contributors

Josefina Aparecida Pellegrini Braga Department of Pediatrics, Paulista Medicine School, Federal
University of Sao Paulo, Sao Paulo, SP, Brazil
Michel Britten Food Research and Development Centre, Agriculture and Agri-Food, St. Hyacinthe,
QC, Canada
Mona S. Calvo Department of Health and Human Services, Center for Food Safety and Applied
Nutrition, U.S. Food and Drug Administration, Laurel, MD, USA
Flávio Diniz Capanema Belo Horizonte, Minas Gerais, Brazil
Raquel de Andrade Cardoso-Santiago Universidade Federal de Goiás—Faculdade de Nutrição,
Goiânia, Goiás, Brazil
Claude P. Champagne Food Research and Development Centre, Agriculture and Agri-Food,
St. Hyacinthe, QC, Canada
Suying Chang UNICEF China, Beijing, China
Visith Chavasit Institute of Nutrition, Mahidol University, Phutthamonthon, Nakhonpathom,
Thailand
Chunming Chen Chinese Center for Disease Control and Prevention, Beijing, China
Shashi A. Chiplonkar Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital,
Pune, Maharashtra, India
Luigi Corvaglia Neonatology and Intensive Care Unit-Sant’Orsola-Malpighi Hospital, University
of Bologna, Bologna, Italy
Maria Teresa Díaz Díaz-Chirón Department of Food Technology, Spanish National Institute for
Agricultural and Food Research and Technology, Instituto Nacional de Investigación y Tecnología
Agraria y Alimentaria (INIA), Madrid, Spain
Marjoleine A. Dijkhuizen Department of Human Nutrition, Copenhagen University, Frederiksberg,
Copenhagen, Denmark
Osaretin Albert Taiwo Ebuehi Department of Biochemistry, College of Medicine, University of
Lagos, Lagos, Nigeria
Medhat K. ElSayed Ministry of Health, Muscat, Oman
Umi Fahmida SEAMEO—RECFON (Southeast Asian Minister of Education Organization Regional
Center for Food and Nutrition), University of Indonesia, Jakarta, Indonesia
Giacomo Faldella Neonatology and Intensive Care Unit-Sant’Orsola-Malpighi Hospital, University
of Bologna, Bologna, Italy
Patrick Fustier Food Research and Development Centre, Agriculture and Agri-Food, St. Hyacinthe,
QC, Canada
Corina Galesanu Department of Endocrinology, Grigore T. Popa University of Medicine and
Pharmacy, Iaşi, Romania
Angeliki Giannopoulou Department of Nutrition and Clinical Dietetics, Harokopio University,
Athens, Greece
Sara Lauzurica Gómez Department of Animal Production, Complutense University of Madrid,
Madrid, Spain
Another random document with
no related content on Scribd:
 treaty and end the war, release the volunteers, remove the
excuse for war expenditures, and then give the Filipinos the
independence which might be forced from Spain by a new treaty.
… The title of Spain being extinguished we were at liberty to
deal with the Filipinos according to American principles. The
Bacon resolution, introduced a mouth before hostilities broke
out at Manila, promised independence to the Filipinos on the
same terms that it was promised to the Cubans.
{661}
I supported this resolution and believe that its adoption
prior to the breaking out of hostilities would have prevented
bloodshed, and that its adoption at any subsequent time would
have ended hostilities. … If the Bacon resolution had been
adopted by the Senate and carried out by the President, either
at the time of the ratification of the treaty or at any time
afterwards, it would have taken the question of imperialism
out of politics and left the American people free to deal with
their domestic problems. But the resolution was defeated by
the vote of the Republican Vice-President, and from that time
to this a Republican Congress has refused to take any action
whatever in the matter.

"When hostilities broke out at Manila, Republican speakers and

Republican editors at once sought to lay the blame upon those
who had delayed the ratification of the treaty, and, during
the progress of the war, the same Republicans have accused the
opponents of imperialism of giving encouragement to the
Filipinos. …

"The Filipinos do not need any encouragement from Americans

now living. Our whole history has been an encouragement, not
only to the Filipinos, but to all who are denied a voice in
their own government. If the Republicans are prepared to
censure all who have used language calculated to make the
Filipinos hate foreign domination, let them condemn the speech
of Patrick Henry. When he uttered that passionate appeal,
'Give me liberty or give me death,' he expressed a sentiment
which still echoes in the hearts of men. Let them censure
Jefferson; of all the statesmen of history none have used
words so offensive to those who would hold their fellows in
political bondage. Let them censure Washington, who declared
that the colonists must choose between liberty and slavery.
Or, if the statute of limitations has run against the sins of
Henry and Jefferson and Washington, let them censure Lincoln,
whose Gettysburg speech will be quoted in defense of popular
government when the present advocates of force and conquest
are forgotten. … If it were possible to obliterate every word
written or spoken in defense of the principles set forth in
the Declaration of Independence, a war of conquest would still
leave its legacy of perpetual hatred, for it was God himself
who placed in every human heart the love of liberty. He never
made a race of people so low in the scale of civilization or
intelligence that it would welcome a foreign master.

"Those who would have this nation enter upon a career of

empire must, consider not only the effect of imperialism on
the Filipinos, but they must also calculate its effects upon
our own nation. We cannot repudiate the principle of
self-government in the Philippines without weakening that
principle here. …

"Our opponents, conscious of the weakness of their cause, seek

to confuse imperialism with expansion, and have even dared to
claim Jefferson as a supporter of their policy. Jefferson
spoke so freely and used language with such precision that no
one can be ignorant of his views. On one occasion he declared:
'If there be one principle more deeply rooted than any other
in the mind of every American, it is that we should have
nothing to do with conquest.' And again he said: 'Conquest is
not in our principles; it is inconsistent with our
government.' The forcible annexation of territory to be
governed by arbitrary power differs as much from the
acquisition of territory to be built up into states as a
monarchy differs from a democracy. The Democratic party does
not oppose expansion when expansion enlarges the area of the
Republic and incorporates land which can be settled by
American citizens, or adds to our population people who are
willing to become citizens and are capable of discharging
their duties as such. …

"A colonial policy means that we shall send to the Philippine

Islands a few traders, a few taskmasters and a few
officeholders and an army large enough to support the
authority of a small fraction of the people while they rule
the natives. If we have an imperial policy we must have a
great standing army as its natural and necessary complement.
The spirit which will justify the forcible annexation of the
Philippine Islands will justify the seizure of other islands
and the domination of other people, and with wars of conquest
we can expect a certain, if not rapid, growth of our military
establishment. …

"The Republican platform assumes that the Philippine Islands

will be retained under American sovereignty, and we have a
right to demand of the Republican leaders a discussion of the
future status of the Filipino. Is he to be a citizen or a
subject? Are we to bring into the body politic eight or ten
million Asiatics, so different from us in race and history
that amalgamation is impossible? Are they to share with us in
making the laws and shaping the destiny of this nation? No
Republican of prominence has been bold enough to advocate such
a proposition. The McEnery resolution, adopted by the Senate
immediately after the ratification of the treaty, expressly
negatives this idea. The Democratic platform describes the
situation when it says that the Filipinos cannot be citizens
without endangering our civilization. Who will dispute it? And
what is the alternative? If the Filipino is not to be a
citizen, shall we make him a subject? On that question the
Democratic platform speaks with equal emphasis. It declares
that the Filipino cannot be a subject without endangering our
form of government. A Republic can have no subjects. A subject
 is possible only in a government resting upon force; he is
unknown in a government deriving its just powers from the
consent of the governed. "The Republican platform says that
'the largest measure of self-government consistent with their
welfare and our duties shall be secured to them (the
Filipinos) by law.' This is a strange doctrine for a
government which owes its very existence to the men who
offered their lives as a protest against government without
consent and taxation without representation. In what respect
does the position of the Republican party differ from the
position taken by the English government in 1776? Did not the
English government promise a good government to the colonists?
What king ever promised a bad government to his people? Did
not the English government promise that the colonists should
have the largest measure of self-government consistent with
their welfare and English duties? Did not the Spanish
government promise to give to the Cubans the largest measure
of self-government consistent with their welfare and Spanish
duties? The whole difference between a Monarchy and a Republic
may be summed up in one sentence. In a Monarchy the King gives
to the people what he believes to be a good government; in a
Republic the people secure for themselves what they believe to
be a good government. …

{662}

"The Republican platform promises that some measure of

self-government is to be given the Filipinos by law; but even
this pledge is not fulfilled. Nearly sixteen months elapsed
after the ratification of the treaty before the adjournment of
Congress last June, and yet no law was passed dealing with the
Philippine situation. The will of the President has been the
only law in the Philippine Islands wherever the American
authority extends. Why does the Republican party hesitate to
legislate upon the Philippine question? Because a law would
disclose the radical departure from history and precedent
contemplated by those who control the Republican party. The
storm of protest which greeted the Porto Rican bill was an
indication of what may be expected when the American people
are brought face to face with legislation upon this subject.
If the Porto Ricans, who welcomed annexation, are to be denied
the guarantees of our Constitution, what is to be the lot of
the Filipinos, who resisted our authority? If secret
influences could compel a disregard of our plain duty toward
friendly people, living near our shores, what treatment will
those same influences provide for unfriendly people 7,000
miles away? …

"Is the sunlight of full citizenship to be enjoyed by the

people of the United States, and the twilight of
semi-citizenship endured by the people of Porto Rico, while
the thick darkness of perpetual vassalage covers the
Philippines? The Porto Rico tariff law asserts the doctrine
that the operation of the Constitution is confined to the
forty-five States. The Democratic party disputes this doctrine
and denounces it as repugnant to both the letter and spirit of
our organic law. There is no place in our system of government
for the deposit of arbitrary and irresponsible power. That the
leaders of a great party should claim for any President or
Congress the right to treat millions of people as mere
'possessions' and deal with them unrestrained by the
Constitution or the bill of rights, shows how far we have
already departed from the ancient landmarks and indicates what
may be expected if this nation deliberately enters upon a
career of empire.

"The territorial form of government is temporary and

preparatory, and the chief security a citizen of a territory
has is found in the fact that he enjoys the same
constitutional guarantees and is subject to the same general
laws as the citizen of a state. Take away this security and
his rights will be violated and his interests sacrificed at
the demand of those who have political influence. This is the
evil of the colonial system, no matter by what nation it is
applied. …

"Let us consider briefly the reasons which have been given in

support of an imperialistic policy. Some say that it is our
duty to hold the Philippine Islands. But duty is not an
argument; it is a conclusion. To ascertain what our duty is,
in any emergency, we must apply well settled and generally
accepted principles. It is our duty to avoid stealing, no
matter whether the thing to be stolen is of great or little
value. It is our duty to avoid killing a human being, no
matter where the human being lives or to what race or class he
belongs. …

"It is said that we have assumed before the world obligations

which make it necessary for us to permanently maintain a
government in the Philippine Islands. I reply, first, that the
highest obligation of this nation is to be true to itself. No
obligation to any particular nations, or to all the nations
combined, can require the abandonment of our theory of
government, and the substitution of doctrines against which
our whole national life has been a protest. And, second, that
our obligation to the Filipinos, who inhabit the islands, is
greater than any obligation which we can owe to foreigners who
have a temporary residence in the Philippines or desire to
trade there. It is argued by some that the Filipinos are
incapable of self-government and that, therefore, we owe it to
the world to take control of them. Admiral Dewey, in an
official report to the Navy Department, declared the Filipinos
more capable of self-government than the Cubans, and said that
he based his opinion upon a knowledge of both races. …

"Republicans ask, 'Shall we haul down the flag that floats

over our dead in the Philippines?' The same question might
have been asked when the American flag floated over
Chapultepec and waved over the dead who fell there; but the
tourist who visits the City of Mexico finds there a national
cemetery owned by the United States and cared for by an
American citizen. Our flag still floats over our dead, but
when the treaty with Mexico was signed American authority
withdrew to the Rio Grande, and I venture the opinion that
during the last fifty years the people of Mexico have made
more progress under the stimulus of independence and
self-government than they would have made under a carpet-bag
government held in place by bayonets. The United States and
Mexico, friendly republics, are each stronger and happier than
they would have been had the former been cursed and the latter
crushed by an imperialistic policy disguised as 'benevolent
assimilation.'

"'Can we not govern colonies?', we are asked. The question is

not what we can do, but what we ought to do. This nation can
do whatever it desires to do, but it must accept
responsibility for what it does. If the Constitution stands in
the way, the people can amend the Constitution. I repeat, the
nation can do whatever it desires to do, but it cannot avoid
the natural and legitimate results of its own conduct. …

"Some argue that American rule in the Philippine Islands will

result in the better education of the Filipinos. Be not
deceived. If we expect to maintain a colonial policy, we shall
not find it to our advantage to educate the people. The
educated Filipinos are now in revolt against us, and the most
ignorant ones have made the least resistance to our
domination. If we are to govern them without their consent and
give them no voice in determining the taxes which they must
pay, we dare not educate them, lest they learn to read the
Declaration of Independence and Constitution of the United
States and mock us for our inconsistency. The principal
arguments, however, advanced by those who enter upon a defense
of imperialism are:

"First—That we must improve the present opportunity to become

a world power and enter into international politics.
{663}

"Second—That our commercial interests in the Philippine

Islands and in the Orient make it necessary for us to hold the
islands permanently.

"Third—That the spread of the Christian religion will be

facilitated by a colonial policy.

"Fourth—That there is no honorable retreat from the position

which the nation has taken.

"The first argument is addressed to the nation's pride and the

second to the nation's pocket-book. The third is intended for
the church member and the fourth for the partisan. It is
sufficient answer to the first argument to say that for more
than a century this nation has been a world power. For ten
decades it has been the most potent influence in the world.
Not only has it been a world power, but it has done more to
affect the politics of the human race than all the other
nations of the world combined. Because our Declaration of
Independence was promulgated others have been promulgated.
Because the patriots of 1776 fought for liberty, others have
fought for it. Because our Constitution was adopted, other
constitutions have been adopted. The growth of the principle
of self-government, planted on American soil, has been the
overshadowing political fact of the nineteenth century. It has
made this nation conspicuous among the nations and given it a
place in history such as no other nation has ever enjoyed.
Nothing has been able to check the onward march of this idea.
I am not willing that this nation shall cast aside the
omnipotent weapon of truth to seize again the weapons of
physical warfare. I would not exchange the glory of this
Republic for the glory of all the empires that have risen and
fallen since time began.

"The permanent chairman of the last Republican National

Convention presented the pecuniary argument in all its
baldness when he said: 'We make no hypocritical pretense of
being interested in the Philippines solely on account of
others. While we regard the welfare of those people as a
sacred trust, we regard the welfare of the American people
first. We see our duty to ourselves as well as to others. We
believe in trade expansion. By every legitimate means within
the province of government and constitution we mean to
stimulate the expansion of our trade and open new markets.'
This is the commercial argument. It is based upon the theory
that war can be rightly waged for pecuniary advantage, and
that it is profitable to purchase trade by force and violence.
… The Democratic party is in favor of the expansion of trade.
It would extend our trade by every legitimate and peaceful
means; but it is not willing to make merchandise of human
blood. But a war of conquest is as unwise as it is
unrighteous. A harbor and coaling station in the Philippines
would answer every trade and military necessity, and such a
concession could have been secured at any time without
difficulty.

"It is not necessary to own people in order to trade with

them. We carry on trade to-day with every part of the world,
and our commerce has expanded more rapidly than the commerce
of any European empire. We do not own Japan or China, but we
trade with their people. We have not absorbed the republics of
Central and South America, but we trade with them. It has not
been necessary to have any political connection with Canada or
the nations of Europe in order to trade with them. Trade
cannot be permanently profitable unless it is voluntary. …

"Imperialism would be profitable to the army contractors; it

would be profitable to the ship-owners, who would carry live
soldiers to the Philippines and bring dead soldiers back; it
would be profitable to those who would seize upon the
franchises, and it would be profitable to the officials whose
salaries would be fixed here and paid over there; but to the
farmer, to the laboring man and to the vast majority of those
engaged in other occupations it would bring expenditure
without return and risk without reward.

"The pecuniary argument, though more effective with certain

classes, is not likely to be used so often or presented with
so much enthusiasm as the religious argument. If what has been
termed the 'gunpowder gospel' were urged against the Filipinos
only, it would be a sufficient answer to say that a majority
of the Filipinos are now members of one branch of the
Christian church; but the principle involved is one of much
wider application and challenges serious consideration. The
religious argument varies in positiveness, from a passive
belief that Providence delivered the Filipinos into our hands
for their good and our glory, to the exultation of the
minister who said that we ought to 'thrash the natives
(Filipinos) until they understand who we are,' and that 'every
bullet sent, every cannon shot and every flag waved, means
righteousness.' … If true Christianity consists in carrying
out in our daily lives the teachings of Christ, who will say
that we are commanded to civilize with dynamite and proselyte
with the sword? …

"Love, not force, was the weapon of the Nazarene; sacrifice

for others, not the exploitation of them, was His method of
reaching the human heart. A missionary recently told me that
the Stars and Stripes once saved his life because his
assailant recognized our flag as a flag that had no blood upon
it. Let it be known that our missionaries are seeking souls
instead of sovereignty; let it be known that instead of being
the advance guard of conquering armies, they are going forth
to help and uplift, having their loins girt about with truth
and their feet shod with the preparation of the gospel of
peace, wearing the breastplate of righteousness and carrying
the sword of the spirit; let it be known that they are
citizens of a nation which respects the rights of the citizens
of other nations as carefully as it protects the rights of its
 own citizens, and the welcome given to our missionaries will
be more cordial than the welcome extended to the missionaries
of any other nation.

"The argument made by some that it was unfortunate for the

nation that it had anything to do with the Philippine Islands,
but that the naval victory at Manila made the permanent
acquisition of those islands necessary, is also unsound. We
won a naval victory at Santiago, but that did not compel us to
hold Cuba. The shedding of American blood in the Philippine
Islands does not make it imperative that we should retain
possession forever. American blood was shed at San Juan Hill
and El Caney, and yet the President has promised the Cubans
independence. The fact that the American flag floats over
Manila does not compel us to exercise perpetual sovereignty
over the islands; the American flag waves over Havana to-day,
but the President has promised to haul it down when the flag
of the Cuban Republic is ready to rise in its place. Better a
thousand times that our flag in the Orient give way to a flag
representing the idea of self-government than that the flag of
this Republic should become the flag of an empire.

{664}

"There is an easy, honest, honorable solution of the

Philippine question. It is set forth in the Democratic
platform, and it is submitted with confidence to the American
people. This plan I unreservedly indorse. If elected, I will
convene congress in extraordinary session as soon as
inaugurated and recommend an immediate declaration of the
nation's purpose, first, to establish a stable form of
government in the Philippine Islands, just as we are now
establishing a stable form of government in Cuba; second, to
give independence to the Cubans; third, to protect the
Filipinos from outside interference while they work out their
destiny, just as we have protected the republics of Central
and South America, and are, by the Monroe doctrine, pledged to
 protect Cuba."

UNITED STATES OF AMERICA: A. D. 1900.

The Republican candidate on the same subject.

The answer of the party controlling the government to the

impeachment of its policy of colonial acquisition, and
especially of its conduct in the Philippine Islands, was given
by Mr. McKinley, in a letter of acceptance, addressed,
September 8, to the committee which gave him formal notice of
his renomination by the Republican convention. After
rehearsing at considerable length the events which preceded,
attended and followed the capture of Manila, he continued:

"Would not our adversaries have sent Dewey's fleet to Manila

to capture and destroy the Spanish sea power there, or,
dispatching it there, would they have withdrawn it after the
destruction of the Spanish fleet; and, if the latter, whither
would they have directed it to sail? Where could it have gone?
What port in the Orient was opened to it? Do our adversaries
condemn the expedition under the command of General Merritt to
strengthen Dewey in the distant ocean and assist in our
triumph over Spain, with which nation we were at war? Was it
not our highest duty to strike Spain at every vulnerable
point, that the war might be successfully concluded at the
earliest practicable moment? And was it not our duty to
protect the lives and property of those who came within our
control by the fortunes of war? Could we have come away at any
time between May 1, 1898, and the conclusion of peace without a
stain upon our good name? Could we have come away without
dishonor at any time after the ratification of the peace
treaty by the Senate of the United States? There has been no
time since the destruction of the enemy's fleet when we could
or should have left the Philippine Archipelago. After the
treaty of peace was ratified, no power but Congress could
surrender our sovereignty or alienate a foot of the territory
thus acquired. The Congress has not seen fit to do the one or
the other, and the President had no authority to do either, if
he had been so inclined, which he was not. So long as the
sovereignty remains in us it is the duty of the Executive,
whoever he may be, to uphold that sovereignty, and if it be
attacked to suppress its assailants. Would our political
adversaries do less?

"It has been asserted that there would have been no fighting
in the Philippines if Congress had declared its purpose to
give independence to the Tagal insurgents. The insurgents did
not wait for the action of Congress. They assumed the
offensive; they opened fire on our Army. Those who assert our
responsibility for the beginning of the conflict have
forgotten that, before the treaty was ratified in the Senate,
and while it was being debated in that body and while the
Bacon resolution was under discussion, on February 4, 1899,
the insurgents attacked the American Army, after being
previously advised that the American forces were under orders
not to fire upon them except in defense. The papers found in
the recently captured archives of the insurgents demonstrate
that this attack had been carefully planned for weeks before
it occurred. This unprovoked assault upon our soldiers at a
time when the Senate was deliberating upon the treaty shows
that no action on our part, except surrender and abandonment,
would have prevented the fighting, and leaves no doubt in any
fair mind of where the responsibility rests for the shedding
of American blood.

"With all the exaggerated phrase-making of this electoral

contest, we are in danger of being diverted from the real
contention. We are in agreement with all of those who
supported the war with Spain and also with those who counseled
the ratification of the treaty of peace. Upon these two great
essential steps there can be no issue and out of these came
all of our responsibilities. If others would shirk the
obligations imposed by the war and the treaty, we must decline
to act further with them, and here the issue was made. It is our
 purpose to establish in the Philippines a government suitable
to the wants and conditions of the inhabitants and to prepare
them for self-government when they are ready for it and as
rapidly as they are ready for it. That I am aiming to do under
my Constitutional authority, and will continue to do until
Congress shall determine the political status of the
inhabitants of the archipelago.

"Are our opponents against the treaty? If so, they must be

reminded that it could not have been ratified in the Senate
but for their assistance. The Senate which ratified the treaty
and the Congress which added its sanction by a large
approbation comprised Senators and Representatives of the
people of all parties. Would our opponents surrender to the
insurgents, abandon our sovereignty or cede it to them? If
that be not their purpose, then it should be promptly
disclaimed, for only evil can result from the hopes raised by
our opponents in the minds of the Filipinos, that with their
success at the polls in November there will be a withdrawal of
our Army and of American sovereignty over the archipelago; the
complete independence of the Tagalog people recognized and the
powers of government over all the other people of the
archipelago conferred upon the Tagalog leaders. The effect of
a belief in the minds of the insurgents that this will be done
has already prolonged the rebellion and increases the
necessity for the continuance of a large army. It is now
delaying full peace in the archipelago and the establishment
of civil governments and has influenced many of the insurgents
against accepting the liberal terms of amnesty offered by
General MacArthur under my direction. But for these false
hopes, a considerable reduction could have been had in our
military establishment in the Philippines, and the realization
of a stable government would be already at hand.

{665}

"The American people are asked by our opponents to yield the

sovereignty of the United States in the Philippines to a small
fraction of the population, a single tribe out of 80 or more
inhabiting the archipelago, a faction which wantonly attacked
the American troops in Manila while in rightful possession
under the protocol with Spain, awaiting the ratification of
the treaty of peace by the Senate, and which has since been in
active, open rebellion against the United States. We are asked
to transfer our sovereignty to a small minority in the
islands, without consulting the majority, and to abandon the
largest portion of the population, which has been loyal to us,
to the cruelties of the guerrilla insurgent bands. More, than
this, we are asked to protect this minority in establishing a
government, and to this end repress all opposition of the
majority. We are required to set up a stable government in the
interest of those who have assailed our sovereignty and fired
upon our soldiers, and then maintain it at any cost or
sacrifice against its enemies within and against those having
ambitious designs from without. This would require an army and
navy far larger than is now maintained in the Philippines and
still more in excess of what will be necessary with the full
recognition of our sovereignty. A military support of
authority not our own, as thus proposed, is the very essence
of militarism, which our opponents in their platform oppose,
but which by their policy would of necessity be established in
its most offensive form.

"The American people will not make the murderers of our

soldiers the agents of the Republic to convey the blessings of
liberty and order to the Philippines. They will not make them
the builders of the new commonwealth. Such a course would be a
betrayal of our sacred obligations to the peaceful Filipinos
and would place at the mercy of dangerous adventurers the
lives and property of the natives and foreigners. It would
make possible and easy the commission of such atrocities as
were secretly planned to be executed on the 22d of February,
1899, in the city of Manila, when only the vigilance of our
Army prevented the attempt to assassinate our soldiers and all
foreigners and pillage and destroy the city and its
surroundings. In short, the proposition of those opposed to us
is to continue all the obligations in the Philippines which
now rest upon the Government, only changing the relation from
principal, which now exists, to that of surety. Our
responsibility is to remain, but our power is to be
diminished. Our obligation is to be no less, but our title is
to be surrendered to another power, which is without
experience or training or the ability to maintain a stable
government at home and absolutely helpless to perform its
international obligations with the rest of the world. To this
we are opposed. We should not yield our title while our
obligations last. In the language of our platform, 'Our
authority should not be less than our responsibility,' and our
present responsibility is to establish our authority in every
part of the islands.

"No government can so certainly preserve the peace, restore

public order, establish law, justice and stable conditions as
ours. Neither Congress nor the Executive can establish a
stable government in these islands except under our right of
sovereignty, our authority and our flag. And this we are
doing. We could not do it as a protectorate power so
completely or so successfully as we are doing it now. As the
sovereign power, we can initiate action and shape means to
ends and guide the Filipinos to self-development and
self-government. As a protectorate power we could not initiate
action, but would be compelled to follow and uphold a people
with no capacity yet to go alone. In the one case we can
protect both ourselves and the Filipinos from being involved
in dangerous complications; in the other we could not protect
even the Filipinos until after their trouble had come. Beside,
if we cannot establish any government of our own without the
consent of the governed, as our opponents contend, then we
could not establish a stable government for them or make ours
a protectorate without the like consent, and neither the
majority of the people or a minority of the people have
invited us to assume it. We could not maintain a protectorate
even with the consent of the governed without giving
provocation for conflicts and possibly costly wars. Our rights
in the Philippines are now free from outside interference and
will continue so in our present relation. They would not be
thus free in any other relation. We will not give up our own
to guarantee another sovereignty.

"Our title is good. Our peace commissioners believed they were

receiving a good title when they concluded the treaty. The
Executive believed it was a good title when he submitted it to
the Senate of the United States for its ratification. The Senate
believed it was a good title when they gave it their
Constitutional assent, and the Congress seems not to have
doubted its completeness when they appropriated $20,000,000
provided by the treaty. If any who favored its ratification
believed it gave us a bad title, they were not sincere. Our
title is practically identical with that under which we hold
our territory acquired since the beginning of the government,
and under which we have exercised full sovereignty and
established government for the inhabitants. It is worthy of
note that no one outside of the United States disputes the
fulness and integrity of the cession. What then is the real
issue on this subject? Whether it is paramount to any other or
not, it is whether we shall be responsible for the government
of the Philippines with the sovereignty and authority which
enable us to guide them to regulated liberty, law, safety and
progress, or whether we shall be responsible for the forcible
and arbitrary government of a minority without sovereignty and
authority on our part and with only the embarrassment of a
protectorate which draws us into their troubles without the
power of preventing them. There were those who two years ago
were rushing us on to war with Spain who are unwilling now to
accept its clear consequence, as there are those among us who
advocated the ratification of the treaty of pence, but now
protest against its obligations. Nations which go to war must
be prepared to accept its resultant obligations, and when they
 make treaties must keep them.

{666}

"Those who profess to distrust the liberal and honorable

purposes of the Administration in its treatment of the
Philippines are not justified. Imperialism has no place in its
creed or conduct. Freedom is a rock upon which the Republican
party was builded and now rests. Liberty is the great
Republican doctrine for which the people went to war and for
which 1,000,000 lives were offered and billions of dollars
expended to make it a lawful legacy of all without the consent
of master or slave. There is a strain of ill-conceived
hypocrisy in the anxiety to extend the Constitutional
guarantees to the people of the Philippines while their
nullification is openly advocated at home. Our opponents may
distrust themselves, but they have no right to discredit the
good faith and patriotism of the majority of the people, who
are opposing them; they may fear the worst form of imperialism
with the helpless Filipinos in their hands, but if they do, it
is because they have parted with the spirit and faith of the
fathers and have lost the virility of the founders of the
party which they profess to represent.

"The Republican party does not have to assert its devotion to

the Declaration of Independence. That immortal instrument of
the fathers remained unexecuted until the people under the
lead of the Republican party in the awful clash of battle
turned its promises into fulfillment. It wrote into the
Constitution the amendments guaranteeing political equality to
American citizenship and it has never broken them or counseled
others in breaking them. It will not be guided in its conduct by
one set of principles at home and another set in the new
territory belonging to the United States. If our opponents
would only practice as well as preach the doctrines of Abraham
Lincoln there would be no fear for the safety of our
institutions at home or their rightful influence in any
 territory over which our flag floats.

"Empire has been expelled from Porto Rico and the Philippines
by American freemen. The flag of the Republic now floats over
these islands as an emblem of rightful sovereignty. Will the
Republic stay and dispense to their inhabitants the blessings
of liberty, education and free institutions, or steal away,
leaving them to anarchy or imperialism? The American question
is between duty and desertion—the American verdict will be for
duty and against desertion, for the Republic against both
anarchy and imperialism."

UNITED STATES OF AMERICA: A. D. 1900 (June).

Revenues and expenditures of the government for the
fiscal year ended June 30, 1900.

The revenues of the Government from all sources (by

warrants) for the fiscal year ended June 30. 1900, were:

From internal revenue.

$295,327,926.76
From customs.
233,164,871.16
From profits on coinage, bullion deposits, etc.
9,992,374.09
From District of Columbia.
4,008,722.77
From fees-consular, letters patents, and land.
3,291.716.68
From sales of public lands.
2,836.882.98
From tax on national banks.
1.998.554.00
From navy pension, navy hospital, clothing,
and deposit funds.
1,621.558.52
From sales of Indian lands.
1,384,663.49
From payment of interest by Pacific railways.
1,173,466.43
From miscellaneous.
997,375.68
From sales of Government property.
779,522.78
From customs fees, fines, penalties, etc.
675,706.95
From immigrant fund.
537,404.81
From deposits for surveying public lands.
273,247.19
From sales of ordnance material.
257,265.56
From Soldiers' Home, permanent fund.
247,926.62
From tax on seal skins, and rent of seal islands.
225,676.47
From license fees, Territory of Alaska.
157,234.94
From trust funds, Department of State.
152,794.56
From depredations on public lands.
76,307.58
From Spanish indemnity.
57,000.00
From sales of lands and buildings
3,842,737.68
From part payment Central Pacific
Railroad indebtedness.