GMOs: Significance in Public Health and Economics

Scenario

With the United Nations meeting to discuss the use of GMOs around the world, we are the group of scientists and socio economists that support the use of GMOs specifically to combat Hidden Hunger in many countries. Many countries, especially one in European Union, want to limit GMOs used in food and crop production. Figure 1 shows where GMOs are produced around the world and how that compares country by country. We are presenting our findings in order to educate and gain support for GMOs and Biofortification of foods that will prevent the micronutrient deficiencies and stimulate the economy in many countries. We are providing information on what foods are biofortified and what deficiencies may be affecting areas who consume this food. GMOs can lead to a healthier population thus reducing the issues with human health that lead to economic losses. GMOs have been met with opposition due to them being seen as unnatural or unhealthy, but our goal is to provide transparency to that agreement. 

Figure 1. Where GMOs are grown, imported, and used in field trails around the world. From: International Service for the Acquisition of Agri-Biotech Applications (2016). (http://www.isaaa.org/resources/publications/briefs/52/default.asp) Copyright 2016 by ISAAA.

Abstract

Genetically modified organisms are one of the most popular topics discussed in food systems. There are a lot of misconceptions out there about GMOs and what they truly are. Genetically modifying have been around since the beginning of agriculture it was just not done in a lab but will deciding what traits you want in animals and selecting appropriate parents. Plants were also genetically modified dating back to the first civilizations. The term biofortification is not used as often as GMO and falls under the category of genetically modified and results in adding important micronutrients to common foods. By finding and understanding research that is already out there we found that Hidden Hunger is silent problem. Not many people in developed countries have issues with malnourishment from micronutrient deficiencies but many developing countries are facing issues with health and economic problems. Biofortification allows for these micronutrients to be added to common food like rice and root crops that people in developing countries have access to. The economy also sees an increase in GPD per capita in the countries that have introduced these products in recent years and lower health care cost. With lower health care cost, countries' incomes can go to improving other aspects of life like education and infrastructure. However, there could be a lot more research on this topic to find out exactly what populations in both developed and developing countries are impacted by micronutrient deficiencies. The social impact of food must also be considered because change is not always easy especially for people who have been eating these common foods for thousands of years. 

Introduction

The term genetically modified organisms is a relatively newer term but the idea of genetic modification and biofortification has been around for a long time. People have been changing or altering their crops and animals since the beginning of agriculture by selecting more desirable traits via breeding (FDA, 2020). It wasn’t until the 20th century that genetic modification occurred through non-breeding methods. There are many misconceptions about the effects of GMOs on health but there is no scientific evidence supporting these claims. There is evidence that biofortification can reduce malnutrition from micronutrient deficiencies as well as improve crop yield, insect resistance, and drought resistance (Liberal et al., 2020). The most common deficiencies are micronutrients vitamin A, iron, iodine, and macronutrient amino acids but this doesn't account for all deficiencies that are considered Hidden Hunger. Hidden Hunger is defined as the vitamin and mineral micronutrient deficiencies that have affected an estimated 2 billion worldwide (Muthayya, 2013). By reducing health problems associated with micronutrient deficiencies less money would go into health care costs and more into stimulating the economy or improving other aspects of the standards of living. 

Research Question

• What is hidden hunger and how does it compare in developing and developed countries?
• How are GMO crops biofortified and how can they help people with nutrient deficiencies?
• How can GMOs help improve public health in terms of improving the health of the overall population?
• What are the economic effects of having an overall healthier population?

Methods

To review literature that was relevant to our subject we used the Web Of Science Article Database. The Basic Search feature was used to search for keywords in the title, topic and author category. Articles were also acquired by using the “cited by” function in Google Scholars article. To keep the review relevant to the present day, only articles written after 1990 were used.

Results

Hidden Hunger

Hidden Hunger refers to the vitamin and mineral deficiencies that have affected an estimated 2 billion worldwide (Muthayya, 2013). These are deficiencies in vitamins A,D, E, K and B, and microminerals like Zinc and Iron. Macrominerals deficiencies, which are needed in excess of a gram per day, also fall into the category of hidden hunger ( Higdon, 2003). The term ‘hunger’, meaning lack of sufficient food needed to survive, may be easy to identify by looking at those experiencing it. Hidden hunger however, is hidden in the sense that it is not as easy to identify and diagnose. Hidden hunger rises when the price of food is increased, causing the poorest populations to cut diversity out of their diets. Relying mostly on calorie dense, inexpensive, poor micronutrient density staple foods, usually cereal grains or tubers. The most common nutrient deficiencies in the word are of iron, vitamin A, and iodine (Muthayya, 2013). 

To estimate the impact of hidden hunger, researchers have used a measure called Disability Adjusted Life Years (DALYs), which are a sum of years of life lost and years lived with disability due to dietary deficiencies of proper nutrients (Muthayya et al., 2013). Looking at DALYs incidence maps can help one understand and see where people are most affected. 

     Figure 2. Estimatation of  DALYs per 100,000 population, attributable to iron, vitamin A, and zinc deficiencies. From Muthayya, S., Rah, J. H., Sugimoto, J. D., Roos, F. F., Kraemer, K., & Black, R. E. (2013). The global hidden hunger indices and maps: an advocacy tool for action. PloS one, 8(6), e67860.

To understand hidden hunger, it is important to know what and where the most prevalent and dangerous deficiencies are. 

In iron deficient people, complications with anemia arise. This is referred to as iron deficient anemia (IDA). Iron-deficient pregnant women have a higher childbirth mortality rate and more commonly have low or underweight babies (WHO, 2000). Anemia is also known to have a negative to cognitive function, behavioral function, and growth in children (WHO, 2001).

     Figure 3. Anemia in pregnant women, defined as hemoglobin level <110 g/L. From Mason, J., Lotfi, M., Dalmiya, N., Sethuraman, K., Deitchler, M., Geibel, S., ... & Mock, N. (2001). The micronutrient report: current progress in the control of vitamin a, iodine, and iron deficiencies. Micronutrient initiative. Ottawa: International Development Research Center.

      Iodine is another of the most prevalent micronutrient deficiencies. Found in marine species food like fish or seaweed, iodine deficiencies more prevalent to populations who don’t consume these products on a regular basis (Kennedy, 2003). Iodine in the diet helps regulate most normal thyroid function and is clinically diagnosed by presence of a swollen goiter.

   Figure 4. Iodine deficiency disorders, defined as both palpable and visible goitre. From Mason, J., Lotfi, M., Dalmiya, N., Sethuraman, K., Deitchler, M., Geibel, S., ... & Mock, N. (2001). The micronutrient report: current progress in the control of vitamin a, iodine, and iron deficiencies. Micronutrient initiative. Ottawa: International Development Research Center.

 Vitamin A is needed for normal function in all parts of the body, especially vision and the immune system. Those who are vitamin A deficient are at risk of developing blindness because of the lack of retinol, an important component of our visual system. Increasing levels of vitamin A in children could significantly prevent death from measles and diarrhea (Kennedy, 2003). 

Figure 5. Vitamin A deficiency, as defined by serum retinol  From Mason, J., Lotfi, M., Dalmiya, N., Sethuraman, K., Deitchler, M., Geibel, S., ... & Mock, N. (2001). The micronutrient report: current progress in the control of vitamin a, iodine, and iron deficiencies. Micronutrient initiative. Ottawa: International Development Research Center.

 

Essential amino acids and fatty acids do not fall into the category of micronutrients, but may be just as hard to incorporate into the diet as other micronutrients. These nutrients are considered essential in the diet because human metabolism lacks the ability to produce them on its own. Omega- 3 fatty acids are essential for the production of phospholipids in cell membranes (NIH, 2021). In populations that lack regular consumption of seafood in diet, it is possible that omega-3s could be absent from the diet. 

  Figure 6. Sources of Omega fatty acids in diet. From Troops, Diane. “Understanding Omega-3 Fatty Acids.” Foodprocessing.com , Putman Media, Aug. 2009, www.foodprocessing.com/articles/2009/augustwellnessomega/.

The other side essential macronutrients are the amino acids histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine (Mediline, 2021). While these are present in most animal proteins, they are less prominent in plant based proteins. A population who rely on only rice beans or most grains will have more trouble getting adequate amounts of all essential amino acids.

How Foods can be Biofortifed

Humans have been genetically modifying their crops since the beginning of agriculture, around 10,000 years ago, by selecting for more desirable traits in the crops they grew (FDA, 2020). However, the more modern definition of a genetically modified organism didn’t come until the 20 th century, referring to modifying DNA through non-breeding methods. The first GMO product to be approved by the FDA was in 1982, when E. coli was modified with a human gene to produce insulin, needed for diabetic patients (FDA, 2020). The first commercially available crop to be enhanced through genetic engineering was a tomato that was designed to resist rot longer, and it gained FDA approval in 1994 (Bruening, 2000). Today, over 90% of all corn, soybean, cotton, sugar beet, and canola are a genetically modified crop (FDA, 2020).

According to the FDA, the process of creating a GMO crop follows 4 main steps: identify, copy, insert, and grow (FDA, 2020). Identifying refers to finding which trait is needed in the GMO crop and where in nature that gene is found. Interestingly enough, the gene does not even have to come from the same animal kingdom. This is referred to as transgenic modification. However, genes can come from the same kingdom or even the same species. The next steps include copying the desired gene from the host organism and inserting it into the new organism. The last step involves growing and carefully monitoring the crops first in a lab setting, eventually moving from greenhouse, to field, to farmers (FDA, 2020).

Biofortification is a specific type of genetic modification in which crops are modified to produce more diverse or abundant vitamins and/or minerals (Sakellariou and Mylona, 2020). The main goal of biofortification is to increase the bioavailable nutrients in edible portions of crops and, in turn, reduce incidence of hidden hunger (Liberal et al., 2020).  Using biotechnology such as clustered regularly spaced palindromic repeats (CRISPR) and CRISPR associated protein 9 (Cas9), genes can be added, edited, and/or gene regulation modified to express factors increasing vitamin or mineral content in crops (Sakellariou and Mylona, 2020).  

The BioCassava Plus Program is an example of GM crops providing a benefit to public health. Cassava is a root crop that is a staple food for 250 million Africans (Sayre, 2011). Like most staple foods, cassava, while calorie dense, is not able to provide adequate nutrition when eaten alone. A cassava diet only provided 30% of the recommended protein intake and 10-20% of the consumer's iron, zinc, and vitamin A needs (Sayre, 2011). Through genetic engineering, researchers were able to increase the levels and bioavailability of all the macro and micronutrients cassava lacked along with extending shelf life (Sayre, 2011).

  

Figure 7. Enhanced gold color in transgenic BioCassava Plus due to increases of  pro-vitamin A. From Sayre, R., Beeching, J. R., Cahoon, E. B., Egesi, C., Fauquet, C., Fellman, J., ... & Zhang, P. (2011). The BioCassava plus program: biofortification of cassava for sub-Saharan Africa. Annual review of plant biology, 62, 251-272.

Video About Golden Rice

Concerns In Golden Rice 

Golden rice is likely the most popular example of biofortification through genetic modification. Golden rice was developed to help those who suffered from vitamin A deficiency. In 2005, this was estimated to be 190 million children and 19 million pregnant women around the world (WHO, 2009). By transferring genes from other species that produce beta-carotene, golden rice proved to be a sufficient source of vitamin A if eaten in sufficient quantities (Tang, 2009).

GMOs and the Economy

 Qaim (2009) describes three different generations of genetically modified crops. The first generation of GM crops are ones that a trait is improved in terms of agronomic traits such as pest resistance. The second generation includes GM crops that are improved for quality of life like improving micronutrient content including vitamins and minerals. The third generation are crops used for pharmaceutical and other industry purposes such as vaccines. Figure 8 breaks down different generations of GMOs and how they would impact human health and the economy. 

Figure 8. Breakdown of GMOs generation. From "Review: genetically modified plants for the promotion of human health". by  Sakakibara, K. Y., & Saito, K. (2006). Biotechnology Letters , 28 (24), 1983–1991.  Copyright © 2006, Springer Science Business Media B.V. 

Golden rice is an example of a second generation GM crop. Comparing households with and without Golden Rice, there was a 60% decrease in health cost associated with vitamin A deficiencies (Qaim, 2009). There was also a high-cost effectiveness calculated and a high rate of return on investment with Golden Rice which saw a 2% growth in China’s income (Qaim, 2009). With Bt cotton, a surplus gain of which 37% was captured by farmers, 18% by consumers, and 45% by the innovating companies (Qaim, 2009). The World Bank estimated that the combined economic costs of iron deficiency, iodine deficiency, and vitamin A deficiency in developing countries could waste as much as 5% of gross domestic product (GDP) (Stein and Qaim, 2007). Biofortification goes beyond improving the health of populations by benefiting the economies of developed and developing countries. 

Discussion

We set out to show that hidden hunger is a problem that affects a large portion of the world's population and that genetically modified crops could be a potential remedy to those vitamin and mineral deficiencies. Comparing the world bank's data on GDP per capita, and most DALY’s due to micronutrient deficiencies, we discovered that hidden hunger disproportionately affects the parts of the world that are less wealthy. These countries tend to be located in Central America, Africa, and Southeast Asia. There could be other factors at play such as diet limitations due to geography and climate. An example of this is landlocked African countries which show the highest indices of goiter (iodine deficiency) because of their limited seafood access. It is likely that reduced wealth in these countries directly affects their ability to grow and access a diverse, nutrient dense diet. Instead, people in these areas must turn to more readily available and calorie dense staple crops to ensure sufficient energy consumption. The problem here is that the lack of diversity in diet is the cause of hidden hunger. Other methods have been explored, with success, to combat the hidden hunger. The vitamin A supplementation was largely successful in preventing childhood blindness due to VAD in much of the world, but is very costly and ensuring the program is funded is not guaranteed. This is why we considered genetically modified crops to be a suitable remedy for hidden hunger because it relies less on annual funding of supplement programs. 

The goal of this project was to explore whether modified crops could be fortified in a way to close the deficiency gap. It was found that, in the past, there is good evidence in both large and small scale studies that staple crops can be modified in a way to become a better reservoir for many kinds of nutrients. Golden rice is likely the most popular of these programs. There is some controversy whether the golden rice project was actually responsible for slowing childhood blindness due to VAD. The initial trials of golden rice reportedly did not contain enough of the provitamin A to properly supplement diets, however this was solved with the invent of Golden Rice 2 which contained 23 times more β-carotene (Paine, et al.). This speaks to the importance of future research being put into these practices, like most things, the reality for GMO crops to really help people is possible if the correct resources are contributed to it.

Hidden hunger not only produce issues for human health but also economic and labor losses. The health benefit may not come directly from increased nutrients but from better health systems built from more efficient agricultural economies (Sakakibara & Saito, 2006). On a macro level, GMOs have been shown to generate more economic benefits to producers and innovators. GMOs could have additional economic benefits to the farmers and communities farming them, helping smallholders stay competitive with larger farms. GMOs have positively impacted the economy (in terms of GDP) by reducing the loss from an unhealthy population due to micronutrient deficiencies.

It would be a mistake to not acknowledge the social impact that food has on a culture. In many parts of the world food is seen as a link to one's heritage and an expression of their culture. These links are normally attributed to staple crops like cassava in parts of Africa, maize in Central America, and rice in Southeast Asia among others. We should not assume that changing something like color, texture, or flavor in order to improve nutrition will not be met with some opposition. It is important to keep this social aspect in mind, and listen to those who will be growing and eating GMO crops.

Conclusion

There have been many successful biofortified/genetically modified foods that have reduced Hidden Hunger around the world. The BioCassava Plus program has done work in Puerto Rico that showed that their GMO crop could improve the lives of those growing it. The Golden rice project furthered this proof of concept by improving the life of hundreds of thousands of women and children, preventing further illnesses and childhood blindness. Vitamin A, iron, iodine, and protein deficiencies are just scratching the surface of all the nutrient deficiencies fueling the world’s hidden hunger. Even with many negative opinions on genetically modified foods, we believe that it is in the best interest of the United Nations to not move forward with restricting GMOs around the world. We are asking for the opposite. We want more research into where Hidden Hunger is impacting people the most. Once this is known, then work can be done on the GMO front to identify what staple crop is grown in that area by that culture and what that crop needs to be fortified with. In the end this could prove economically beneficial by first, allowing for a much better and more productive life for those who were affected, and second,  less needed for costly supplementation like what was seen on the vitamin deficiencies. Education of the general public is another key goal in order to improve public health. With no evidence that GMOs cause health risk, we can move forward with efforts for GMOs to benefit the public. 

Citations

Bruening, G., & Lyons, J. (2000). The case of the FLAVR SAVR tomato. California Agriculture, 54(4), 6-7.

Center for Food Safety and Applied Nutrition. “GMO Crops, Animal Food, and Beyond.” U.S. Food and Drug Administration, FDA, Sept. 2020, www.fda.gov/food/agricultural-biotechnology/gmo-crops-animal-food-and-beyond.

Center for Food Safety and Applied Nutrition. “Science and History of GMOs and Other Food Modification Processes.” U.S. Food and Drug Administration, FDA, Apr. 2020, www.fda.gov/food/agricultural-biotechnology/science-and-history-gmos-and-other-food-modification-processes.

Higdon, J. (2003). An evidence-based approach to vitamins and minerals health benefits and intake recommendations. Thieme Medical Publishers, Inc..

Kennedy, Gina, Guy Nantel, and Prakash Shetty. "The scourge of" hidden hunger": global dimensions of micronutrient deficiencies." Food Nutrition and Agriculture 32 (2003): 8-16.

Liberal, Â, Pinela, J., Vívar-Quintana, A. M., Ferreira, I. C., & Barros, L. (2020). Fighting Iron-Deficiency Anemia: Innovations in Food Fortificants and Biofortification Strategies. Foods, 9(12), 1871. 

Mason, J., Lotfi, M., Dalmiya, N., Sethuraman, K., Deitchler, M., Geibel, S., ... & Mock, N. (2001). The micronutrient report: current progress in the control of vitamin a, iodine, and iron deficiencies. Micronutrient initiative. Ottawa: International Development Research Center.

Muthayya, S., Rah, J. H., Sugimoto, J. D., Roos, F. F., Kraemer, K., & Black, R. E. (2013). The global hidden hunger indices and maps: an advocacy tool for action. PloS one, 8(6), e67860.

Paine, J. A., Shipton, C. A., Chaggar, S., Howells, R. M., Kennedy, M. J., Vernon, G., ... & Drake, R. (2005). Improving the nutritional value of Golden Rice through increased pro-vitamin A content. Nature biotechnology, 23(4), 482-487.

Qaim, M. (2009). The economics of genetically modified crops. Annu. Rev. Resour. Econ., 1(1), 665-694.

Sakakibara, K. Y., & Saito, K. (2006). Review: genetically modified plants for the promotion of human health. Biotechnology Letters, 28(24), 1983–1991. 

Sakellariou, M., & Mylona, P. V. (2020). New Uses for Traditional Crops: The Case of Barley Biofortification. Agronomy, 10(12), 1964. doi:10.3390/agronomy10121964

Sayre, R., Beeching, J. R., Cahoon, E. B., Egesi, C., Fauquet, C., Fellman, J., ... & Zhang, P. (2011). The BioCassava plus program: biofortification of cassava for sub-Saharan Africa. Annual review of plant biology, 62, 251-272.

Stein, A. J., & Qaim, M. (2007). The Human and Economic Cost of Hidden Hunger. Food and Nutrition Bulletin, 28(2), 125–134. 

Troops, Diane. “Understanding Omega-3 Fatty Acids.” Foodprocessing.com, Putman Media, Aug. 2009, www.foodprocessing.com/articles/2009/augustwellnessomega/.

World Health Organization. (2000). Turning the tide of malnutrition: Responding to the challenge of the 21st century (No. WHO/NHD/00.7). World Health Organization.

World Health Organization. (2001). Iron deficiency anemia. assessment, prevention, and control. A guide for programme managers, 47-62.

 

Authors

Grace Larson

Hello, everyone! I am from Spring Valley, WI, a small, rural town in Northwest Wisconsin. I did not live on a farm growing up but was surrounded by grain and dairy farmers my whole life. Currently, I am in my final year of studying Food Science at the University of Wisconsin-Madison. With GMOs being a hot topic in many parts of the food industry and in many courses I have taken with my time at UW, I decided to focus on the positives of GMOs and how they can benefit people in need. 

McKenna Meyer

Hey there! I'm from a tiny town in Northwest Wisconsin called Balsam Lake. I'm currently a senior studying Animal Sciences at UW Madison with hopes of attending the UW School of Veterinary Medicine! This project focusing on the connection between GMOs and human health allowed me to connect my rural roots to my passion for fitness and global health advancement.

Joe Mitchell

Hello! I am from Neenah, Wi. I decided to study Food Science at University of Wisconsin Madison after realizing the positive impact healthy, safe and affordable food can have on peoples lives. GMOs are an interesting subject to me because I feel the potential for them is not limited to increasing profit margins for seed companies and cooperate farms, but having real beneficial impacts on world health, and tool to be used in future sustainability of the food system.