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Tardy to the Party – Nutrition in the Genetic Engineering Conversation

By Kevin Klatt

The National Academies of Science, the World Health Organization, The American Association for the Advancement of Science, the European Food Safety Authority and Food Standards Australia New Zealand are just a few of the international organizations that have position papers on the use of genetic engineering as it applies to food. These reports all conclude that genetically modified foods present no unique safety threats compared to traditionally bred crops and/or have not been linked to detrimental human health outcomes (the Genetic Literacy Project has a nice infographic depicting these organizations here). Notably missing from this extensive list are, oddly, nutrition organizations.

Two of the major American nutrition organizations are the Academy of Nutrition and Dietetics (AND) and the American Society for Nutrition (ASN). The AND does not currently have a position on genetic engineering; however, its member center (1) informs us that a new Evidence Analysis Library paper entitled “Advanced Technology in Food Production” is due to come out soon. ASN does not have an official position paper on genetic engineering, either. Rather, genetically engineered foods are briefly mentioned in two of their publications: “Processed Foods: contributions to nutrition” (2) and “Nutrition Research to Affect Food and A Healthy Lifespan” (3).

At a time when misinformation about genetically engineered crops is all too common in the public discourse, it seems rather odd that neither of the two largest nutrition organizations are providing guidance on or actively engaging in this topic of conversation. Nevertheless, the conversation continues on without nutrition. A quick look at the agenda (4) for the upcoming National Academies workshop on January 15-16th entitled “When Science and Citizens Connect: Public Engagement on Genetically Modified Organisms” highlights this disheartening reality: no one representing the field of nutrition is scheduled in the line-up of speakers or presenters.

There are likely many reasons why nutrition has abstained from the conversation. Genetically engineered foods inherently address wildly interdisciplinary concepts: everything from sustainability, to agricultural economics and plant genetics. Nutrition is certainly a piece of the puzzle, but it is not the whole thing. Alternatively, maybe we were not invited to the conversation. It only takes a few seconds of Google’ing to see that many nutrition professionals, particularly registered dietitians, have been rather vocal in the crusade against genetically engineered foods.

Regardless of the reason for nutrition’s absenteeism, the field should take a vested interest in influencing the conversation with its unique perspective. The scientific literature is filled with numerous examples of genetic engineering with great potential for the field, even beyond the case of golden-rice; folate-enriched tomatoes (5), calcium-enhanced carrots (6), non-browning Arctic Apples (7) and low acrylamide potatoes (8) illustrate just a few of the ways that GE technology can be responsibly used to improve the nutrient quality of an individual’s diet. A recent paper in Nature Biotechnology did a thorough analysis of the status and market potential of transgenic biofortified crops, highlighting the wide spectrum that have undergone nutrient biofortification and their potential role in human nutrition (9). As this paper highlights, the promise and potential of GE foods is not that they will be the solution to improving diet, but rather, that they can be a part of the solution. We have been breeding crops with little to no consideration for the nutritional phenotype for centuries (10); nutritional scientists working with plant scientists (similar to what HarvestPlus currently does) could certainly alter that trajectory and improve the nutrient quality of the food supply. In addition to genetically engineered crops for human consumption, genetically engineering feed consumed by farm animals can alter the nutrient profiles of animal foods; most recently, yeast genetically modified to produce their own omega 3 fatty acids (11) made headlines as a way to sustainably improve the fatty acid profiles of farmed salmon (12). Though likely far from market availability, the potential to genetically engineer animals themselves to alter their nutrient profiles has even been discussed (13).

While the promise of genetic engineering’s potential abounds, ASN’s publication on the future of nutrition research (3) asks us a rather prudent question: “Can we leverage technologies, such as biotechnology and nanotechnology, to develop novel foods and food ingredients that will improve health, both domestically and abroad, and provide credible, tangible functional health benefits?” As it stands now, the answer to that question is still unknown, and further research to identify the answer continues unguided by statements from professional nutrition organizations.

The scientific community as a whole could benefit from including nutrition in the genetic engineering conversation. As the National Academies prepare for this conference, and wonder how to improve communications between the public and scientists, I cannot help but see an alternative route through nutrition. While the National Academies seems to realize that crops resistant to already-feared agricultural chemicals offer an intangible benefit to consumers, their focus on chestnut trees, butterflies, and mosquitoes still feels distant. Addressing the conflation of genetic engineering with pesticide resistance is certainly a start, but these alternative applications of genetic engineering do not address food, which is where the controversy exists most prominently. To truly address this issue, the public is going to need to see a direct benefit from genetic engineering as it applies to food; nutrient biofortification offers a promising outlet for this. Imagine if individuals were introduced to genetically engineered foods through folate-enriched tomatoes instead of pesticide-resistant corn.

Position stances from nutrition organizations on the applications, safety aspects, and future directions of genetically engineered foods are long overdue. With the genetic engineering debate furthering consumer distrust in scientific bodies, it is all the more essential for prominent nutrition organizations to team up with other scientific bodies, and enter into this conversation. The benefactors of our research and professional activities are those who eat food, some of which is genetically modified; we should no longer sit silent on this major food-related issue.

References
1. http://www.eatright.org/Members/content.aspx?id=6442482664
2. http://ajcn.nutrition.org/content/99/6/1525.abstract
3. http://advances.nutrition.org/content/4/5/579.full
4. http://nas-sites.org/publicinterfaces/files/2014/07/PILS-02-GMO-Interface-agenda05.pdf
5. http://www.pnas.org/content/101/38/13720.full
6. http://www.pnas.org/content/105/5/1431.long
7. http://www.arcticapples.com/arctic-apple-nutrition/
8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607532/
9. http://www.nature.com/nbt/journal/v33/n1/full/nbt.3110.html
10. http://www.ncbi.nlm.nih.gov/pubmed/20467463
11. http://www.ncbi.nlm.nih.gov/pubmed/20804805
12. http://civileats.com/2014/02/24/costco-to-sell-salmon-fed-gmo-yeast/
13. https://www.bio.org/sites/default/files/2011_ge%20animal_benefits_report.pdf

Mobile Innovations in Global Nutrition Research

By Marion Roche, PhD

At the 2014 Clinton Global Initiative in late September, former President Bill Clinton remarked that a Masaai Warrior has better access to mobile communications today using a small cell phone than he had during his presidency 25 years ago. This access to technology is providing a wealth of opportunities, including in nutrition research and programming. Cell phones are ubiquitous across the African continent and are being used increasingly as an essential part of health community plans: in the area of emergency maternal health, such as when labour stops progressing; for improving supply demands, such as when rural clinics run low on zinc and oral rehydration salts (ORS). The use of cell phones has been at the forefront of the emergence of an entire field of mobile health, known as m-health. One of the most popular uses is probably communications messaging, such as sending regular SMS reminders to parents for growth monitoring visits.

Mobile technologies also offer innovations in global nutrition research. As cell phone use across Africa increases, it becomes easier and easier to train field workers in the use of personal data assistants (PDAs), as people are more familiar with the technology from having their own cell phones. One such example from the Micronutrient Initiative (MI) is the use of PDAs for data collection in our field surveys evaluating a mass media intervention to improve zinc and ORS for the treatment of diarrhea in Senegal. Interviewers carried a PDA with questionnaires loaded onto their device. Text-prompts guided them through the questionnaire, eliminating the need for paper surveys and the logistical complications of storage and transportation that paper surveys add. In the case of our Senegal survey, the PDAs connected to the mobile network daily and sent the interviews to a central server, eliminating the step of manual data entry, as PDAs are configured to send the data directly into the digital database. Anyone who has done data entry can appreciate the extreme benefit of being able to skip this time-consuming and high-risk-for-errors step. Further, the study supervisor can check for concerns in data quality from multiple study sites on a daily basis and follow up with interviewers the next day, potentially increasing overall data quality. And just as important, the issue of lost or damaged paper questionnaires is greatly reduced.

Using PDAs for field surveys opens up other new opportunities, such as incorporating visual media into questionnaires. We were able to provide caregivers in our Senegal zinc and ORS study with pictures of the different brands of products available, giving programmers important insights. The use of images can also be helpful in surveys with dietary recalls, although this option would require preparation of uploading photos and knowing the foods and supplements available to the targeted audience in advance. After a media campaign, we could include images from television spots or radio segments to see if parents recall the ads.

Global Positioning System (GPS) is now offered with some PDAs, which can help in monitoring data quality, survey implementation, and new ways for interpreting data. For example, with the Senegal project, we have the GPS coordinates for households and a visual map of clusters, or hot spots, for diarrhea infections, enabling us to prioritize these areas for intervention. We were also able to ask families about radio stations they listened to and create a map of radio stations reaching the communities in order to develop a national mass media campaign using local radio stations. With traditional surveys it could be months before this type of information would be available.

Despite the advances in using PDAs for data gathering, there are downsides, the biggest being initial purchase costs, related software, as well as having the training and expertise to support surveys in-country. Other challenges are short battery life, theft, connectivity issues, and, in some cases, the need for accompanying paper consent forms. At MI we are fortunate to work with Canadian partner Health Bridge whose expertise and equipment support our local partners and the MI office in Senegal. Innovations in enabling access to these new technologies may be the next challenge in m-health for nutrition surveys, as we work towards systems that provide greater access to larger segments of populations in low to middle income countries.