Goals for nutrition

A diverse diet, made up of a variety of grains, beans, vegetables, fruits, and animal products is the best way to get all the essential macro and micro nutrients.

Over at Agricultural Biodiversity Weblog, Jeremy has been critical of information coming out of the First Global Conference on Biofortification. He wonders if the organizers and attendees were/are too focused on a techno-fix rather than on diverse diets as a solution. This being a conference on biofortification, we talked about biofortification a lot, and it could be argued that biofortification is a techno-fix, whether by breeding or biotechnology.
However, we talked about a lot more at the conference, including supplementation and fortification, diverse diets and education, cooking and farming methods. To say that diverse diets were ignored would be incorrect. That obviously isn’t getting through in the materials coming out of the conference through the organizers or media, which is a problem.
If we polled each conference attendee, I think most if not all would say that a diverse diet for every human on the planet is the ultimate goal. Many of the sessions addressed this specifically, getting into the details of how diet and nutrition are intertwined. Here are just three examples:
Percentage of funds spent by families on different items before and after a 50% increase in food prices. The red and green blocks represent high-nutrient foods from plant and animal sources. Image from Howie Bouis's plenary talk at the Global Conference on Biofortification.

For example, Merideth Bonierbale, of the International Potato Center, described how consumption of some potatoes that are high in vitamin C but low in iron can assist with absorption of iron in other foods for low-income people in rural areas of Peru.
Mark Failla, Professor of Human Nutrition at Ohio State, talked about  how cooking methods can change bioavailability of nutrients. Pro-vitamin A in cassava is more bioavailable in fufu than in gari, possibly because the high temperature used in roasting gari breaks the nutrient down. Because pro-vitamin A is fat soluble, adding oil helps make the vitamin more bioavailable, but even the type of oil can make a big difference.
Howarth Bouis, Director of Harvest Plus, in his plenary The Five Big Challenges, reminded us that the percentage of the diet that has the most vitamins isn’t grains but the leafy greens, animal products, etc. When the price of grain goes up, consumption of nutrient rich foods goes down, because the grains provide more calories per dollar. The people buying these foods might still have full stomachs but the nutrients aren’t there. Ideally, people would be able to buy those nutrient rich foods and eat a diverse diet, but we know that’s not what is happening out there, especially when food prices are high.

Why vitamins and minerals matter

While starvation due to lack of food is a problem that certainly needs attention, malnutrition due to lack of vitamins and minerals has gone virtually unnoticed. The hidden hunger of malnutrition affects an astonishing 1 in 3 people worldwide, according to the Micronutrient Initiative. Lack of key micronutrients, especially in the first 1000 days of life (from conception to the second birthday), results in adverse effects to cognitive and physical development as well as a reduction in immune function. Those key nutrients include iodine, vitamin A, iron, zinc, and folate.
The sad truth is that, in many places, whole generations of people are growing up with brains and bodies that aren’t what they should be. How can we expect these people to find ways to bring themselves, their families, their villages, and their countries out of poverty? The truth is, they can’t, or at least the task is far more difficult than it would be for people who weren’t malnourished. This is the real tragedy of malnutition. If we can find ways to deliver nutrition to this generation’s mothers and their young children, those children will grow up strong and smart, and able to fight off disease as they should be. If we can improve the nutrition of just one or two generations then they will be able to make change for themselves and those around them, including those who do not have enough food. We need to help these people receive adequate nutrition through any methods that are appropriate for the situation. The goal is not just a healthy diet, but a self-sufficient healthy diet.

What can we do?

Impoverished people aren’t getting the nutrients they need because they don’t have access to a diverse diet, often because they can’t afford to purchase anything but grains. The long term goal is to enable people to have access to a diet that includes vegetables, fruits, and animal products. That will take global, regional, and national efforts to increase incomes for the poor. These changes are obviously something we all want to do but also obviously something that is going to take a very long time. While we work on reducing poverty, we can make nutritional improvements to the foods people are eating. In the mean time, there are a lot of people who are getting enough calories but who can’t afford nutrient dense foods.
Can we improve staple foods to meet more of the nutritional needs of the people eating them? The answer is, in a lot of cases, yes. In the developed world, we have fortified foods, including iodized salt, iron and folic acid fortified flour. These interventions have been successful in eliminating deficiencies of those nutrients. Similar efforts have worked in the developing world, but rural areas, distant from roads, have not received the benefits. Another problem with fortified foods is that they do add to the cost of the food, which doesn’t work well for rural or urban poor who can’t afford even a few extra pennies. Some government fortification initiatives have worked, but require constant monetary input.
Another option for nutrient delivery is supplementation as pills, shots, vitamin packets that can be added to foods, or food products like Plumpy’nut. These can be very effective in certain circumstances, such as for disaster relief, or while longer-term fortification programs are being initiated. But they have some significant drawbacks, including the requirement for frequent delivery of often perishable products, low acceptance rates by the people who might benefit from them, side effects like nausea, and health problems from over-supplementation. And again, rural people often don’t have access to such products.
What can we do for those people in rural areas who don’t have access to fortified foods? Most people in rural areas farm, even if only a small plot of land. Can they farm more diverse foods? In some cases, yes, depending on soil and rain and other factors. In some cases, the people are lucky if they get a few potatoes or cassava or a few ears of corn or stalks of rice out of the ground, and adding additional crops isn’t possible. One of the speakers at the conference said that many farmers in developing countries only produce enough food for part of the year, and must purchase the rest (I unfortunately don’t remember who said this). If we can put the ability to accumulate more nutrients in the seeds themselves (or cuttings, in the case of potatoes and cassava), then those few staple foods can be that much more valuable nutritionally.

Biofortified crops

Biofortified crops have many advantages over fortified foods or supplements. First, the nutrients can be packaged in biological molecules are easily absorbed by the body yet recognized by the body so over-consumption (within reason) won’t result in overdose of the nutrient. Second, the seeds only have to be distributed once, if they are non-hybrid varieties, and each generation the seeds will still have increased nutrients. If they are hybrids, the seeds can be distributed via existing seed distribution channels (if they exist – obviously hybrids would not be a good solution where there is no way to purchase or otherwise obtain seed each year). Finally, the improved seed can be bred or engineered to contain not only improved nutrients but also disease resistance, stress tolerance, and other traits that will help the plants be more productive without additional inputs. The same is true for plants propagated by cuttings or tubers, but even more so because each plant is clonal so there is no chance of genetic drift reducing nutrient content or other traits.
Biofortified and otherwise improved plants would allow farmers to have a higher income due to greater yields, as well as providing nutrients to allow the farmer’s family to be strong and healthy. Biofortified crops have the potential for big impacts on urban and non-farming malnourished persons as well. If all someone can afford is a bowl of rice or a little corn for arepas, and biofortified varieties are available, then their food dollar can go much further nutritionally. Biofortified crops aren’t just useful for people in the developing world, either. We in the developed world often don’t get the nutrients we need despite access to a diverse diet, fortified foods, and supplements.
Of course, biofortification isn’t without problems. For example, there are unique economic issues that could arise. There is potential for biofortified varieties of a crop to be considered more valuable than non-biofortified varieties, so the biofortified food would actually be more expensive, just like the fortified food can be more expensive. This would benefit farmers but wouldn’t help non-farmers. However, unlike fortified food, after some time, the seeds could be passed from farmer to farmer until most of the available food is biofortified, so the price differential would no longer be there. Another option would be for a country to make rules about new seed varieties, such as saying that they must contain certain levels of a nutrient, so that over time all seed would be biofortified.

Moving forward

Ideally, biofortified crops would be developed in ways that would benefit small farmers in developing countries the most. There are many issues to consider but I think there are two that are the most important.

Golden Rice, just another improved rice strain, yet it has a great potential to cover micronutrient needs of rural, rice-based societies. Photo from Goldenrice.org.

First, the traits must be developed with the intent for free distribution to those who need it most. Governments and non-profit organizations like Harvest Plus are doing good work, but partnerships with corporations have a lot of potential. Golden rice (set to debut in 2012 with enough pro-vitamin A to meet nutritional needs with regular rice consumption levels) is the first example of a public-private partnership, although because it was the first, securing a humanitarian license wasn’t quite as smooth as it could have been.
Now, there is evidence that corporations see value in such partnerships, and the process is much smoother. The method being pursued by the Gates Foundation and Monsanto with Water Efficient Maize for Africa (PDF) could be used as a model for new public-private partnerships. They plan to distribute improved seed with the water efficient trait to low income farmers at no cost, while relatively wealthy farmers may be required to pay for the seed.
Second, the plants must come with education. In Kenya, for example, education of the health benefits of orange sweet potato over white sweet potato has been key to acceptance. One way to distribute information that was discussed at the conference is to train one trusted person in each village who will then be able to disseminate the information. If a foreigner just drops off some stuff, whether it’s seeds, medicine, or anything else, without information, the items might not be accepted.
I think it was Denis Kyetere, Director General of the National Agriculture Research Organisation in Uganda who said – imagine an African villager walking into your neighborhood and telling you what you need to do to be healthy, to exercise and eat more vegetables. Would you listen to an outsider? We don’t even listen to our doctors, but we might listen to a friend.
Community based education has been shown to work. One example is Living Goods, an Avon style service that provides life-saving medicines, supplements, condoms, and more at a low cost. Education comes along with the products. The “Health Promoters” who sell the goods are members of the community so are much more likely to be trusted.

30 thoughts on “Goals for nutrition

  1. This narrative has a history.
    Not too long ago, Benedikt Haerlin of Greenpeace went on the record as saying deliberate destruction of field trials of Golden Rice was a viable option.
    The result was extreme embarrassment for Greenpeace, and Haerlin being shuffled off to another, much smaller, activist group.
    Not wishing to repeat the experience, anti-biotech activist groups have since then focused instead on how to offer something, anything, ‘better’ than Golden Rice. If they fail at this task, their narrative might be crippled beyond recovery, which is bad for business.

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    1. Eric, could you provide a source for Benedikt Haerlin going on record saying that? I am finding stuff about the moral dilemma that Greenpeace was faced with at the time, and him saying the opposite that Greenpeace will not destroy field trials. It is possible that he was forced to reverse his position, so this would potentially be some good information about the background of this story.

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      1. Karl,
        Here you go:
        Greenpeace renews its opposition to GM rice
        The Telegraph (UK)
        12 Mar 20
        http://www.telegraph.co.uk/news/uknews/1326051/Greenpeace-renews-its-opposition-to-GM-rice.html
        and
        Genetically modified crops: the ethical and social issues. By Roger Highfield, Science Editor of The Daily Telegraph, 8-25-2002, http://cellbank.nibio.go.jp/information/ethics/uk_nuf/gm_crops_preface.pdf (pdf, 5 pp.)
        Pull quote (Haerlin):
        ”Although we [Greenpeace] do not have any immediate plans to take direct action against ‘golden rice’ field trials, we reserve the right to take direct, non-violent actions against any releases of GMOs into the environment. The fundamental environmental safety issues remain unresolved for golden rice just as for any other genetically modified organisms.”

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      2. Thanks for the links, Eric. I found pretty much the same quotes in my own searches, except for the part about “reserving the right” to rip out any GE crop, including Golden Rice. For my next trick, I will reserve the right to fail to stop at a red light if I feel like it. Oh wait, I don’t have the right to do that – it’s illegal.
        What strikes me as contradictory in the field-trial tear-out approach is that it is supposedly a statement against unilateral non-democratic actions, i.e. planting a GE crop. But it is, in and of itself, a unilateral non-democratic action – an internal contradiction that I can’t see a way out, logically. Direct citizen action to stop horrible things from happening is a tool that should be used rarely, if ever. These crops are not one of those cases.
        I wonder if there is a source for Haerlin leaving Greenpeace in connection to his comments regarding Golden Rice?

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  2. Anastasia says that one problem with biofortification is that biofortified crops may be more expensive. This is really a minor problem. Other problems are much more serious.
    One statement that I noticed came out of the conference was that biofortified varieties produce just as much as high-yielding varieties. But is there really any evidence for this? There has been a lot of evidence that as yields have improved over the last half-century and longer, micronutrient concentration in food crops has declined. Farmers will not adopt lower yielding varieties unless there is some kind of noticeable benefit – something that crops high in iron or zinc does not have. One problem with the research and development system in biofortification is that these initiatives are being funded by organizations that believe biofortification is a solution to micronutrient deficiencies. Therefore, scientists have a vested interest in showing that they can get high yields and high micronutrient concentrations. After all, if they cannot show this their research funding will dry up. We need much more research, by independent scientists, that looks at the relationship between yield and micronutrient concentration.

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    1. Peter,
      Biofortified crops will always lag behind conventional crops, in terms of bushels/acre.
      That’s because of the time spent in R&D, and the extra regulatory hoops to jump prior to commercialization. While people are struggling to develop a biofortified version of an elite line, breeding efforts involving conventional high-production cultivars will have continued apace.
      One commentator (i forget who) called this ‘the bunny effect’. (Yield lag vs. yield drag.)

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      1. In developing nations etc where these crops are targetted this probably isn’t such a huge issue – if your crop yields 30% of the maximum that it could yield under perfect agronomic conditions then you don’t really have to worry about yield lag in this respect.
        In an industrialized setting where you have a biofortified elite line (by GMO methods) then it is simply (and herein you can tell I’m no plant breeder!) a matter of introgressing the trait into elite germplasm.
        From seeing presentations on the initial high zinc (I think it was Zinc, lets assume it was for the sake of arguement) Cassava it is clear that at least in this case yield drag is a significant issue – the cassava plants had vastly improved zinc levels – all the graphs pointed to great success.
        Then came the pictures of WT cassava vs GM cassava – the GM was maybe 20% the size of the WT and looked deathly sick – my guess is that similar issues arise commonly with improved nutrient crops (hence the paucity of positive results) and require a lot of work to get around (I’m hopeful that in the next decade the kinks will be worked out and improved nutrient cassava that works just as well as WT in terms of yield will be a reality)

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  3. Ewan and Eric,
    My point is that if you are a farmer, which variety do you select? The higher-yielding one or the slightly less higher-yielding biofortified variety?
    There is no visible difference between them if they are biofortified for iron or zinc?

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    1. Peter – generally you’ll select the high yielding variety – although this would depend on the value of the biofortified variety – if this made up for the yield difference then you’d pick the biofortified version – I just wonder whether a 20% yield drag in good agronomic conditions would manifest itself on a farm in a developing nation where yields aren’t limited by genetics but by environment (in my example of cassava they clearly would be, but for a yield drag equivalent to 10 years of varietal difference I doubt you’d see a thing)
      I fully agree however that yield claims need to be robustly tested for biofortified crops (multi year, multi environment testing, not 6 1’x1′ plots in a field at a single agronomic station)

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    2. Peter,
      You pose a very interesting question. If the market offers a premium for biofortified over conventional, the farmer will grow biofortified — but only if the premium is worth the effort. In this wise it’s good to consider the premiums paid for organic/non-GMO soy and maize. There are substantial premiums for such crops — but the reduction in yield nearly always completely erases the premium.
      Ewan,
      As far as I know, it takes roughly ten years to get a new biotech event on the market. That’s ten years that conventional breeders have been getting ahead of what was state of the art a decade earlier. Anastasia can probably fine this timetable down quite a bit — it’s unusual for the biotech corporations to discuss the issue in any detail.

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      1. Eric – ok lets assume it takes 10 years to get an event to market (which is as good a timeline as any – say 2-3 years per development phase and 4 phases (to work on the Monsanto model, although my times may be off there) – what happens when you get a commercial trait? You put it into all the elite germplasm you can, you license the trait out and have others put it into their elite germplasm – you don’t have to develop one trait per germplasm, you develop once and breed it into leading genetics (which is why all MON810 events are called MON810 – they can all trace their ancestry back to a single transformation event which was designated MON810 – yet MON810 exists now in diverse elite germplasm)

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    3. At the conference, we repeatedly discussed this problem. The consensus is that any biofortified variety to be put out must also have yield protection traits or stress resistance traits, and the varieties must be locally adapted. As a plant breeder, I think what would need to happen is development of the trait in as elite of germplasm as possible while simultaneously working on making locally adapted varieties better, such as rust resistance and things like that. Then, as Ewan said, introgress the nutritional trait into many different improved lines. The total time to development of a new crop isn’t much longer than that of a non-biofortified crop (unless we’re talking regulatory hurdles of transgenics, which is sort of another issue). Maker assisted selection is a fairly cost effective and time saving method. To see how MAS helped get a flood-tolerance gene in rice into many locally adapted varieties, check out Pam Ronald’s work.

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  4. Another huge problem with biofortification is adoption by farmers and acceptance by consumers. Much of the economic modeling that shows the great potential of biofortification (using the DALY methodology) is based on wildly unrealistic assumptions about farmer adoption levels, especially for crops other than rice and wheat. The poorest and most nutritionally deficient populations are usually the ones that use traditional varieties. They have no history of adopting improved varieties. And amongst consumers, there is very little evidence that they will find these biofortified varieties acceptable – in terms of cooking quality, taste, color and many other qualities.
    Biofortification may succeed and be a great development interventions, but we must also recognize that it has a fairly good chance of being a bust.

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    1. Peter,
      We already have a real-world model of the situation you describe, and it involves high-lysine maize. Lysine is an essential protein in the human diet, i.e., we have to consume it because the human metabolism can’t produce it, and without it, we suffer malnutrition.
      That is something which easily could be advertised on boxes of breakfast cereal. But it’s not — and the problem is, the biotech corporations know how to sell to farmers. When it comes to talking to consumers, they’re clueless. At the same time, the food manufacturers know how to communicate with consumers — but they’re equally clueless in communicating with farmers.
      On top of all this, consider: GM crops have been nothing but a headache for food companies. All these crops have meant to them is boycotts and recalls. There’s no love lost between the biotech corporations and the food companies.
      This will when everyone in the supply chain can perceive a commercial advantage.

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    2. Acceptance by consumers in the developed would will require 1) having a company that thinks a “now with extra x” label will sell more, 2) that company would need to seek out farmers willing to contract for that speciality variety of a crop, 3) marketing. We already have so many fortified foods, from older items like vitamin loaded breakfast cereal to newer items like omega 3 fish oil dairy products. Some fortified products and superfoods flop, some stick.
      Acceptance by consumers in the developing world is at once easier and more difficult. In most cases, the consumer is the farmer. Successes with orange sweet potato indicate that changing cultural proclivities for white foods is possible. Can this be repeated with Golden rice? We’ll see.

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      1. Can I just remind Eric and Anastasia that the very first GM product offered for sale in the UK was indeed one that offered consumers a perceived advantage: tomato paste from Astra Zeneca tomatoes engineered, like Flavr Savr, to ripen more before softening. One reason consumers and suppliers in Europe at least have turned against GM so violently is that it offered them no benefits, not even price. If GM products offered demonstrable benefits, I suspect a lot of the opposition would fall by the wayside. But that’s not really to the point.

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      2. Did that product actually have any consumer benefit? The slow softening trait is nullified when the tomatoes are made into paste. Give me a tomato that actually tastes good that I can keep on my counter for two weeks before it starts to go soft and then we’ll talk. I don’t think there has actually been any genetically engineered trait that has a direct consumer benefit. And there probably will never be, or at least not for a very long time.
        As far as I’m concerned, we (as in scientists) should continue researching and finding interesting transgenes and cisgenes, including ones that have direct consumer benefit, slowly amassing proof-of-concept studies. But they’ll never actually be released because the activists have won. They fought and got exactly what they didn’t want. Only giant corporations can afford to invest millions of dollars testing a trait only to have popular opinion prevent it from ever being released. Take a look at who’s doing the research today – anything in Europe has been basically abandoned, the USDA stopped funding for research on genetic engineering a long time ago, all the small companies have folded or been sold – the only ones actively researching genetically engineered traits are the big bad multinational companies and the Chinese government.
        So, we’re stuck, for example, breeding rice for improved iron even though there is little genetic variation in the species and ten years of breeding has resulted in very little actual improvement in iron content of milled seeds, and even though genetic engineers have shown real improvement in rice iron content by overexpressing the plant protein ferritin.

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      3. Apart from price, as Eric has pointed out, I believe there may also have been a perceived benefit to flavour, because the tomatoes were riper when processed.

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      4. Jeremy,
        The story of the GM tomato paste in the UK is actually a bit different. The tomatoes involved were modified to reduce the cost of processing. These savings were passed on to consumers, and the product was clearly marked ‘GM’.
        The tomato paste was a huge hit with consumers, who clearly were more interested in price than in GM status.
        The anti biotech crowd could not suffer this situation to continue, and launched a program to make it illegal to grow these tomatoes in the UK. They were successful.
        The result: the GM tomatoes would have to be grown elsewhere, and shipped to the UK. Costs of transportation completely overshadowed the savings in processing cost, so the tomatoes disappeared from the market.

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  5. Thanks for this excellent round-up, Anastasia. It does rather make the point that coverage of hunger, hidden hunger and solutions is often biassed towards the simple and the simplistic.
    Can I also say that having to click to open each comment drives me nuts. Is there a way to open them all at once? I couldn’t see it …

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    1. We’re working on revamping the comment system to be way more user friendly. As much as I love WordPress, they have some things that are lacking- including a good comment system. We’re considering a lot of options, including Disqus. If you have any ideas, please let me know.

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  6. I have a difficult time believing that there is much production of paste tomatoes in a climate like the UK given other EU production zones. In fact, it’s highly unlikely. That anyone would invest in such a tomato specifically for UK production is even more unlikely. My memory is that the tomatoes were suppose to be produced in Spain and Italy, not UK, but perhaps it was a UK paste company marketing them? And I think it was consumer rejection, not cost of shipping them to UK when production was banned, that brought about their demise in the late 90s.
    Just did a little search and found this: http://www.ipa.org.au/news/659/nothing-to-fear-from-genetically-modified-tomato-paste-but-fear-itself
    suggests that retailers stopped stocking it

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    1. I agree, and said as much in a comment that alas got eaten. The paste tomato engineered by Astra Zeneca was never grown commercially in the UK. It was grown for trials at Jealott’s Hill.
      I don’t think it was consumer rejection that caused the GM paste to be abandoned. I think it was the supermarkets’ fear of consumer rejection, linked to BSE, that prompted the supermarkets to give up on GM tomato paste. Campaigners took advantage of human cases of vCJD to link the two issues in shoppers’ perceptions. That and reports of Dr Pusztai’s interviews about the effect of Gm potatoes on rats.
      It is a very complicated story, and alas nothing to do with dietary diversity.
      And (another comment that got eaten) I still hate having to click on each comment to read it in full. Where is the “expand all” button?

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  7. Please i would like to know the difference between Biofortified food and GM food. Aguements concerning them seems confusing. I would like to know more about them.

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    1. Sure thing. “Biofortified” food is food that has been enhanced, nutritionally, on a genetic level. This can be done through breeding – or – genetic engineering. For example, Golden Rice is a rice that has been genetically engineered (GM) to produce beta carotene, an important vitamin. And Orange Maize is a maize that has been bred conventionally to also have more of the same vitamin. Both are biofortified, but use different methods to get there. In this case, because some varieties of maize produce higher levels of beta carotene, it makes sense to use breeding, however, no varieties of rice produce it, so they use genetic engineering in that case. Does that make sense?

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