From Golden Rice to Golden Diets: How to turn its recent approval into practice.

Following its approval in the Philippines in July 2021, provitamin A-rich "Golden Rice" is set to become the worlds' first commercialized genetically modified crop with direct consumer benefits. Despite supplementation and fortification programs, the burden of micronutrient deficiencies remains high. For Golden Rice to be successful in reducing vitamin A deficiency, it needs to be taken up by food systems and integrated into consumer diets. Despite negative information often being associated with genetic engineering, evidence suggests that consumers react positively to Golden Rice. Thus, it offers policy makers and public health stakeholders a new, powerful option to address micronutrient malnutrition that they can integrate as a cost-effective component in broader nutrition strategies and tailor it to consumers' heterogeneous socio-economic contexts and needs to promote "Golden Diets". For this to happen, the right framing of the pathway from policy to consumption is crucial.

The sustainability of "local" food: a review for policy-makers.

In the political discussion, the promotion of local food systems and short supply chains is sometimes presented as a means to increase the resilience of the food system, e.g. in the context of the COVID-19 pandemic, and it is also suggested as a means to improve the environmental footprint of the food system. Differentiating between local food systems and short supply chains, a review of the literature on the environmental, social and economic dimensions of sustainability is carried out. "Local food" cannot simply be equated with "sustainable food"; in most cases, it neither can ensure food security nor does it necessarily have a lower carbon footprint. For the environmental sustainability of food systems, many more factors matter than just transportation, not least consumers' dietary choices. In terms of social sustainability, local food systems are not necessarily more resilient, but they can contribute to rural development and a sense of community. In terms of economic sustainability, selling via short supply chains into local markets can benefit certain farmers, while for other producers it can be more profitable to supply international markets.

The social and economic impact of biofortification through genetic modification.

Genetic modification (GM) has been advocated as an alternative or complement to micronutrient interventions such as supplementation, fortification or dietary diversification. While proof-of-concept of various GM biofortified crops looks promising, the decision tree of policy makers is much more complex, and requires insight on their socio-economic impacts: Will it actually work? Is it financially sound? Will people accept it? Can it be implemented in a globalized world? This review shows that GM biofortification could effectively reduce the burden of micronutrient deficiencies, in an economically viable way, and is generally well received by target beneficiaries, despite some resistance and uncertainty. Practically, however, protectionist and/or unscientific regulations in some developed countries raise the (perceived) bar for implementation in target countries.

Valuing increased zinc (Zn) fertiliser-use in Pakistan.

BACKGROUND AND AIMS: Use of zinc (Zn) fertilisers may be cost-effective in increasing crop yields and in alleviating dietary Zn deficiency. However, Zn fertilisers are underutilised in many countries despite the widespread occurrence of Zn-deficient soils. Here, increased Zn fertiliser-use scenarios were simulated for wheat production in Punjab and Sindh Provinces, Pakistan. Inputs and outputs were valued in terms of both potential yield gains as well as health gains in the population. METHODS: The current dietary Zn deficiency risk of 23.9 % in Pakistan was based on food supply and wheat grain surveys. "Disability-adjusted life years (DALYs) lost" are a common metric of disease burden; an estimated 245,000 DALYs y-1 are lost in Punjab and Sindh due to Zn deficiency. Baseline Zn fertiliser-use of 7.3 kt y-1 ZnSO4.H2O was obtained from published and industry sources. The wheat area currently receiving Zn fertilisers, and grain yield responses of 8 and 14 % in Punjab and Sindh, respectively, were based on a recent survey of >2500 farmers. Increased grain Zn concentrations under Zn fertilisation were estimated from literature data and converted to improved Zn intake in humans and ultimately a reduction in DALYs lost. RESULTS: Application of Zn fertilisers to the area currently under wheat production in Punjab and Sindh, at current soil: foliar usage ratios, could increase dietary Zn supply from ~12.6 to 14.6 mg capita -1 d-1, and almost halve the prevalence of Zn deficiency, assuming no other changes to food consumption. Gross wheat yield could increase by 2.0 and 0.6 Mt. grain y-1 in Punjab and Sindh, respectively, representing an additional return of US$ >800 M and an annual increased grain supply of 19 kg capita -1. CONCLUSIONS: There are potential market- and subsidy-based incentives to increase Zn fertiliser-use in Pakistan. Benefit-Cost Ratios (BCRs) for yield alone are 13.3 and 17.5 for Punjab and Sindh, respectively. If each DALY is monetised at one to three fold Gross National Income per capita on purchasing power parity (GNIPPP), full adoption of Zn fertiliser for wheat provides an additional annual return of 405-1216 M International Dollars (I$) in Punjab alone, at a cost per DALY saved of I$ 461-619.

Dietary mineral supplies in Africa.

Dietary micronutrient deficiencies (MNDs) are widespread, yet their prevalence can be difficult to assess. Here, we estimate MND risks due to inadequate intakes for seven minerals in Africa using food supply and composition data, and consider the potential of food-based and agricultural interventions. Food Balance Sheets (FBSs) for 46 countries were integrated with food composition data to estimate per capita supply of calcium (Ca), copper (Cu), iron (Fe), iodine (I), magnesium (Mg), selenium (Se) and zinc (Zn), and also phytate. Deficiency risks were quantified using an estimated average requirement (EAR) 'cut-point' approach. Deficiency risks are highest for Ca (54% of the population), followed by Zn (40%), Se (28%) and I (19%, after accounting for iodized salt consumption). The risk of Cu (1%) and Mg (<1%) deficiency are low. Deficiency risks are generally lower in the north and west of Africa. Multiple MND risks are high in many countries. The population-weighted mean phytate supply is 2770 mg capita(-1) day(-1). Deficiency risks for Fe are lower than expected (5%). However, 'cut-point' approaches for Fe are sensitive to assumptions regarding requirements; e.g. estimates of Fe deficiency risks are 43% under very low bioavailability scenarios consistent with high-phytate, low-animal protein diets. Fertilization and breeding strategies could greatly reduce certain MNDs. For example, meeting HarvestPlus breeding targets for Zn would reduce dietary Zn deficiency risk by 90% based on supply data. Dietary diversification or direct fortification is likely to be needed to address Ca deficiency risks.

Global value of GM rice: a review of expected agronomic and consumer benefits.

Unlike the other major crops, no genetically modified (GM) varieties of rice have been commercialized at a large scale. Within the next 2-3 years new transgenic rice varieties could be ready for regulatory approval and subsequent commercialization, though. Given the importance of rice as staple crop for many of the world's poorest people, this will have implications for the alleviation of poverty, hunger and malnutrition. Thus, policy-makers need to be aware of the potential benefits of GM rice. We provide an overview of the literature and discuss the evidence on expected agronomic and consumer benefits of genetically engineered rice. We find that while GM rice with improved agronomic traits could deliver benefits similar to already commercialized biotechnology crops, expected benefits of consumer traits could be higher by an order of magnitude. By aggregating the expected annual benefits, we estimate the global value of GM rice to be US$64 billion per year. This is only an indicative value, as more GM varieties will become available in future. Nevertheless, such a figure can help guide policy-makers when deciding on the approval or funding of biotechnology crops and it may also raise awareness among consumers about what is at stake for their societies.

Soil-type influences human selenium status and underlies widespread selenium deficiency risks in Malawi.

Selenium (Se) is an essential human micronutrient with critical roles in immune functioning and antioxidant defence. Estimates of dietary Se intakes and status are scarce for Africa although crop surveys indicate deficiency is probably widespread in Malawi. Here we show that Se deficiency is likely endemic in Malawi based on the Se status of adults consuming food from contrasting soil types. These data are consistent with food balance sheets and composition tables revealing that >80% of the Malawi population is at risk of dietary Se inadequacy. Risk of dietary Se inadequacy is >60% in seven other countries in Southern Africa, and 22% across Africa as a whole. Given that most Malawi soils cannot supply sufficient Se to crops for adequate human nutrition, the cost and benefits of interventions to alleviate Se deficiency should be determined; for example, Se-enriched nitrogen fertilisers could be adopted as in Finland.

Potential impacts of iron biofortification in India.

Iron deficiency is a widespread nutrition and health problem in developing countries, causing impairments in physical activity and cognitive development, as well as maternal mortality. Although food fortification and supplementation programmes have been effective in some countries, their overall success remains limited. Biofortification, that is, breeding food crops for higher micronutrient content, is a relatively new approach, which has been gaining international attention recently. We propose a methodology for ex ante impact assessment of iron biofortification, building on a disability-adjusted life years (DALYs) framework. This methodology is applied in an Indian context. Using a large and representative data set of household food consumption, the likely effects of iron-rich rice and wheat varieties are simulated for different target groups and regions. These varieties, which are being developed by an international public research consortium, based on conventional breeding techniques, might be ready for local distribution within the next couple of years. The results indicate sizeable potential health benefits. Depending on the underlying assumptions, the disease burden associated with iron deficiency could be reduced by 19-58%. Due to the relatively low institutional cost to reach the target population, the expected cost-effectiveness of iron biofortification compares favourably with other micronutrient interventions. Nonetheless, biofortification should not be seen as a substitute for other interventions. Each approach has its particular strengths, so they complement one another.

Plant breeding to control zinc deficiency in India: how cost-effective is biofortification?

OBJECTIVE: To estimate the potential impact of zinc biofortification of rice and wheat on public health in India and to evaluate its cost-effectiveness compared with alternative interventions and international standards. DESIGN: The burden of zinc deficiency (ZnD) in India was expressed in disability-adjusted life years (DALYs) lost. Current zinc intakes were derived from a nationally representative household food consumption survey (30-day recall) and attributed to household members based on adult equivalent weights. Using a dose-response function, projected increased zinc intakes from biofortified rice and wheat were translated into potential health improvements for pessimistic and optimistic scenarios. After estimating the costs of developing and disseminating the new varieties, the cost-effectiveness of zinc biofortification was calculated for both scenarios and compared with alternative micronutrient interventions and international reference standards. SETTING: India. SUBJECTS: Representative household survey (n = 119 554). RESULTS: The calculated annual burden of ZnD in India is 2.8 million DALYs lost. Zinc biofortification of rice and wheat may reduce this burden by 20-51% and save 0.6-1.4 million DALYs each year, depending on the scenario. The cost for saving one DALY amounts to $US 0.73-7.31, which is very cost-effective by standards of the World Bank and the World Health Organization, and is lower than that of most other micronutrient interventions. CONCLUSIONS: Not only may zinc biofortification save lives and prevent morbidity among millions of people, it may also help accommodate the need to economise and to allocate resources more efficiently. Further research is needed to corroborate these findings.

The human and economic cost of hidden hunger.

BACKGROUND: Micronutrient malnutrition is a public health problem in many developing countries. Its negative impact on income growth is recognized in principle, but there are widely varying estimates of the related economic cost. OBJECTIVE: To discuss available studies that quantify the cost of micronutrient malnutrition, and to develop an alternative framework and apply it to India. METHODS: Detailed burden of disease calculations are used to estimate the economic cost of micronutrient malnutrition based on disability-adjusted life years (DALYs) lost. RESULTS: The short-term economic cost of micronutrient malnutrition in India amounts to 0.8% to 2.5% of the gross domestic product. CONCLUSIONS: Although the results confirm that micronutrient malnutrition is a huge economic problem, the estimates are lower than those of most previous studies. The differences may be due to differences in underlying assumptions, quality of data, and precision of calculation, but also to dynamic interactions between nutrition, health, and economic productivity, which are difficult to capture. Clear explanation of all calculation details would be desirable for future studies in order to increase credibility and transparency.