Most Health Groups Question the Safety of GM foods

Background:

Genetically modified (GM) foods and crops are a controversial subject. There is controversy in many regards including the safety of GM foods, if the current regulations are sufficient, whether or not GM foods should be labeled and if there should be a moratorium on GM foods and/or crops.

Purpose:

To determine the consensus of opinion among the medical and public health groups and health student groups on topics related to GM foods based on statements made between the years 1996-2019. These topics include safety, regulation and labeling of GM foods and their beliefs about a moratorium on GM food and/or crops.

Data Sources and Selection:

Electronic literature systematic search using Google search engine and manual reference checks of all articles related to health group statements on genetically modified foods and crops.

Data Extraction:

123 medical and public health groups with related statements on GM foods and crops were found.

Of which:

73 groups had statements on GM food safety

35 groups had statements on the current GM food regulatory process

83 groups had statements on GM food labeling

34 groups had statements on GM crop moratoriums

Results:

About 74% of the groups with statements on GM food safety indicated there was not enough evidence to conclude that GM foods were safe. This rose to 91.5% when groups with conflicts of interest (COI) were eliminated.

About 74.3% of the groups with statements on regulations indicated the current regulatory process for GM foods and crops is insufficient. This rose to about 92.9% when groups with a COI were eliminated.

About 95.2% of the groups with statements on labeling believed GM food labeling should be mandatory. This rose to about 98.8% when groups with a COI were eliminated.

About 61.8% of the groups with statements on moratoriums believed there should be a moratorium on all or some GMOs. This rose to about 77.8% when groups with a COI were eliminated.

Conclusion:

Based on the results of this systematic review a clear consensus among health groups emerged. The consensus among health experts is that GM foods currently on the market cannot presently be considered as safe as their conventional counterparts. This is either due to lack of evidence of safety, or because of a consensus in the scientific literature from animal studies that at least some GM foods currently on the market may be unsafe compared to their conventional counterparts. This is supported by a systematic review of surveys regarding the opinions of individual health professionals (GMO Free Florida 2022a). Also a systematic review of the scientific evidence supports this consensus since in the majority of relevant animal feeding studies using the popular GM soy GTS 40-3-2 adverse effects or biomarkers indicative of adverse effects were reported (GMO Free Florida 2022b). Health groups also overwhelmingly support mandatory labeling of GM foods and better regulations for GM foods. There is also general support for a moratorium on at least some GMOs which is consistent with a systematic review of surveys of the opinions of individual health professionals (GMO Free Florida 2022a).

Therefore, we call upon the health community, who are the experts on health, to continue to inform the public of the potential harms from GM foods and to choose non-GMO and organic foods to avoid those potential harms. We urge the governments of the world to impose a moratorium on all GM foods until each GM food has been demonstrated as safe in independent long-term and multigenerational chronic toxicity/carcinogenicity studies using both rodents and non-rodents comparable to humans. We also call upon all who have published papers claiming that there is a consensus that all GM foods on the market are safe to provide corrections, or formally retract their papers if necessary. Our systematic reviews indicate this claim is not supported by the consensus, nor does it appear this claim was ever supported by the consensus.

A precautionary approach should be taken especially since there is now a consensus among health groups and individual health professionals that GM foods currently on the market cannot be considered as safe as their conventional counterparts at this present time and a consensus in the scientific literature that some GM foods currently on the market may be unsafe compared to their conventional counterparts.

Disclaimer: Neither GMO Free Florida, our fiscal sponsor GMO Free USA, nor any person acting on behalf of GMO Free Florida or GMO Free USA are responsible for the use, actions or decisions taken as a result of the information in this report. The views expressed in this report are those of the unpaid volunteers who authored this report and are not necessarily the views of GMO Free Florida or GMO Free USA. The authors declare no conflicts of interest.

Introduction:  

GM foods are also referred to as genetically engineered (GE) or bioengineered (BE) foods. These include foods derived from organisms modified through techniques such as transgenesis, intragenesis, cisgenesis, zinc finger proteins, transcription activator-like effector nucleases, and clustered, regularly interspaced, short, palindromic repeats. The process of genetic modification can result in unexpected consequences, potentially causing the plant to produce toxins, create foreign proteins, or other unanticipated results (Ho 2013, Wilson 2006, Dona 2009, Rang 2005, Mesnage 2016, Eckerstorfer 2019). GM foods and crops are, therefore, a controversial subject. There is controversy in many regards including the safety of GM foods, whether the current regulations are sufficient, whether or not GM foods should be labeled, if people want to consume GM foods and if there should be a moratorium on GM foods and/or crops.

GM foods are generally intended to be consumed for a lifetime by humans and animals of different ages, sexes, and with different medical conditions. However, GM foods are not generally tested long-term before deregulation. Despite this lack of long-term testing, claims have been made that there is a worldwide consensus in the medical and public health communities and the scientific literature on the safety of GMOs currently consumed (Gostin 2016, McHughen 2013). One of the most cited pieces of evidence provided for this claim is a position statement by the American Association for the Advancement of Science (AAAS) Board of Directors (Gostin 2016, McHughen 2013). The AAAS is the largest general science group in the world with over 120,000 members consisting of scientists, as well as college and high school students (American Association for the Advancement of Science 2014). The AAAS members have backgrounds ranging from agriculture, biological, medical, chemistry, earth, engineering, math, computer, physics, astronomy, social, behavioral and other sciences (Funk 2015).

The 2012 AAAS Board of Director’s statement opposes GM food labeling. It also contains a very strong statement on GM food safety stating that, “every other respected organization that has examined the evidence has come to the same conclusion: consuming foods containing ingredients derived from GM crops is no riskier than consuming the same foods containing ingredients from crop plants modified by conventional plant improvement techniques” (American Association for the Advancement of Science 2012). Some AAAS members, however, have opposed the AAAS Board’s statement (Hunt 2012, Hornig Priest 2013). Others also have contested the claim of a consensus on the safety of GM foods (Silverman 2017, Hilbeck 2015, Krimsky 2015). For example, in a 2017 review it states, “Recent claims of consensus over the safety of genetically modified organisms (GMOs) seems to be an artificial and misguided perpetuated construct” (Tsatsakis 2017).

Using the history of harm from tobacco as a basis it would be expected that if harm from GM foods were to be found it would be first identified by the independent medical and public health community. Although plant scientists and agricultural scientists studied tobacco for many years, it was the medical and public health community that first identified harm from tobacco use (Proctor 2012). This would be expected as health professionals are the experts on health. The Pew Research Center survey of AAAS scientists also considers those in the field of health to be the experts on GM food safety (Pew Research Center 2015). Following the history of identifying harms to health from tobacco, the following are unlikely to report harm from a product even when overwhelming evidence exists from independent health groups and professionals and the scientific literature published in peer reviewed journals: 1. companies involved in selling a product, 2. universities or groups receiving funding from industry, 3. individual scientists and health professionals affiliated with industry, 4. politicians receiving contributions from industry, 5. related government agencies (Brownell 2009, Brandt 2012).

As far as we are aware, no systematic review of the opinions of experts on health, the medical and public health community, regarding GM food safety, regulations, labeling and moratoriums has ever been conducted. In the absence of such a systematic review claims of a consensus are largely speculative. Therefore, position statements, reports and other documents from medical and public health groups around the world between the years 1996-2019 were used to determine a consensus of opinion on GM foods and crops.

Results and Discussion: See Supplementary Table Report 1.

Of the medical and public health groups with a statement on GM food safety, representing 22 countries as well as international groups, about 74% (54/73) made statements indicating they were unsure if GM foods were safe (Supplementary Table Report 1).

However, if groups with a known conflict of interest are eliminated, this rises to about 91.5% (54/59) of health groups indicating they were unsure if GM foods were safe (Supplementary Table Report 1).

This result is fairly consistent with our systematic review of surveys of individual health professionals. In that review in at least 92.9% of surveys, about GM food safety, the majority of health professionals and health students either believe GM foods have health risks, or are neutral or unsure about the safety of GM foods (GMO Free Florida 2022a). It is also consistent with our review of the scientific evidence for GM soy GTS 40-3-2. The results of that review indicate that in the majority of relevant animal feeding studies, using the popular GM soy, adverse effects or biomarkers indicative of adverse effects were observed in the GTS 40-3-2 fed groups (GMO Free Florida 2022b).

For groups with statements on the current regulatory process, representing 16 countries as well as international groups, about 74.3% (26/35) indicated the current regulatory process for GMOs is insufficient (Supplementary Table Report 1).

However, if groups with a known conflict of interest are eliminated, this rises to about 92.9% (26/28) indicating the current regulatory process for GMOs is insufficient (Supplementary Table Report 1).

This result is consistent with our systematic review of surveys of individual health professionals. The results of that review indicate that in 100% of surveys the majority of health professionals and students either do not believe the regulatory process is adequate for GM foods and crops, or were unsure about the adequacy (GMO Free Florida 2022a).

About 61.8% (21/34) of medical and public health groups with a statement on a moratorium, representing 16 countries as well as international groups, believed there should be a moratorium on all or some GMOs (Supplementary Table Report 1).

However, if groups with a known conflict of interest are eliminated, this rises to about 77.8% (21/27) believing there should be a moratorium on all or some GMOs (Supplementary Table Report 1).

This result is consistent with our systematic review of surveys of individual health professionals. That review indicates that in at least 80% of surveys the majority of health professionals and health students either do not support GM foods or GM crop production in their respective countries, or are unsure (GMO Free Florida 2022a).

For medical and public health groups with a statement on GM food labeling, representing 17 countries as well as international groups, about 95.2% (79/83) believed labeling of GM foods should be mandatory (Supplementary Table Report 1).

However, if groups with a known conflict of interest are eliminated, this rises to 98.8% (79/80) believing labeling should be mandatory (Supplementary Table Report 1).

This result is consistent with our systematic review of individual health professionals. That review indicated that in 100% of surveys about GM food labeling the majority of health professionals and health students believe GM food products should be labeled (GMO Free Florida 2022a).

It should be noted that not all medical groups reviewed had a statement on every issue listed. Only about 27.6% of groups had statements on a moratorium and about 28.5% had a statement on regulations. A large number of groups, however, had statements on GMO safety (about 59.3% of groups) and GMO labeling (about 67.5%).

Types of Beliefs

Statements from these groups on GM food safety can generally be divided into 2 categories: 1. Those that believe the current level of evidence, or absence of evidence, is sufficient to determine safety, 2. Those that believe the current level of evidence is insufficient to determine safety.

Those that believed GM foods on the market are safe generally relied on handpicked animal or other studies and/or the absence of human or animal health effects in the populations consuming GM foods. Some of those making claims based on animal or other studies admitted that these statements were based on limited evidence or poor quality evidence. For example, the National Academies of Sciences, Engineering, and Medicine (NASEM) stated, “Although the design and analysis of many animal-feeding studies were not optimal, the many available animal experimental studies taken together provided reasonable evidence that animals were not harmed by eating foods derived from GE crops.” This claim is not supported by our review of the popular GM soy GTS 40-3-2 where the large majority of relevant animal studies indicated adverse effects or biomarkers indicative of adverse effects in the animals consuming this GM food (GMO Free Florida 2022b). It is also not clear how such a general claim could be made about GM foods when in a systematic review of published rat feeding studies examining the digestive tract the authors only found such studies for 9 of 47 (about 19%) GM foods approved for human and/or animal consumption and the studies that were found were considered significantly inadequate or flawed (Zdziarski 2014).

It should be noted that many groups that believed GM foods were safe made the statement that GM foods have been consumed for years by many people and no reports of substantial human harm have been documented in peer reviewed literature. Conversely, most of the groups that state there is not enough evidence to conclude that GM foods are safe, argued against such a statement, indicating: 1. There has not been enough time for chronic health problems to develop, 2. That GM foods are not labeled in many of the countries they are most consumed and this makes it difficult to trace adverse effects, 3. There is a lack of epidemiological studies, 4. There is no alert system in many countries where health professionals can notify authorities if they believe adverse effects occurred due to the consumption of GM foods (Supplementary Table 1).

This is not surprising since, unlike tobacco, GM foods are not always clearly and/or accurately labeled. Clear and accurate labeling allows individuals to know if they have been exposed to a product, the amount of times they have been exposed, the duration of exposure and other important information. Consumers of GM foods are, therefore, often unaware if, when and how often they may have consumed GM foods which makes it difficult to associate an adverse effect with a GM food. Even though the World Health Organization stated GM foods on the market are not likely to present risks for human health, they also stated, “long-term monitoring must be carried out to catch any possible adverse effects early” (Food Safety Department World Health Organization 2005). Yet, it appears no such long-term monitoring is being carried out. As the American Cancer Society states, “the absence of evidence of harmful effects is not equivalent to evidence of safety, and since their introduction into the food supply is relatively recent, long-term health effects are unknown” (Kushi 2012). In a recent survey, however, respondents indicated improvements of various health symptoms after removing or reducing consumption of GM foods (Smith 2017). Some health professionals have also reported allergic reactions from GM foods or plants in their patients (Eubanks 2015, Shetterly 2016, Banner Health 2017).

Conflicts of Interest

Even though about 11.4% of health groups in this review had a known conflict of interest, this only decreased the overall percentage opposed to GM food labeling by 3.6%. This could be because several groups with conflicts of interest were in Europe where GM labeling had already been in place at the time of their statement, or in the case of the NASEM and Academy of Nutrition and Dietetics (AND) statements, were made after a GM food labeling bill was approved in the U.S. Congress (114th Congress 2015). This is supported by the category of GM food labeling having one of the smallest number of countries represented, even though this was the category with the most total groups. This suggests groups in countries which already had GM food labeling were less likely to make statements about labeling in general, and those that did were likely to support labeling that was already mandated in their country even if they had a conflict of interest. On the other hand, groups with conflicts of interest increased the overall percent of groups that believe that GM foods are safe by 17.5%, increased the belief that regulations were sufficient by 18.6% and decreased support for a moratorium on some or all GM foods/crops by 16%.

It is also possible that some groups or authors of the statements made on behalf of a group, which did not declare conflicts of interest, may have other conflicts of interest. For example, the Academy of Medical Sciences received funding from the Wellcome Trust (Dickson 1998). One of the governors of the Wellcome Trust in 1999, the time of the statement, was Michael Llewelyn Rutter. Governors have the ultimate responsibility for Wellcome’s activities. During that same time Rutter was also a trustee of the Novartis Foundation (Rutter Undated). In 1999 Novartis was one of the 5 largest GM seed companies (Runge 1999). Wellcome Trust, which receives its funds through investments, also invests in Novartis and accusations have been made that Wellcome stands to gain financially from the grants they give to groups (Schwab 2021). The Academy of Medical Sciences itself had close ties with the Novartis Foundation, eventually merging with them in 2008 (Academy of Medical Science Undated).

The author of this statement, and President of the Academy of Medical Sciences at the time, Peter Lachmann is on the Advisory Council of Sense About Science, a group funded by ISAAA (Public Interest Investigations 2009, Public Interest Investigations 2015, Public Interest Investigations 2010). While this is a conflict of interest by our predetermined criteria, this statement was made in 1999 and Sense About Science was not established until 2002 (Public Interest Investigations 2015). In one study a professional COI, such as affiliation with GM seed companies, was significantly related to the article conclusion being in favor of the interests of GM seed companies (Diels 2011). While such close ties between the Academy of Medical Sciences and GM seed companies may be a conflict of interest, this did not meet the criteria for conflicts of interest that we established before beginning this systematic review.

Joint Statements

It should be mentioned that in some cases health groups made joint statements with groups in other fields. In these cases it is unclear if such a joint statement clearly reflects the opinion of the health group. For example, a joint statement which included the National Academy of Medical Sciences, and other science groups in India, states that there was, “no unanimity” and that, “The recommendations are synthesised from the opinions of an overwhelming majority of participants” (Inter-Academy Report on GM Crops 2010). Most of the participants, however, were in the fields of agriculture, plant science or biotechnology. For example, an author of the report, Asis Datta, has patents on transgenic crops indicating a conflict of interest (Justia Undated). There is also some evidence suggesting that scientists in some fields, such as plant science, may have different opinions than those in medicine or public health  (Bray 2017, ). It is, therefore, unclear what the participants in this report who were health professionals believed. It should also be noted that although we included this group as believing GM foods are safe, their statement was only that they believed one type of GM brinjal, or eggplant, was safe. Therefore, even if this medical group agreed with this statement it is unclear if they believe all GM foods on the market are safe.

Other groups participated in joint statements with groups that were not health groups, such as the U.S. National Academy of Medicine, the Società Italiana di Fisiologia, Associazione Ricercatori Nutrizione Alimenti, Nutrition Foundation of Italy and non-health groups. However, in the case of the latter, the Nutrition Foundation of Italy itself had a conflict of interest as the president and co-author of the statement, Rodolfo Paoletti, was also the president of the International Atherosclerosis Society, which was sponsored by the GM seed company Bayer (International Atherosclerosis Society 1999). Some might believe that when groups or authors with a conflict of interest are combined with those without conflicts of interest that this would still lead to a consensus based on the wisdom of the crowd. While this may be true in the case of statements made anonymously and those judgments averaged, research indicates this is not the case when individuals are aware of the statements made by others which often reduces the diversity of opinions to such an extent that it undermines the wisdom of crowd effect (Lorenz 2011). This may explain why in one review if even one author had a professional COI, such as affiliation with GM seed companies, this significantly related to the article conclusion being in favor of the interests of GM seed companies (Diels 2011).

In 2005, when making their statement in support of GM food safety, the Food Safety Department World Health Organization included James Clive, of ISAAA. The ISAAA is funded by GM seed companies (Food Safety Department World Health Organization 2005, Public Interest Investigations 2010). On the other hand, in 2009, in a joint report that did not include authors affiliated with GM seed companies, the World Health Organization (WHO), Food and Agricultural Organization of the United Nations (FAO), the Global Environment Facility (GEF), United Nations Development Programme (UNDP), United Nations Environment Programme (UNEP), United Nations Educational, Scientific and Cultural Organization (UNESCO), and the World Bank, stated, “The safety of GMO foods and feed is controversial due to limited available data, particularly for long-term nutritional consumption and chronic exposure. Food safety is a major issue in the GMO debate. Potential concerns include alteration in nutritional quality of foods, toxicity, antibiotic resistance, and allergenicity from consuming GM foods. The concepts and techniques used for evaluating food and feed safety have been outlined (WHO, 2005b), but the approval process of GM crops is considered inadequate (Spök et al., 2004). Under current practice, data are provided by the companies owning the genetic materials, making independent verification difficult or impossible” (UN Environment Programme 2009). As these are very different statements, it is unclear if the influence of affiliations with GM seed companies led to the 2005 statement. In 2014 the WHO updated their website to include statements on GMOs. This statement on the WHO website did not clear up the discrepancy as the statement on GM food safety was practically identical to the 2005 statement and was clearly copied from this earlier report.

Food Safety Department World Health Organization 2005: “GM foods currently available on the international market have undergone risk assessments and are not likely to present risks for human health” (Food Safety Department World Health Organization 2005).

WHO website 2014: “GM foods currently available on the international market have passed safety assessments and are not likely to present risks for human health” (World Health Organization 2014).

Health groups should avoid joint statements with groups or individuals representing GM seed companies if they must compromise to come to an agreement with these groups or individuals. The public looks for accurate information from health groups and such compromising may give the public a false sense of safety about topics such as GM foods. While it is acceptable for health groups to sign on to statements they agree with or support a political campaign they agree with, it is not acceptable for health groups to downplay the risks regarding a health issue simply to come to an agreement for a joint statement with groups or individuals that represent GM seed companies.

Adopted Positions

In one instance a group, the Academy of Nutrition and Dietetics, adopted the position statement of another group, the National Academies of Sciences, Engineering, and Medicine. Some of the authors of the adopted position paper by NASEM had conflicts of interest (Krimsky 2017). In October 2015, shortly before adopting the NASEM position paper, the AND Academy Positions Committee decided to not develop a position paper on GMOs because of limited evidence resulting from an Evidence Analysis Library (EAL) project. The EAL project concluded that most of the evidence for GMO safety in humans was limited and repeatedly stated, “Additional research on human consumption of GE plant foods is needed” (Edge 2018). This echoes a previous AND position paper, which expired at the end of 2017, that stated, “Biotechnology in the form of genetic engineering, commonly referred to as genetically modified organisms, has produced some crops that are biofortified, chemically resistant, and/or pest resistant. There is no consensus on the benefit or harm of this approach and more research is needed to determine the impact on human and environmental health” (Nordin 2013). The authors of the EAL paper stated that the NASEM report reviewed animal studies and found differences in growth rates and organ composition, but concluded they were unlikely to be biologically relevant. The NASEM, however, handpicked studies to include and reviewed primarily short-term animal studies. The NASEM report missed many medium and long-term studies where adverse effects and biomarkers indicative of adverse effects were reported (See below).

A recent review of GM corn studies states, “we found that, compared to the absence of COI, the presence of a COI was associated with a 50% higher frequency of outcomes favorable to the interests of the GM crop company” (Guillemaud 2016). In another review, a professional COI, such as affiliation with GM seed companies, was significantly related to the article conclusion being in favor of the interests of GM seed companies (Diels 2011). Conflicts of interest may therefore lead to a biased review. Interestingly, some of the EAL authors had professional conflicts of interest such as affiliation with GM seed companies and selling GM foods (America’s Farmers 2011, Foodie Farmer 2013, U,S, Right to Know 2020). Yet, in a survey of registered dietitians in the United States the majority of respondents agreed that it is the role of professional organizations such as The Academy of Nutrition and Dietetics to take an unbiased position on genetically modified foods (Vogliano 2012).

Statements Based on Studies With Conflicts of Interest

In some cases, in their statements, groups did not declare a conflict of interest, but relied heavily on studies with a conflict of interest. For example, in the conclusion of the toxicology section of the American Medical Association Council on Science and Public Health report all but one of the studies referenced were conducted or contracted by GM seed companies Monsanto and DuPont (Hammond 1996, 2006, Doull 2007, MacKenzie 2007). The one exception that did not involve a biotech company states, “Nevertheless the experiences from this study lead to the overall conclusion that safety assessment for unintended effects of a GM crop cannot be done without additional test group(s)” (Shroder 2007). As previously mentioned, studies with a conflict of interest are more likely to have outcomes in the interest of the GM seed companies (Guillemaud 2016). As for the one independent study, it cannot be assumed that authors who conclude more research is necessary are endorsing a safety claim.

Vast Difference Between Health Groups and AAAS Board

The results of this systematic review largely disagree with the AAAS Board of Director’s statement on GM foods. Although the Board is in agreement with a small number of statements from health groups, it disagrees with a much larger number of medical and public health groups that are unsure about the safety of GM foods and believe more evidence is needed. The AAAS board also disagrees with the overwhelming majority of health groups that support labeling of GM foods (Supplementary Table 1). A possible explanation for this difference may be that the AAAS Board of Directors could have been largely unaware of the primary evidence. The AAAS Board of Directors used only 2 references in their statement and both were secondary sources. Their first reference titled A decade of EU-funded GMO research (2001–2010) did not include feeding trials with GM foods currently on the market and therefore could not be used to claim safety of GM foods currently on the market (Hilbeck 2015). This report was published by the European Commission (EC), but states it is not necessarily the opinion of the EC (European Commission 2010). Interestingly, the EC disagrees with the AAAS Board of Directors stance on the mandatory labeling of GM foods, as the EC supports such labeling (European Commission 1997).

The second source used by the AAAS Board of directors was a literature review with a lead author, Chelsea Snell, who was a Ph.D. student in plant science at the time of publication. This literature review concluded that GMOs can be safely used in food and feed and long-term studies should only be done if reasonable doubt remains after a 90-day feeding trial (Snell 2012). This statement, however, largely disagreed with the authors of the studies that were reviewed. A majority, 9 of 12, of the long-term studies reviewed by Snell et al. were rodent health studies using glyphosate-tolerant soy (Malatesta 2002a, 2002b, 2003, 2008, Vecchio 2004, Daleprane 2009, 2010, Sakamoto 2007, 2008). Of those 9 studies, 6 reported unintended effects and the authors in all 6 of those studies stated that further research was necessary to determine the cause of the unintended effects (Malatesta 2002a, 2002b, 2003, 2008, Vecchio 2004, Sakamoto 2007). Statements by the authors of all of the 9 studies indicated the importance of long-term studies, that the long-term data was scarce and, therefore, the issue of possible adverse health effects due to long-term consumption of GM foods has not been settled. This difference between the statements from the primary authors and Snell et al. may be due to differences in the way plant scientists interpret evidence compared to those in other fields such as medicine (Bray 2017, GMO Free USA 2015). Had the AAAS Board members reviewed the primary evidence they may have noticed that the authors of the primary evidence often disagreed with the conclusions in the Snell et al. review.

According to the AAAS Board statement, ”Indeed, a recent review of a dozen well-designed long-term animal feeding studies comparing GM and non-GM potatoes, soy, rice, corn and triticale found that the GM and their non-GM counterparts are nutritionally equivalent” (American Association for the Advancement of Science 2012). Recent studies, however, have reported that some GM foods currently on the market are to be considered not substantially equivalent to their non-GM counterparts (Bøhn 2013, Mesnage 2016). Moreover, even if GM and non-GM crops were nutritionally equivalent that would not necessarily mean that GM crops were safe to consume. For example, if poison hemlock were nutritionally equivalent to spinach, containing equivalent amounts of macronutrients and micronutrients, that would not mean consuming poison hemlock is as safe as consuming spinach.

Statements Based on Arbitrary Selection of Studies

A small number of medical or public health groups identified in the search have made statements similar to the AAAS Board of Directors, and incorporated long-term studies into their report. The reports have the same deficiency of failing to review all, or even most, of the primary long-term feeding studies (GMO Free Florida 2022b). For example, the National Academies of Sciences, Engineering, and Medicine (NASEM) report states that “our committee carefully examined literature—peer-reviewed and nonreviewed,” and, “we committed ourselves to taking a fresh look at the primary literature itself.” The NASEM report, however, relied primarily on secondary sources in their section dedicated to long-term studies.

Even when primary literature was mentioned the studies were mostly of a shorter duration than what the NASEM report itself considers is needed for chronic toxicity studies (National Academies of Sciences 2016). Since the NASEM report is a narrative review, and not a systematic review, they could include or exclude studies in an arbitrary, or biased, and inconsistent manner to convey a specific narrative which reflects the authors’ opinion (Krimsky 2017). A narrative review does not need to be able to be replicated and the conclusion does not have to be based on the weight of the scientific evidence. Since narrative reviews have a large potential to be biased, apply double standards and omit relevant studies, such reviews are not considered high quality evidence (Rys 2009, UTHealth 2020, Icahn Undated).

We identified many medium or long-term studies, of a longer duration than most studies used in the NASEM report, which would have been available to the authors, but are missing from the section dedicated to long-term studies in the NASEM report (Zinoviev 2014, Vecchio 2004, Malatesta 2008, Brasil 2009, Battistelli 2010, Gorbach 2016, Zinoviev 2016, Kulik 2014, Gubin-Vakulik 2013a, Gubin-Vakulik 2012, Gorbach 2012, Malatesta 2003, Malatesta 2002a, Malatesta 2002b, Gubin Vakulik 2013b). Unlike the NASEM report, 100% of the medium and long-term studies, of 6 months feeding duration or longer, from our systematic review suggest adverse effects or biomarkers indicative of adverse effects in animals fed the GM soy GTS 40-3-2 diet (GMO Free Florida 2022b). The NASEM report, therefore, did not base their opinions on the weight of the scientific evidence and any conclusions on the long-term safety of GM foods in this NASEM report should be considered unreliable.

Bias Among Authors

Another possibility for the AAAS Board of Director’s statement may be bias among authors. It has been argued that at least some AAAS Board Members may have conflicts of interest (Simon 2012). One was involved in consulting for biotechnology companies and another was a founder of a biotechnology company (GMWatch 2015). Some other medical or public health groups identified in the search, that have made statements similar to the AAAS Board of Directors, also include authors with conflicts of interest, such as some of the authors of the NASEM report (Krimsky 2017). The NASEM report authors were aware that people believed they were biased, stating, “We received other comments indicating that research studies that found adverse biological or social effects of GE crops had been ignored, and because of our committee’s composition, we too would probably ignore them” (National Academies of Sciences 2016).

The NASEM report also states, “Sources must not be used selectively to justify a preferred outcome.” (National Academies of Sciences 2016). However, besides missing the many medium and long-term studies previously mentioned, the NASEM report also missed most of the opinions of medical and public health groups obtained from our search. The NASEM report includes a “Sample of Statements About the Safety of Genetically Engineered Crops and Food Derived from Genetically Engineered Crops” which lists only groups who have made statements similar to the NASEM. These groups include the AAAS Board of Directors, American Medical Association’s Council on Science and Public Health and the World Health Organization (National Academies of Sciences 2016). Our review, however, found most of the medical and public health groups with a statement on GM food safety question their safety (Supplementary Table 1). However, most medical or public health groups that indicated involvement from GM seed company employees in their report, or were otherwise affiliated with GM seed companies, were found to be favorable towards GM foods possibly due to conflicts of interest (Supplementary Table 1). Medical and public health groups making statements on GMOs should, therefore, avoid conflicts of interest, such as involvement from GM seed company employees and partnering with or receiving funds from these companies, to ensure their views are not slanted.

Failure to Consider Long-term Studies

Another possibility is that some American-based groups may simply be unaware of the long-term research because, based on the results of our search, it appears little, if any, of this research has been done in the United States. According to our search results, of the relevant medium and long-term animal studies using GTS 40-3-2 found, all were conducted by authors from Asia, Europe and South America (GMO Free Florida 2022b). This may explain why some American-based groups did not include many, or any, long-term studies in their statements.

It should also be noted that a small number of medical and public health groups did not believe long-term feeding studies were necessary, or, they believed that in most cases such studies wouldn’t provide meaningful information. A greater number of health groups, however, believed long-term feeding studies were needed (Supplementary Table 1). Also, statements by the large majority of research groups that conducted medium or long-term studies appeared to indicate they believed long-term studies played an important role in determining the safety of GM foods (GMO Free Florida 2022b).

Limitations – Current Consensus

Statements from health groups can only provide a snapshot of the opinion at a given time. As opinions are dynamic, and not static, it is not possible to say an opinion at a given time extends beyond that time period or is still a current opinion. The same could be said, however, about the AAAS Board’s statement since the Board of Directors periodically change or new evidence may change the opinions of Board members. However, due to the large agreement in statements by various groups over the long time period reviewed, and that this review is largely consistent with the results of our systematic review of surveys of the opinions of individual health professionals (GMO Free Florida 2022a) and a consensus in the scientific literature on GTS 40-3-2 (GMO Free Florida 2022b), we can conclude that the results of this review, for all intents and purposes, represents the current consensus.

Limitations – Personalized Search

Our search also relied on the use of the Google search engine, and because Google has a personalized search it is possible that certain groups appeared, or did not appear, in our search based on our previous search history (Google 2009). Our search did, however, yield many results such as a website that boasts, “More than 280 scientific and technical institutions support the safety of GM crops” (Norero 2017). Our search also yielded websites funded by the makers of GM crops, such as GMOAnswers and the International Service for the Acquisition of Agri-biotech Applications (ISAAA) and others, with lists of medical groups which they state believe GM foods are safe (ISAAA 2009, GMOAnswers Undated, GMOAnswers Undated2). Since we identified more health groups in our search, stating they believe GM foods on the market are as safe as conventional foods, than these websites this suggests our results were not skewed by Google’s personalized search.

Limitations – Statements that Might not Represent Groups

It should also be mentioned that some statements found were made by the president, executive director or another member of a health group, but it was unclear if these statements represented the group itself, as they didn’t mention the group’s position and/or did not originate on the group’s website. These statements, even if they did not represent the health groups, would not have significantly changed the results of our systematic review as many of these statements were supportive of GM foods (e.g., Batra 2016, Isaac 2018, Lachmann 1999).

Limitations – Conflicts of Interest

In some instances the names of authors involved in statements made by groups were not available and therefore conflicts of interest could exist that we could not identify. Funding and corporate members or partners were also not always available. However, even when conflict of interest statements declare that GM seed companies were not involved in a statement, this may not be accurate as GM seed company employees have already secretly ghostwritten or edited parts of papers without the authors declaring this conflict of interest (Krimsky 2018). Therefore, the conflicts of interest we have identified may not represent the full extent of COIs.

We also only took into consideration conflicts of interest for individual authors or groups that would benefit by supporting GM foods/crops. While it is possible that some groups may also have benefited by not supporting GM foods/crops, our results were not likely significantly skewed by such conflicts of interest as GM seed companies and food companies that sell GM foods significantly outspend companies that are opposed to the use of GM foods (e.g., Ballotopedia 2012, Ballotopedia 2013). This makes it unlikely that most of the medical and public health groups that support mandatory labeling, question the safety of GM foods, believe regulations are insufficient and support a moratorium on some or all GM foods do so because of conflicts of interest.

Limitations – Contradictory Statements

Some groups made statements that are somewhat contradictory and some may use quote mining to claim that we misrepresented the statements made by these groups. For example, the American Medical Association Council on Science and Public Health made the statement, “Bioengineered foods have been consumed for close to 20 years, and during that time, no overt consequences on human health have been reported and/or substantiated in the peer-reviewed literature. However, a small potential for adverse events exists” (American Medical Association Council on Science and Public Health 2012). In this instance we could have placed this statement in the category of questioning safety since this group still believes there is the possibility of adverse events occurring. In a similar example, the Food Safety Department World Health Organization stated, “long-term monitoring must be carried out to catch any possible adverse effects early” and with regards to antibiotic resistant markers, “gene transfer to microorganisms residing in the gastrointestinal tract of humans or animals … the potential of this gene transfer cannot be completely ruled out” indicating safety concerns (Food Safety Department World Health Organization 2005). We classified these groups as believing GM foods are safe because these groups also indicated that they believed the level of research and assessments, at that time, were sufficient to make a claim that adverse effects were unlikely.

On the other hand, the British Medical Association Board of Science and Education stated, “In our view, the potential for GM foods to cause harmful health effects is very small and many of the concerns expressed apply with equal vigour to conventionally derived foods. However, safety concerns cannot, as yet, be dismissed completely on the basis of information currently available” and “Many unanswered questions remain, particularly with regard to the potential long-term impact of GM foods on human health and on the environment. There is a lack of evidence-based research with regard to medium and long-term effects on health and the environment” (Jarman 2004). While the American Cancer Association stated, “At this time, there is no evidence that genetically modified foods that are currently on the market or the substances found in them are harmful to human health or that they would either increase or decrease cancer risk because of the added genes. However, the absence of evidence of harmful effects is not equivalent to evidence of safety, and since their introduction into the food supply is relatively recent, long-term health effects are unknown. Ongoing evaluation of the safety of genetically modified foods is important to ensure their genuine safety” (Kushi 2012). In these examples these groups are clearly stating the level of research and assessments are insufficient to draw conclusions about the safety and were put in the questioning safety category.

It should be mentioned that these types of examples were rare as most groups were clear about their beliefs. We also don’t believe that we’ve misrepresented any statements, or miscategorized any groups, but even if we had, these examples of statements were so rare that it would not have significantly altered the results of our systematic review. Especially since the results of this review are largely consistent with the results of our systematic review of surveys of the opinions of individual health professionals (GMO Free Florida 2022a).

Limitations – Implied Meanings

Our review made every attempt to include only what was stated. Some may believe that if a group questions the safety of GM foods they must automatically be in favor of mandatory labeling and, even though the group didn’t explicitly state this, we should mark them as supporting labeling. There are, however, reasons why a group might question the safety of GM foods and not support labeling. For example, the group may believe that if certain tests are done in the future and no harm is detected that GM foods should not require labels. In the same way that some might assume that if a group believed GM foods and crops were safe for both humans and the environment they must automatically be opposed to a moratorium on GM crops and foods. There are, however, reasons that this might occur such as a belief that GM foods might contaminate other crops and this would stop consumers from being able to choose non-GMO foods.

Therefore, we looked for statements that were specific to the topic and did not assume a position existed if it was not stated. We did, however, make some exceptions to this in the case of statements in favor of support for GM foods. While we were very conservative in our assumptions about statements opposing GM foods, we were somewhat liberal with our assumptions about those supporting GM foods because these groups represented such a small number. Therefore, if a group stated that they believed GM foods and crops were safe for humans and the environment, and believed GM and non-GM crops and foods could co-exist with minimal contamination, we assumed that they were opposed to a moratorium on GM foods or crops. Since it is possible these groups were opposed to GM foods on some other grounds, e.g., moral, religious, it is possible that we overstated the percent of groups that opposed a moratorium on GM foods or crops.

Limitations – Members Only Access

It should also be noted that some statements made by medical or public health groups may only be available to current members of a particular group and, therefore, would not appear in our systematic search of publicly available statements. Therefore, it is possible that the search used in this review is not representative of medical and public health groups in general. However, the large number of statements found for this review, which do not appear to support the claim that there is a consensus that GM foods are as safe as their conventional counterparts, makes it unlikely that the results would significantly change if groups with positions only available to their members were added.

Limitations – Search Terms

Another limitation of this systematic review is the search terms used as they were all in English. Search terms in other languages might identify more health groups that believe GM foods are safe, shouldn’t be labeled, are properly regulated and there shouldn’t be a moratorium on such foods or crops. Our systematic review, however, identified groups from over 25 countries representing 6 continents.

Conclusion:

Based on the results of our review the consensus among health groups is that GM foods currently on the market cannot presently be considered as safe as their conventional counterparts due to lack of evidence of safety. This consensus is also supported by surveys of the opinions of individual health professionals (GMO Free Florida 2022a). The scientific evidence also supports this consensus since in the majority of relevant studies using the popular GM soy event 40-3-2 adverse effects or biomarkers indicative of adverse effects were reported (GMO Free Florida 2022b). Health groups also overwhelmingly support mandatory labeling of GM foods and better regulations for GM foods. There is also general support for a moratorium on at least some GMOs, which is consistent with surveys of the opinions of individual health professionals (GMO Free Florida 2022a).

Method: 

A systematic review was performed for the following questions:

Do health groups believe genetically modified foods on the market are safe, there is not enough evidence to determine if genetically modified foods on the market are safe, or there is enough evidence to determine that genetically modified foods on the market are not safe?

Do health groups believe the current regulations for genetically engineered foods are sufficient (excluding labeling), the current regulations for genetically engineered foods are not sufficient (excluding labeling),  or the current regulations for genetically engineered foods are too restrictive (excluding labeling)?

Do health groups believe labeling of genetically engineered ingredients should be mandatory, labeling of genetically engineered ingredients should only be mandatory if the ingredient is not substantially equivalent, or labeling of genetically engineered ingredients should never be mandatory?

Do public health groups believe there should be a moratorium on all or some commercial GM foods or crops, or there should not be a moratorium on all or some commercial GM foods or crops?

Criteria for groups: All health groups that consist of primarily health practitioners were included such as physicians, nurses, dietitians and nutritionists. Groups that consisted largely of both health professionals and scientists in other fields were excluded. Individual hospitals and medical centers were excluded, but groups operating or representing many hospitals or medical centers were included. Regulatory agencies were excluded. All statements made before 1996 or after 2019 were excluded.  Documents that were undated but referred to an event that occurred between 1996 and 2019, or could otherwise be dated  (e.g., the group wasn’t formed until 1996), were included.

Rationale for group criteria: Groups that consisted of mostly health professionals and scientists in other fields were excluded in order to try to separate non-health scientists from health professionals. Groups operating or representing many hospitals or medical centers were included as they represent large numbers of health professionals. Regulatory agencies were excluded due to questions about GM food safety and whether regulations were adequate which may skew results in favor of current regulations being adequate. Regulatory agencies also often have the dual job of regulating and promoting GMOs. The focus is on GM foods currently on the market and therefore statements before 1996 could not adequately assess GM foods currently on the market.

Criteria for conflicts of interest: Authors – 1. Conflicts of interest are stated in the document for the author(s), 2. author(s) receives funding from a GM seed/food producer(s) or seller(s) or a group(s) primarily funded by a GM seed/food producer(s) or seller(s), 3. has a patent(s) on a GM crop(s), 4. is employed by or has a high level position (e.g., president, Board of Directors) in a group that is sponsored by or has a GM seed/food producer(s) or sellers as a corporate member, 5. otherwise profit financially from a GMO(s).

Groups – 1. Conflicts of interest are stated in the document for the group(s), 2. The group making the statement receives funding from a GM seed/food producer(s) or seller(s) or a group(s) primarily funded by a GM seed/food producer(s) or seller(s), 3. has a patent(s) on a GM crop(s), 4. is sponsored by or has a GM seed/food producer(s) or seller(s) as a corporate member, 5. otherwise profits financially from a GMO(s).

Conflicts of interest were considered when such conflicts existed at or before the time the statements were made or endorsement occurred. In instances where information was not available for the time the statement or endorsement was made, we looked at the group’s current conflicts of interest.

Google search was performed using the following terms:

“genetically modified foods” “medical group”

“genetically modified foods” “medical association”

“genetically modified foods” “medical society”

“genetically modified foods” “academy of medicine”

“genetically modified foods” “medical organization”

“genetically modified foods” “osteopathic association”

“genetically modified foods” “osteopathic society”

“genetically modified foods” “osteopathic organization”

“genetically modified foods” “public health association”

“genetically modified foods” “public health organization”

“genetically modified foods” “nurses association”

“genetically modified foods” “nurses organization”

“genetically modified foods” “dietetics association”

“genetically modified foods” “nutrition and dietetics”

“genetically modified foods” “nutrition association”

“genetically modified foods” “nutrition organization”

“genetically modified foods” “food science association”

“genetically modified foods” “food science organization”

All hits were examined within the first 10 pages of the Google search. This includes articles, blogs, as well as conference papers and peer reviewed studies. No language restrictions were applied. In cases where relevant references were mentioned those references were searched for using Google, Google Scholar or the search feature on the website it was attributed to if available. In cases where links to websites were provided but were no longer working, Internet Archive was used. This search was performed in January of 2020 by one reviewer and selections were made by that reviewer based on the inclusion and exclusion criteria. A second reviewer, who was blinded to the selections of the first reviewer, also independently made selections and only the selections made by both reviewers were used in this systematic review. In October of 2021 this same search and process was repeated. The data obtained from both search periods were used for this review.

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