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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.  These include safety, regulation and labeling of GM foods and their beliefs about a moratorium on GM food and/or crops between the years 1996-2019.

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:

88 medical and public health groups with related statements on GM foods and crops were found. Of which :

54 groups had statements on GMO safety

30 groups had statements on the current GM food regulatory process

61 groups had statements on GM food labeling

21 groups had statements on GM crop moratoriums

Results:

About 69.8% of the groups with statements on GMO safety indicated there was not enough evidence to conclude that GM foods were safe.

80% indicated the current regulatory process for GMOs is insufficient.

About 93.7% believed GM food labeling should be mandatory.

About 63.2% believed there should be a moratorium on all or some GMOs.

Conclusion:

Based on the results of this systematic review a clear consensus amongst 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 evidence that at least some GM foods currently on the market may be unsafe compared to their conventional counterparts. This is also supported by surveys of the opinions of individual health professionals(See Report 2). The scientific evidence also 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 observed.(See Report 3)  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(See Report 2).

Introduction:  

GM foods are not tested long-term before deregulation.  Despite this, claims have been made that there is a worldwide consensus in the medical, public health and scientific communities 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 and science students. The AAAS members have backgrounds ranging from agriculture, biological, medical, chemistry, earth, engineering, math, computer, physics, astronomy, social, behavioral and other sciences.(AAAS 1)

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.”(AAAS Board)  Others, however, have contested this statement saying there is no 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)

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 1.


Of the medical and public health groups with a statement on GM food safety about 69.8% (37/53) made statements indicating they were unsure if GM foods were safe.

However, if groups where a known conflict of interest exists are eliminated, this rises to about 75.5%.(37/49)

This result is fairly consistent with our systematic review of surveys of individual health professionals. In that review at least 92% 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.(See Report 2) It is also consistent with our review of the scientific evidence for GM soy GTS 40-3-2. The results of that review indicate in the majority of relevant animal feeding studies using the popular GM soy adverse effects or biomarkers indicative of adverse effects were observed. (See Report 3)

For groups with statements on the current regulatory process, 80% indicated the current regulatory process for GMOs is insufficient.

However, if groups where a known conflict of interest exists are eliminated, this rises to about 82.8%.

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. (See Report 2)

About 63.2% of medical and public health groups with a statement on a moratorium believed there should be a moratorium on all or some GMOs.

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.(See Report 2)

For medical and public health groups with a statement on GM food labeling, about 93.7% (59/63) believed labeling should be mandatory.

However, if groups where a known conflict of interest exists are eliminated, this rises to 95.2%.(59/62)

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.(See Report 2)

It should be noted that not all medical groups listed had a statement on every issue listed.  Only about 21.6% of groups had statements on a moratorium and about 34.1% had a statement on regulations. A large number of groups, however, had statements on GMO safety(about 60.2% of groups) and GMO labeling (about 71.6%).

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.  There is 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.

Undeclared Conflicts of Interest

It should also be mentioned that in some cases no conflict of interest was declared by the authors of the statement on behalf of a group, but other conflicts of interest may exist.  For example, the position statement for Sociedad Argentina de Nutrición(SAN) included several authors who later went on to write a book with another author from Monsanto and another author from Argenbio who have conflicts of interest(Alimentacion 2009) Dr. Edgardo Ridner, president of the SAN and coordinator of their position statement on GMOs, is also a committee member in the Council for Information on Food Safety and Nutrition which is a group founded by ILSI, ArgenBio and SAN.  Both ILSI and ArgenBio have conflicts of interest.(Argenbio Undated, Steele 2020)

Adopted Positions

In one instance a group, the Academy of Nutrition and Dietetics(AND), adopted the position statement of another group, the National Academies of Sciences, Engineering, and Medicine(NASEM).  Some of the authors of the adopted position paper by NASEM had a conflict of interest(Krimsky 2017).  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.(Behavioral Health Nutrition 2016)  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.  It is unlikely, however, that the EAL authors were aware that some of the NASEM authors had a conflict of interest 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 observed.(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)  Conflicts of interest may therefore lead to a biased review.  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 groups did not declare a conflict of interest, but relied heavily on studies with a conflict of interest in their statements.  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(Shroder 2007) 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).” 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 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 some statements from health groups, it disagrees with a 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.(See Report 1 Supplementary Table).  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 GMO 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 PhD 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.  9 of the 12 long-term studies reviewed by Snell et al., the majority, 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 indicate 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 GMO 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).  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”.  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, containing equivalent amounts of macronutrients and micronutrients, to spinach that would not mean consuming poison hemlock is as safe as consuming spinach.

Statements Based on Arbitrary Selection of Studies

Some 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(See Report 3).  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 chronic.(National Academies of Sciences 2016)  We identified many medium or long-term studies, longer than most 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)

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 purported to have a conflict of interest such as some of the authors of the NASEM report(Krimsky 2017).  The NASEM report authors were aware that at least some 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 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(Report 1 Supplementary Table).  However, most medical or public health groups that indicated involvement from biotech company employees in their report were found to be favorable towards GMO foods possibly due to conflicts of interest(Report 1 Supplementary Table).  Medical and public health groups making statements on GMOs should, therefore, avoid conflicts of interest, such as involvement from biotech company employees, 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.(Report 3)  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 some medical and public health groups did not believe long-term feeding studies were necessary or that such studies wouldn’t provide meaningful information in most cases.  A greater number of health groups, however, believed long-term feeding studies were needed(Report 1 Supplementary Table)  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 GMO foods.(See Report 3)

Statements Based on Absence of Evidence

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.  Most of the groups stating there is not enough evidence to conclude 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 are a lack of epidemiological studies, 4. There is no alert system where health professionals can notify authorities if they believe adverse effects occurred due to the consumption of GM foods.(See Report 1 Supplementary Table)  This is not surprising since, unlike tobacco, GM foods are not always clearly labeled.  Clear 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. 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”.  In a recent survey, however, respondents indicated improvements of various health symptoms after removing or reducing consumption of  GM foods(Smith 2017) Some health practitioners have also reported allergic reactions to GM foods in their patients.(Banner Health 2017, Shetterly 2016)

Limitations

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 statement since the Board of Directors periodically change or new evidence may change the opinions of Board members.

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:” Our search also yielded websites funded by the makers of GM crops, such as GM Answers 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, GMO Answers Undated).  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.

It should also be mentioned that some statements were found by the president or executive director of a health group, but it was unclear if these statements represented the group itself and were excluded.(Batra 2016 , Moench 2015, Okoth 2017, ISAAC 2018).  These statements, even if they represented the health groups, would not have significantly changed the results of our systematic review.

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.  Therefore, it is possible that the search used in this review is not representative of medical and public health groups in general.  However, the statements found for this review largely disagree with the AAAS Board of Directors statement on GM food labeling and do not appear to support the claim that there is a consensus that GM foods are as safe as their conventional counterparts.

Conclusion:

Based on the results of our review the consensus amongst health groups is that GM foods currently on the market cannot be currently 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.(See Report 2) 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 observed.(See Report 3)  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(See Report 2).

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),  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 occur if the ingredient is not substantially equivalent?

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.  Hospitals and medical centers were excluded.  Regulatory agencies were excluded.  Physician-based groups that did not consist of primarily medical doctors and/or doctors of osteopathic medicine 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 were included.

Rationale for group criteria:  Groups that consisted of both health professionals and scientists in other fields were excluded in order to try to separate scientists from health professionals.  Regulatory agencies were excluded due to questions about 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.

Method:  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, including 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 and/or Google Scholar.  In cases where links to websites were provided but were no longer working, Internet Archive was used.

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Asociación Técnicos en Dietética y Nutrición de Canarias (2010) Transgénicos.  http://astedyn-canarias.blogspot.com/2010/04/transgenicos.html

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