David R. Schubert
Cellular Neurobiology Laboratory, The Salk Institute for Biological
Studies, La Jolla, California
JOURNAL OF MEDICINAL FOOD
J Med Food 11 (4) 2008, published on line
http://www.liebertonline.com/doi/abs/10.1089/jmf.2008.0094?
prevSearch=allfield%3A(schubert)
ABSTRACT
Among the next generation of genetically modified (GM) plants are those that are engineered to produce elevated levels of nutritional molecules such as vitamins, omega-3 fatty acids, and amino acids. Based upon the U.S. current regulatory scheme, the plants and their products may enter our food supply without any required safety testing. The potential risks of this type of GM plant are discussed in the context of human health, and it is argued that there should be very careful safety testing of plants designed to produce biologically active molecules before they are commercially grown and consumed. This will require a mandatory, scientifically rigorous review process.
INTRODUCTION
The evolution of genetically modified (GM) plant production
is in a new phase that could have serious health
consequences if the biology of these plants and their interaction
with the consumer are not better understood. Currently
the only widely planted GM crops are those engineered
for insect and herbicide resistance, but there has been
interest in marketing plant-based pharmaceuticals as well as
nutritionally enhanced plants (NEPs), such as those producing
vitamins and other food supplements. The bestknown
example of a NEP is golden rice, which is engineered
for the overproduction of -carotene, the precursor to retinol
(vitamin A), but not yet commercialized.
1 Other examples
include plants enriched in vitamin E2,3 or omega-3 fatty
acids.
4
Protein-based pharmaceuticals meeting Food and Drug
Administration (FDA) clinical standards have been difficult
to produce in plants in their native form, in part because secondary
modifications, such as glycosylation, are quite distinct
from those made by mammalian cells and can contribute
to the proteins’ immunogenicity.
5–7 In contrast to
protein-based pharmaceuticals, most NEPs only necessitate
the manipulation of small molecule metabolism and will,
based upon current GM crop regulation, likely be viewed
by U.S. government agencies as generally recognized as safe
(GRAS), thereby not requiring any mandatory safety testing.
8
Substances produced in plants by GM technology are regulated
by the food additives provision of the Federal Food,
Drug and Cosmetic Act. Food additives are required to undergo
extensive premarket safety testing, including longterm
animal testing. However, testing is not required for
foods that are generally recognized as safe by the FDA. Furthermore,
it is largely up to the producer to decide whether
or not the GM product and the plant that produces it are exempt
from testing. To date, the FDA has not disallowed a
single favorable biotech industry safety determination in
over 100 completed applications.9 Since a number of plants
with altered small molecule metabolism, such as those producing
high oleic acid, have already passed FDA’s voluntary
biotechnology review,
9 it is very likely that the FDA
will accept this designation from other NEP producers. The
FDA, however, has the authority to require the full testing
protocol for food additives if there is evidence of possible
harm.
While there has been an extensive discussion of the problems
associated with aberrant secondary modifications of
mammalian proteins expressed in plants, there has been no
discussion about the potential harmful side effects of producing
large amounts of biologically active compounds in
plant hosts that have an enormous repertoire of enzymes capable
of modifying small molecules in an unpredictable
manner.
10 For example, with golden rice there has been concern
about -carotene absorption,
11 but none about the potential
for teratogenesis. Indeed, in a recent article in Science
on golden rice,
12 there was no discussion about safety,
despite the fact that simple derivatives of -carotene are
known teratogens.
13–16
NEPs are designed to make molecules that are biologically
active in animals. Given that the transfection proce-dures used to make GM plants cause random mutations that
can alter the already unpredictable plant metabolism,
17–19
that there will be unforeseen pleiotropic interactions between
overproduced metabolites of introduced enzymes and
normal plant metabolism,20 and that NEPs will likely have
no required safety testing, there should be significant concern
about allowing the introduction of this type of GM plant
product into the marketplace.
To explain the reasoning behind these concerns, several
examples illustrating how altering the human diet with biologically
active compounds can have clinical consequences
will be used. These examples include a tryptophan food supplement
to demonstrate that an extremely small amount of
a metabolite contaminant in a product can be lethal, glycolysis
in GM yeast to show that changes in even the best understood
metabolic pathway can produce unpredicated toxins,
and golden rice to demonstrate how plant-derived small
molecules based upon the -carotene chemical scaffold may
negatively influence human development.
A TRYPTOPHAN NUTRITIONAL SUPPLEMENT
An underappreciated fact of biology is that very small
amounts of a compound can have profound effects in biological
systems. Plant metabolism can produce toxic products,
but while these have been selected against in our food
supply during the 10,000 years of crop development or eliminated
through food processing before consumption,
21 they
may be unintentionally re-introduced by modern technology.
A good example is the health disaster caused by tryptophan
in the guise of a dietary supplement.
In the late 1980s, L-tryptophan was widely used as an
over-the-counter supplement to combat insomnia and depression.
In 1989, more than 1,500 people contracted a rare
disease, eosinophilia myalgia syndrome (EMS), manifested
by increased levels of a subset of blood cells (eosinophils)
and severe muscle pain; at least 37 died from a complex of
inflammatory conditions.
22 The epidemic was traced to the
L-tryptophan producer, which had recently modified its production
procedures.
22 The purity of the toxic preparations
was greater than 99%. However, a comparison of high-performance
liquid chromatography profiles between toxic and
nontoxic lots revealed several case-associated minor contaminants.
All of those that were identified were structurally
related to tryptophan or biosynthetic intermediates.
23
Although it was believed at the time that a tryptophan
metabolite was the cause of the EMS outbreak, there was no
explanation as to how a very minor contaminant (less than
0.01% by weight) could cause a fatal dysregulation of the immune
system. It has since been shown that tryptophan metabolites
control the immune response at steps where interference
by competing tryptophan analogues could have clinical consequences. For example, the rate-limiting enzyme in tryptophan
catabolism is up-regulated during some forms of inflammation.
24 The metabolic products of this enzyme, which
are similar in structure to some of the compounds identified
in the tryptophan preparations that likely caused EMS, are
made by small numbers of cells, but derivatives are orally active
and can change cytokine profiles and suppress autoreactive
T helper cell type 1 cells.
25 In addition, a defect in the
synthesis of another tryptophan derivative, L-kynurenine, enhances
the inflammatory response.
26
These data show that minute amounts of a compound contaminating
a dietary supplement can be lethal and that chemical
modifications of common, small molecules such as amino
acids can lead to biologically active derivatives.
25 GM maize
with high tryptophan levels has recently been introduced in
association with the introduced trait of high lysine content.
9,27
Although this product is intended for animal feed, the promiscuous
nature of corn pollen and other routes of dispersal such
as seed mixing will certainly lead to the contamination of corn
destined for human consumption.
GLUCOSE METABOLISM
An example of how the manipulation of a well-understood
metabolic process by GM technology can have unexpected
consequences is ethanol production in yeast. When
three genes were introduced into yeast to enhance glycolysis
a few-fold, there was a concomitant, unintended 30-fold
increase in the synthesis of methylglyoxal (MG).28 MG is a
highly toxic 2-oxoaldehyde that reached concentrations of
1 mM in the GM yeast strain.28 MG is mutagenic and also
causes protein glycation and oxidative stress, conditions associated
with diabetes and neurodegenerative disease as well
as a variety of autoimmune diseases.
29 The authors of the
yeast study concluded that “careful thought should be given
to the potential metabolic products and their safety when a
genetically modified yeast is applied to food-related fermentation
processes.”
28 This advice has apparently not been
heeded, for another GM yeast strain called ML01 is commercially
available and can be used in the production of
wines in the United States.
30 This yeast is modified to carry
out a second fermentation step in the wine making process,
the conversion of malic acid to the less acidic lactic acid, a
step normally carried out by bacteria. The commercialization
of this GM yeast was allowed via FDA GRAS status
and required no safety testing, such as animal feeding studies.
Since there are no food labeling requirements in the
United States, the consumer has no way of knowing whether
or not the wine they are drinking is made with the help of
ML01. GM yeast is not allowed in the production of European
wines.
RETINOIDS AND PLANT SECONDARY METABOLISM
Of perhaps even greater concern than the modification of
amino acid or carbohydrate metabolism in plants are the attempts
to alter plant secondary metabolism to create NEPs.
Examples include increased synthesis and accumulation of
lycopenes, vitamin E, and -carotene, the precursor to vitamin
A.
31 Unlike primary metabolism, which is similar in
plants and animals, plants possess the ability to synthesize
between 90,000 and 200,000 nonessential, small molecules,
with up to 5,000 in one species.
32,33 These molecules have
adaptive functions to counteract various forms of predation
and infection,
32,33 but the regulation of their synthesis and,
indeed, many of their structures largely remain mysteries.
For example, potatoes engineered to accumulate zeaxanthin
have an unexplained threefold increase in vitamin E.
34 This
enormous repertoire of phytochemicals is due in part to the
fact that they are synthesized by enzymes with very low substrate
specificity whose amounts and specificities are unpredictably
altered by the types of mutations and pleiotropic
effects associated with GM technology.
10,18–20 A National
Academy of Science advisory panel on GM food safety concluded
that the genetic engineering of a biosynthetic pathway“raises the potential for unintended changes in the
chemical composition of the resulting food” and “could lead
to an increased concentration of catabolic products” (pp.
78–79).
35 The well-publicized example of GM-enhanced -
carotene production in golden rice will be used to illustrate
potential health risks resulting from this type of genetic manipulation
of plant secondary metabolism.
Retinoids are a family of compounds derived from plant
carotenoids that are required for many aspects of human
health and development. The best-studied retinoids are
retinol (vitamin A), retinal, and retinoic acid (RA). Deficiencies
in retinol are found in many developing countries
where insufficient dietary vitamin A is a leading cause of
blindness and other maladies.36 Dietary vitamin A can be
derived from -carotene in plants, but also indirectly from
many animal tissues, in particular the liver, where retinol
esters are stored. In countries such as the United States most
dietary retinol is obtained from animal products; only 30%
is provided by the metabolism of -carotene from plants.
However, in some cultures up to 60% of their calories come
from plants such as rice,37 which contains relatively little -
carotene. Therefore there has been an effort toward making
rice that is augmented with -carotene. It is called golden rice.
-Carotene consists of an 18-carbon polyene chain with
a six-carbon -ionone ring on either end. Upon ingestion by
animals, -carotene is cleaved in half by a dioxygenase to
generate retinal for use in the visual cycle. Retinal is also
reduced to retinol, or oxidized to RA, which interacts with
highly specific nuclear receptors.38 Essentially all of the biological
activity of retinoids, except for vision, involves RA.
While high concentrations of retinol are toxic,
13 RA is biologically
active at concentrations several orders of magnitude
lower than retinol, and for this reason excess RA or
RA derivatives are exceedingly dangerous, particularly to
infants and during pregnancy.14 RA is required for the development
of the nervous system, both by directly controlling
nerve differentiation and by generating concentration
gradients that direct cell migration, embryonic segmentation,
and development.
38 Therefore, RA and synthetic derivatives
of RA are teratogenic. Furthermore, they can accumulate
in fat and plasma, becoming a risk factor for
pregnancy for up to 2 years following ingestion,
13–16,38 and
multiple low doses of retinoids have greater toxicity than a
single high dose.
39
Although toxicity from carrots has been reported,
40 it is
difficult to ingest sufficient plant -carotene to cause toxicity
because the enzyme in the gut required to cleave it to
retinal is rate limiting. In contrast, RA and derivatives are
directly assimilated and are not subject to the same physiological
safety net as -carotene following ingestion.
14,39 Because
of the type of biological functions controlled by low
levels of RA, any perturbation of its signaling pathways by
plant-derived RA receptor agonists or antagonists will have
clinical consequences. Could the GM modifications used to
enhance -carotene synthesis create such compounds?
To produce -carotene in rice endosperm, genes for
enzymes that convert geranylgeranyl diphosphate to
-carotene with high efficiency were transfected into
plants. Six hundred naturally occurring compounds exist
in the carotene family, and at least 60 can be precursors to
retinoids.
13 Plant enzymes involved in carotenoid metabolism
have homologies to human enzymes, including the
oxygenase required for the cleavage of carotenoids to
retinoids in the gut. Therefore, plants have the potential to
make many potentially harmful retinoid-like compounds
when there are increased levels of synthetic intermediates
to -carotene as in golden rice.
31,41–43 It is well known that
the accumulation of a biosynthetic intermediate will lead
to the synthesis of new compounds by broad-specificity
plant enzymes.44 While all retinoids and derivatives are
likely to be teratogenic, good assays and information regarding
the behavioral and teratologic activity are available
for only three: retinol, RA, and retinal.
13 Therefore,
extensive safety testing should be required before the introduction
of golden rice as a food.
CONCLUSIONS
The above paragraphs summarize published data that
clearly show the following:
(1) Compounds structurally related
to a common small molecule can have a lethal effect
when present as even a minor contaminant in a food supplement.
(2) The GM enhancement of a metabolic pathway
by the overexpression of genes for that pathway can have
unpredictable consequences in the form of synthesizing a
toxin.
(3) Finally, in the case of golden rice, it is argued that
biologically active compounds derived from aberrant plant
carotenoid synthesis could have profound effects on human
development. Similar arguments can be made for NEP-derived
fatty acids that are directly incorporated into brain
lipids and about NEPs overproducing vitamin E. Aberrant
fatty acid composition of brain lipids is implicated in
Alzheimer’s disease,
45,46 and vitamin E has a role similar to
RA in mammalian development.
47
The excess consumption of a nutrient can also have negative
effects. For example, a clinical trial with vitamin E
supplementation showed that a relatively small dose increased
the risk of heart failure,48 and smokers who supplemented
their diet with -carotene had an increased risk
of lung cancer.
49 Therefore, there is a potential for nutrient
toxicity in NEPs because upper tolerable levels of many nutrients
are not well established (p. 107)
35 and are likely to
vary between individuals and lifestyles.
The information presented here shows that not only the
potential harm of the product should be considered for risk
assessment, but the GM process itself. The data clearly invalidate
the argument that “the regulatory trigger for risk assessment
should be based upon the physical features of the
product rather than the process by which the product was
generated.”
50 While it is true that traditional breeding methods
can give rise to potentially hazardous products, the most
recent assessment of GM food safety by the National Research
Council35 stated that GM “has a higher probability
of producing unanticipated changes than some genetic modification
methods” (p. 118), but it curiously concludes by
stating that the risk of GM technology is no greater than
conventional breeding methods. There are, in fact, no data
comparing the food safety profiles of GM versus conventional
breeding, and the ubiquitous argument that since there
is no evidence that GM products make people sick, they are
safe (see, for example, McHughen and Smyth,
50 Bradford
et al.,
51 and Miller et al.
52) is both illogical and false. There
are, again, simply no data or even valid assays to support
this contention.
53 Without proper epidemiological studies,
most types of harm will not be detected, and no such studies
have been conducted. The necessity of labeling all GM
products and particularly NEPs is therefore critical if there
is any hope of monitoring adverse health consequences due
to their consumption. For example, it would have been impossible
to identify the source of the toxic tryptophan supplement
if the product were not traceable through labeling.
It follows that before NEPs producing biologically active
molecules such as -carotene, omega-3 fatty acids, or vitamin
E are introduced into the food chain, great care must be
taken to do rigorous, multigenerational animal safety assessments
with the hope of identifying risks to health (for
methods, see, for example, the 2007 publication by the National
Toxicology Program54 and Pusztai and Bardocz55). In
addition, the products must be labeled and traceable, and the
unpredictable and unintended metabolic changes that may
occur in NEPs require the thorough testing of the entire edible
portion of the plant, not just the designated product as
is almost always done by biotech companies.
56 To date there
is essentially no multigenerational animal safety testing published
for GM plants
55,57 and no required labeling in the
United States for any GM product. In an excellent review of
our current GM regulatory process, Mandel58 concluded that
for second-generation GM products, like NEPs, “it is necessary
to establish a comprehensive, efficient and scientifically
rigorous regulatory system.” As discussed herein there are
very valid scientific concerns to support this conclusion.
AUTHOR DISCLOSURE STATEMENT
No competing financial interests exist.
REFERENCES
1. Ye X, Al-Babili S, Kloti A, et al.: Engineering the provitamin A
(beta-carotene) biosynthetic pathway into (carotenoid-free) rice
endosperm. Science 2000;287:303–305.
2. Cahoon EB, Hall SE, Ripp KG, et al.: Metabolic redesign of vitamin
E biosynthesis in plants for tocotrienol production and increased
antioxidant content. Nat Biotechnol 2003;21:1082–1087.
3. Van Eenennaam AL, Lincoln K, Durrett TP, et al.: Engineering
vitamin E content: from Arabidopsis mutant to soy oil. Plant Cell
2003;15:3007–3019.
4. Kinney AJ: Metabolic engineering in plants for human health and
nutrition. Curr Opin Biotechnol 2006;17:130–138.
5. Schubert D: A different perspective on GM food. Nat Biotechnol
2002;20:969.
6. Prescott VE, Campbell PM, Moore A, et al.: Transgenic expression
of bean alpha-amylase inhibitor in peas results in altered
structure and immunogenicity. J Agric Food Chem 2005;53:
9023–9030.
7. van Ree R, Cabanes-Macheteau M, Akkerdaas J, et al.: Beta(1,2)-
xylose and alpha(1,3)-fucose residues have a strong contribution
in IgE binding to plant glycoallergens. J Biol Chem 2000;275:
11451–11458.
8. FDA POLICY: Statement of policy: foods derived from new plant
varieties; notice. Federal Register 1992;57(104):22983–23005.
9. U.S. Food and Drug Administration: List of completed consultations
on bioengineered foods. http://www.cfsan.fda.gov/ lrd/
consulpr.html (accessed November 2007).
10. Schwab W: Metabolome diversity: too few genes, too many
metabolites? Phytochemistry 2003;62:837–849.
11. Krawinkel MB: What we know and don’t know about Golden
Rice. Nat Biotechnol 2007;25:623; author reply 624.
12. Enserink M: Tough lessons from golden rice. Science 2008;
320:468–471.
13. Adams J, Holson RR: The neurobehavioral teratology of vitamin
A analogs. In: Handbook of Developmental Neurotoxicology
(Slikker W, Chang LW, eds.). Academic Press, San Diego, CA,
1998, pp. 631–642.
14. Marcus R, Coulston AM: Fat-soluble vitamins. In: The Pharmacological
Basis of Therapeutics, 10th ed. (Hardman JG, Limbird
LE, Gilman AG, eds.). McGraw Hill, New York, 2001, pp.
1773–1791.
15. Teelmann K: Retinoids: toxicology and teratogenicity to date.
Pharmacol Ther 1989;40:29–43.
16. Wyatt EL, Sutter SH, Drake LA: Dermatological pharmacology.
In: The Pharmacological Basis of Therapeutics, 10th edition
(Hardman JG, Limbird LE, Gilman AG, eds.). McGraw Hill, New
York, 2001, pp. 1795–1818.
17. Wilson A, Latham J, Steinbrecher R: Genome Scrambling—Myth
or Reality? Transformation-Induced Mutations in Transgenic
Crop Plants. EcoNexus, Brighton, UK, 2004, p. 35.
18. Zubieta C, Ross JR, Koscheski P, et al.: Structural basis for
substrate
recognition in the0 salicylic acid carboxyl methyltransferase
family. Plant Cell 2003;15:1704–1716.
19. Johnson ET, Ryu S, Yi H, et al.: Alteration of a single amino acid
changes the substrate specificity of dihydroflavonol 4-reductase.
Plant J 2001;25:325–333.
20. Poerschmanna J, Gathmannb A, Augustinc J, Langera U,
Goreckid T: Molecular composition of leaves and stems of genetically
modified Bt and near-isogenic non-Bt maize—characterization
of lignin patterns. J Environ Qual 2005;34:1508–
1518.
21. Diamond JM: Guns, Germs, and Steel: The Fates of Human Societies.
W.W. Norton, New York, 1997.
22. Mayeno AN, Gleich GJ: Eosinophilia-myalgia syndrome and
tryptophan production: a cautionary tale. Trends Biotechnol
1994;12:346–352.
23. Hill RH, Caudill SP, Philen RM, et al.: Contaminants in L-tryptophan
associated with eosinophilia myalgia syndrome. Arch Environ
Contam Toxicol 1993;25:134–142.
24. Munn DH, Zhou M, Attwood JT, et al.: Prevention of allogeneic
fetal rejection by tryptophan catabolism. Science 1998;281:1
191–1193.
25. Platten M, Ho PP, Youssef S, et al.: Treatment of autoimmune
neuroinflammation with a synthetic tryptophan metabolite. Science
2005;310:850–855.
26. Romani L, Fallarino F, De Luca A, et al.: Defective tryptophan
catabolism underlies inflammation in mouse chronic granulomatous
disease. Nature 2008;451:211–215.
27. Huang S, Frizzi A, Florida CA, Kruger DE, Luethy MH: High lysine
and high tryptophan transgenic maize resulting from the reduction
of both 19- and 22-kD alpha-zeins. Plant Mol Biol 2006;
61:525–535.
28. Inose T, Murata K: Enhanced accumulation of toxic compound
in yeast cells having high glycolytic activity: a case study on the
safety of genetically engineered yeast. Int J Food Sci Technol
1995;30:141–146.
29. Kurien BT, Hensley K, Bachmann M, Scofield RH: Oxidatively
modified autoantigens in autoimmune diseases. Free Radic Biol
Med 2006;41:549–556.
30. BioSpringer: ML01: The first available malolactic wine yeast.
http://www.lesaffreyeastcorp.com/wineyeast/ML01%20KH%20
6-13-05.pdf OE828.11/04 (accessed November 11, 2004).
31. DellaPenna D, Pogson BJ: Vitamin synthesis in plants: tocopherols
and carotenoids. Annu Rev Plant Biol 2006;57:711–738.
32. Verpoorte R: Plant secondary metabolism. In: Metabolic Engineering
of Plant Secondary Metabolism (Verpoorte R, Alfermann
AW, eds.). Kluwer Academic Publishers, Dordrecht, The Netherlands,
2000, pp. 1–29.
33. Roessner U, Luedemann A, Brust D, et al.: Metabolic profiling
allows comprehensive phenotyping of genetically or environmentally
modified plant systems. Plant Cell 2001;13:11–29.
34. Romer S, Lubeck J, Kauder F, et al.: Genetic engineering of a
zeaxanthin-rich potato by antisense inactivation and co-suppression
of carotenoid epoxidation. Metab Eng 2002;4:263–272.
35. National Research Council, National Academy of Science: The
Safety of Genetically Engineered Foods: Approaches to Assessing
Unintended Health Effects. National Academies Press, Washington,
DC, 2004. http://books.nap.edu/catalog/10977.html (accessed
July 28, 2004).
36. Sommer A: New imperatives for an old vitamin (A). J Nutr 1989;
119:96–100.
37. Khush G: Productivity improvements in rice. Nutr Rev 2003;
61(Suppl):S114–S116.
38. McCaffery PJ, Adams J, Maden M, Rosa-Molinar E: Too much
of a good thing: retinoic acid as an endogenous regulator of neural
differentiation and exogenous teratogen. Eur J Neurosci 2003;18:
457–472.
39. Allen JG, Bloxham DP: The pharmacology and pharmacokinetics
of the retinoids. Pharmacol Ther 1989;40:1–27.
40. Donahue SP: Recurrence of idiopathic intracranial hypertension
after weight loss: the carrot craver. Am J Ophthalmol 2000;130:
850–851.
41. Auldridge ME, McCarty DR, Klee HJ: Plant carotenoid cleavage
oxygenases and their apocarotenoid products. Curr Opin Plant
Biol 2006;9:315–321.
42. Moise AR, von Lintig J, Palczewski K: Related enzymes solve
evolutionarily recurrent problems in the metabolism of
carotenoids. Trends Plant Sci 2005;10:178–186.
43. Dawson MI, Zhang XK: Discovery and design of retinoic acid receptor
and retinoid X receptor class- and subtype-selective synthetic
analogs of all-trans-retinoic acid and 9-cis-retinoic acid.
Curr Med Chem 2002;9:623–637.
44. Grotewold E: Plant metabolic diversity: a regulatory perspective.
Trends Plant Sci 2005;10:57–62.
45. Cole GM, Teter B, Frautschy SA: Neuroprotective effects of curcumin.
Adv Exp Med Biol 2007;595:197–212.
46. Roland I, De Leval X, Evrard B, et al.: Modulation of the
arachidonic
cascade with omega3 fatty acids or analogues: potential
therapeutic benefits. Mini Rev Med Chem 2004;4:659–668.
47. Cuddihy SL, Ali SS, Musiek ES, et al.: Prolonged alpha-tocopherol
deficiency decreases oxidative stress and unmasks alphatocopherol-
dependent regulation of mitochondrial function in
brain. J Biol Chem 2008;283:6915–6924.
48. Lonn E, Bosch J, Yusuf S, et al.: Effects of long-term vitamin E
supplementation on cardiovascular events and cancer: a randomized
controlled trial. JAMA 2005;293:1338–1347.
49. The effect of vitamin E and beta carotene on the incidence of lung
cancer and other cancers in male smokers. The Alpha-Tocopherol,
Beta Carotene Cancer Prevention Study Group. N Engl J Med
1994;330:1029–1035.
50. McHughen A, Smyth S: US regulatory system for genetically
modified [genetically modified organism (GMO), rDNA or transgenic]
crop cultivars. Plant Biotechnol J 2008;6:2–12.
51. Bradford KJ, Van Deynze A, Gutterson N, Parrott W, Strauss SH:
Regulating transgenic crops sensibly: lessons from plant breeding,
biotechnology and genomics. Nat Biotechnol 2005;23:
439–444.
52. Miller HI, Conko C, Kershen DL: Why spurning food biotech has
become a liability. Nat Biotechnol 2006;24:1075.
53. Schubert D: Two views of the emperor’s new clones. Nat Biotechnol
2007;25:282–283.
54. National Toxicology Program: Multigenerational Reproductive
Toxicology Study of Ethinyl Estradiol (CAS No. 57-63-6) in
Sprague-Dawley Rats (Feed Studies). National Toxicology Program,
National Institute of Environmental Health Sciences, National
Institutes of Health, Department of Health and Human Services,
Research Triangle Park, NC, 2007.
55. Pusztai A, Bardocz S: GMO in animal nutrition: potential benefits
and risks. In: Biology of Nutrition in Growing Animals
(Mosenthin R, Zentek J, Zebrowska T, eds.). Elsevier, Amsterdam,
The Netherlands, 2006, pp. 513–540.
56. Freese W, Schubert D: Safety testing of genetically engineered
food. Biotechnol Genet Eng Rev 2004;21:299–325.
57. Domingo JL: Toxicity studies of genetically modified plants: a
review of the published literature. Crit Rev Food Sci Nutr
2007;47:721–733.
58. Mandel GN: Gaps, inexperience, inconsistencies, and overlaps:
crisis in the regulation of genetically modified plants and animals.
In: William & Mary Law Review, Vol. 45. William & Mary Marshall-
Wythe School of Law, Williamsburg, VA, 2004, pp.
2167–2259.
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