Global Food Security 32 (2022) 100596 Contents lists available at ScienceDirect Global Food Security journal homepage: www.elsevier.com/locate/gfs From Golden Rice to Golden Diets: How to turn its recent approval into practice Hans De Steur a,*, Alexander J. Stein b, Matty Demont c a Ghent University, Department of Agricultural Economics, Coupure Links 653, 9000, Ghent, Belgium b European Commission, Directorate-General for Agriculture and Rural Development, 1049 Brussels, Belgium c International Rice Research Institute, Los Baños, Laguna, Philippines A R T I C L E I N F O A B S T R A C T Keywords: Following its approval in the Philippines in July 2021, provitamin A-rich “Golden Rice” is set to become the Biofortification worlds’ first commercialized genetically modified crop with direct consumer benefits. Despite supplementation Consumer acceptance and fortification programs, the burden of micronutrient deficiencies remains high. For Golden Rice to be suc- Golden rice cessful in reducing vitamin A deficiency, it needs to be taken up by food systems and integrated into consumer Planetary health diets The Philippines diets. Despite negative information often being associated with genetic engineering, evidence suggests that Vitamin A deficiency consumers react positively to Golden Rice. Thus, it offers policy makers and public health stakeholders a new, powerful option to address micronutrient malnutrition that they can integrate as a cost-effective component in broader nutrition strategies and tailor it to consumers’ heterogeneous socio-economic contexts and needs to promote “Golden Diets”. For this to happen, the right framing of the pathway from policy to consumption is crucial. 1. A history of controversy widely adopted first-generation GM crops with farmer-oriented agro- nomic benefits (such as insect resistance or herbicide tolerance) may July 2021 was yet another landmark for the strengthening of the have intensified the struggle for approval of this second-generation GM agriculture-nutrition-health nexus, when the Philippines gave their crop with clear consumer benefits. green light for the cultivation of genetically modified (GM) Golden Rice, However, instead of looking (again) at the heated debate and po- a rice variety biofortified with provitamin A (Science, 2021). Bio- larization between proponents and opponents (Kettenburg et al., 2018), fortification refers to the use of crop breeding or of agronomic practices it is worthwhile to focus on how Golden Rice could be taken up by local to increase the mineral or vitamin content in crops to address micro- communities and how its use could be better framed by policy makers, nutrient malnutrition and improve public health. Hundreds of conven- nutritionists and the scientific community. tionally biofortified crop varieties have already been released and shown impact and acceptance (Birol et al., 2015; CAST, 2020), but 2. The post-approval dialogue Golden Rice is set to become the worlds’ first commercialized GM bio- fortified crop. When it comes to novel and controversial products, a routine dia- After being declared safe for consumption in four countries logue takes place when positive new scientific evidence or policy de- (Australia, New Zealand, Canada and the United States) (Greedy, 2018), cisions are published: pro-parties typically lend their support through it is the Philippines that was the first to approve its cultivation, which is positive messaging, quickly followed by anti-campaigning by opposing expected to happen in Bangladesh soon, too. Since Potrykus and Beyer parties. In light of the upcoming commercialization of Golden Rice in the developed its first version in 1999 (Qamar et al., 2020; Ye et al., 2000), Philippines, the potential influence of information campaigns should not Golden Rice has been facing sustained criticism that undoubtedly be ignored, not the least at the level of consumers (and of farmers as delayed the progress of this humanitarian project to help alleviate the consumers), who are the key beneficiaries of Golden Rice. health and economic burden of vitamin A deficiency (Wesseler and Information may be retained, whether it is validated or not. Trans- Zilberman, 2014). Carrying the legacy of the controversy over the lating consumer studies on Golden Rice and other GM biofortified crops * Corresponding author. E-mail address: Hans.DeSteur@ugent.be (H. De Steur). https://doi.org/10.1016/j.gfs.2021.100596 Received 26 October 2021; Received in revised form 19 November 2021; Accepted 21 November 2021 Available online 29 November 2021 2211-9124/© 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). H. De Steur et al. G l o b a l F o o d S e c u r i ty 32 (2022) 100596 Fig. 1. Overview of consumer acceptance studies on Golden Rice. Source: Own development, based on a systematic review, updated with recent literature (De Steur et al., 2015; Zheng et al., 2018). Note: Acceptance represents the share of consumers with a positive attitude towards Golden Rice. Purchase intention is measured through the share of consumers with an intention to purchase Golden Rice if it were available. Willingness-to-pay represents consumers’ perceived added-value of Golden Rice relative to conventional rice. It is measured as the mean price premium consumers would be prepared to pay for Golden Rice—if it were available—as compared to conventional rice. Ultimately, prices are determined on the market by aggregate supply and demand and, if applicable, by government subsidies, though. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.) into practice (De Steur et al., 2015; Zheng et al., 2018), the interplay areas) (DOST-FNRI, 2020) and beyond (De Moura et al., 2016), agro- between positive and negative information on Golden Rice can be ex- nomic performance of targeted local varieties should be at least unaf- pected to affect consumer acceptance in some way or the other. Negative fected and preferably improved. Encouragingly, earlier confined field information associated with genetic engineering is certainly found to tests of recent Golden Rice introgression lines in the Philippines and reduce peoples’ intentions to consume Golden Rice, but research has Bangladesh demonstrated both agronomic performance and carotenoid shown that it would not necessarily increase overall rejection rates as expression in three popular rice varieties (Swamy et al., 2021). The long as the nutritional benefits are highlighted (De Steur et al., 2017a). humanitarian sublicense for resource-poor farmers (i.e. farmers own the This is an important finding, as it suggests that, overall, negative in- seeds, and use the seeds royalty-free without additional costs for the formation does not necessarily overshadow the effect of positive infor- trait; www.goldenrice.org) could further facilitate its cultivation, as mation. Currently the evidence overwhelmingly points to positive competitive seed prices will likely incentivize them to grow Golden Rice consumer reactions to Golden Rice (Fig. 1), which do not differ from varieties (Potrykus, 2010). Indeed, the available evidence suggests that those reported for other GM and non-GM biofortified crops (De Steur farmers will likely need to be incentivized to adopt Golden Rice (Glover et al., 2017b; Oparinde and Birol, 2019). Making target populations et al., 2020; Stone and Glover, 2017), e.g., through higher agronomic aware of the nutritional content and specific benefits of Golden Rice for performance and market access. their own health and well-being and that of their children could have a much larger impact than trying to resolve the larger discussion about the 4. Deploying Golden Rice and moving the debate forward general benefits of genetic engineering (De Steur et al., 2017a). This discussion often extends to the role of knowledge and education. When commercialized, Golden Rice needs to take its place in the While nutritional knowledge indeed appears to increase consumer current food system, i.e. it needs to be taken up by value chains and acceptance of GM biofortified foods, the role of knowledge of genetic integrated into food environments (where food acquisition and con- engineering is much less straightforward. Hence, following its approval, sumption takes place) and consumer diets. It is important to emphasize a new wave of communication efforts to explain the value of Golden Rice that this crop is not, or should not, be framed as a silver bullet—or a to target populations should be focused even more on its nutritional golden bullet, as it were—for ending micronutrient malnutrition. value. Thereby, the design of the communication strategy should be Rather, it has an important role in addressing a particular micronutrient carefully adapted to the context, taking into account differential impacts deficiency that still imposes a considerable burden on public health and based on the information content (e.g., length, frequency), source (e.g., that requires innovative but cost-effective and culturally appropriate trustworthiness) and channel (e.g., audiovisual, community-driven) interventions that go beyond conventional vitamin A supplementation (Birol et al., 2015). programs that typically target high priority population groups (children of 6–59 months old) (Hamer and Keusch, 2015). Implementing 3. The push for adoption food-based solutions is particularly important as these are less vulner- able to disruptions caused by funding shortfalls or catastrophes, as For Golden Rice to be successful in reducing vitamin A deficiency, it shown most recently by the drop in vitamin A supplementation rates due needs to be accepted by consumers. As studies show that changes to a to COVID-19 (HKI, 2020). Improving the micronutrient status of poor biofortified crop’s sensory qualities, including its color, do not act as populations can also more generally contribute to stronger immune obstacles to its acceptance (Talsma et al., 2017), communicating its systems, which again is of particular importance to boost their resilience nutritional value remains key. However, even if consumer acceptance is in case of (public health) crises (Heck et al., 2020). needed, and even if it can signal the market demand for Golden Rice to Even though disseminating Golden Rice is expected to be a valuable farmers, also adoption of the rice by the latter is important. Regardless of and cost-effective complementary intervention to combat vitamin A its potential to reduce the prevalence of vitamin A deficiency in the deficiency in particular, to win the fight against malnutrition in general, Philippines (e.g., nearly 1 out of 5 children of 6–59 months old in rural it is time to move the framing forward and shift the debate. Instead of 2 H. De Steur et al. G l o b a l F o o d S e c u r i ty 32 (2022) 100596 Fig. 2. Integrating Golden Rice as a component of a “Golden Diet.” Source: adapted from Custodio et al. (2021). Note: Diets are structured through culturally inherited “gastronomic systems” that are contextualized by the socio-economic status of consumers (who) and the food environment (where) in which they purchase and consume food. The gastronomic system defines the eating occasions (when) during which food is typically consumed (breakfast, snacks, lunch, dinner, special occasions, etc.), which in their turn determine the dishes (what) that are consumed (rice-based and other dishes), which combine ingredients (rice, staples, vegetables, viands, sauces, etc.) that carry certain sensory and hedonic attributes and provide nutritional content (why). Each of the hierarchical layers in the system provides entry points for nutrition interventions. For example, Golden Rice can be promoted in food environments (where; e.g., in schools, cafeteria, etc.), during certain occasions (when; e.g., as a healthy breakfast, snack, lunch or dinner), through special dishes centered around Golden Rice or as a healthy ingredient in rice-based dishes (what), and for its sensory, hedonic and nutritional attributes (why; e.g., through information campaigns, school education programs, etc.). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.) discussing technological aspects of individual crops, such as Golden within consumer diets, it will have to be paired to other ingredients in Rice, we need to come to an understanding of how to achieve “Golden terms of its various sensory attributes (aroma, taste, color), and it will Diets”, i.e. winning diets that are sustainable and wholesome. need to be incorporated into existing dishes or become the center piece One of the trail blazers in this respect is the EAT-Lancet Commission. of new ones. These dishes, in turn, will have to become integrated in It promotes a dietary shift towards “planetary health diets” that aim at eating occasions (breakfast, snacks, lunch, dinner, and special occa- striking a balance between human nutrition and planetary health sions), which are determined by consumers’ culture, their socio- (Willett et al., 2019). It acknowledges that despite nutrition programs, economic status and the food environments they are exposed to. All the burden of micronutrient deficiencies remains high and that for these components—the where, who, when, what, and why—are part of a achieving planetary health diets, the adequacy of most micronutrients in system that needs to be optimized to achieve “Golden Diets” (Fig. 2). low-income countries must increase—not least through greater con- The system provides multiple entry points for nutrition interventions sumption of fruits and vegetables, which are an essential source also of to help consumers achieve such diets. For these interventions to have provitamin A. impact, they should be situation-specific and use multiple strategies that However, the challenges for poor consumers are that (i) not only are need to be tailored to consumers’ heterogeneous situations and needs their low incomes a barrier to more diversified and wholesome diets, (Custodio et al., 2021); e.g., using Golden Rice to diversify micronutrient also the relative prices of fruits and vegetables (higher compared to strategies, or as a provitamin A-rich food item when promoting staple crops, such as rice) affect food consumption patterns (low intake nutrient-richer diets to resource-poor target groups. of fruits and vegetables) and related health outcomes; and (ii) high After a long series of delays in the regulatory process, the approval of prices and low incomes mean that wholesome diets (such as the EAT- Golden Rice in the Philippines marks an important breakthrough in the Lancet diet) are well outside the reach of the average consumer in fight against vitamin A deficiency. Policy makers and public health poor countries for the foreseeable future as they surpass their disposable stakeholders now have a new, powerful option to help target pop- daily incomes. Indeed, globally, about 3 billion people cannot afford the ulations achieve planetary health diets. However, the success of Golden minimum cost of healthy diets recommended by national governments Rice and other nutritionally enhanced crops in the pipeline will crucially (Herforth et al., 2020). In addition to economic growth and depend on two factors: (i) how these crops are integrated into national nutrition-sensitive social protection, supply-side interventions that nutrition strategies; and (ii) how consumers manage to incorporate them improve the affordability of nutritious foods are needed. This means that into their daily lives in their efforts to achieve “Golden Diets.” Such diets until widespread consumption of more diversified and wholesome diets can be another illustration on how to operationalize the EAT-Lancet is achieved through economic growth and nutrition-sensitive social planetary health diets (Béné et al., 2020), but it is up to policy makers protection, interventions that improve the affordability of nutritious to ensure that these crops are integrated as cost-effective components foods will be crucial (Fan et al., 2021). within a broader nutrition strategy, and to communicate to consumers In this context, Golden Rice has a valuable role to play. It can be a that eating Golden Diets means winning. provitamin A-rich component in broader interventions that rely on rice being a traditional and accepted staple to enable more nutrient-rich Disclaimer diets that better satisfy consumers’ physiological and nutritional needs than diets that are based on conventional rice. Such diets can still fit the The information and views set out in this article are those of the respective socio-demographic, economic and cultural contexts and authors and do not necessarily reflect the official position of the Euro- fulfill the hedonic motivations of the target groups (Custodio et al., pean Commission. 2021). Once available on the market, Golden Rice will have to find its place 3 H. De Steur et al. G l o b a l F o o d S e c u r i ty 32 (2022) 100596 Author contributions DOST-FNRI, 2020. Philippine Nutrition Facts and Figures: 2018 Expanded National Nutrition Survey (ENNS). Food and Nutrition Research Institute, Manila. 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