# Myths and Realities about Genetically Modified Food: A Risk-Benefit Analysis
## 4 The Application of GMOs to Agriculture and Food Production
### Nutritional Improvement  
Apart from the aforementioned improvements, GE technologies have been applied to increase plant nutritional value. The importance of nutrition and food in human health has drawn plenty of attention in recent years [15]. Enhancing crops' nutrient contents instead of adding nutrients to food during their processing is known as biofortification. Recent studies have shown the value of biofortification with conventional breeding as a successful nutrition and public health intervention in developing countries in SE Asia, sub-Saharan Africa, and Latin America. GM foods that provide nutritional benefits are extremely promising for fighting malnutrition (Table 3) [110]. For instance, retinol or vitamin A is a fat-soluble micronutrient contained mainly in eggs, liver, and butter. Green and yellow vegetables also produce vitamin A precursors, such as b-carotene and other carotenoids. As too much retinol can cause toxic excess in vitamin A, vegetable carotenoids have the advantage over retinol from animal sources because carotenoids can be converted into retinol depending on metabolic requirements. Vitamin A deficiency (VAD) may cause several diseases such as night-blindness, xerophthalmia, bone growth deficiencies, or keratomalacia or may weaken the immune system and can lead to serious problems, depending on the patient's age. Children are the most vulnerable population group, with a death rate of up to 50%. According to the WHO, VAD is a global public health concern, especially for children, and it affects 140-250 million preschool children in over 118 countries [87]. Rice is the major staple food for hundreds of millions of people worldwide. The edible part of rice grainscontains starch granules and protein bodies but lacks several essential nutrients, such as carotenoids, that maintain health. This makes VAD related to rice-based diets a serious public health problem in at least 26 countries, including areas in Asia, sub-Saharan Africa, and Latin America [111]. In 1984, the Golden Rice concept was first suggested, which is an engineered rice in which the endosperm would be rendered yellow through b-carotene accumulation (pro-vitamin A) [89]. The first Golden Rice was engineered by inserting the PSY gene from _Narcissus pseudonarcissus_ and the bacterial phytoene desaturase (Crtl) gene from _Erwinia uterovora_, which can catalyze phytoene to retinol precursors. However, according to both the FAO and WHO, the carotenoid content of Golden Rice did not meet the minimum nutritional requirements, not even if consumed as staple food. Nevertheless, the biotechnology company Syngenta developed Golden Rice2 in 2005 by choosing the maize PSY gene instead of the previously used PSY genes. This new crop increased carotenoid content by up to 23-fold compared to the original Golden Rice and came close to a realistic level to palliate children's VAD [87; 112]. Because of its high carotenoid content, Golden Rice could act as a possible VAD treatment and could favorably influence human health. As such, its adaptation to local cultivation is relevant and is under study [87]. Another example of GM crops in which nutritional value is improved could be by altering the fatty acid profile. The health benefits associated with a diet containing omega-3 long-chain polyunsaturated fatty acids are a well-known fact of life. It is scientifically proven that they reduce the risk of cardiovascular disease, act as positive anti-inflammatory lipid mediators, and play roles in brain and retinal functions. Currently, these fatty acids are obtained mainly from oceans via the wild capture of marine fish and shellfish [115]. In the late 1990s, interest began to be shown in engineering plants to accumulate omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs). These omega-3 LC-PUFAs include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are absent in higher plants. The biosynthesis of EPA and DHA involves many enzymes that are not expressed in higher plants.