According to the World Health Organization, Genetically Modified Organisms(GMOs) are "organisms in which the genetic material (DNA) has been altered in such a way that does not occur naturally."1 This technology is also referred to as "genetic engineering", "biotechnology" or "recombinant DNA technology" and consists of randomly inserting genetic fragments of DNA from one organism to another, usually from a different species. For example, an artificial combination of genes that includes a gene to produce the pesticide Cry1Ab protein (commonly known as Bt toxin), originally found in Bacillus thuringiensis, is inserted in to the DNA of corn randomly. Both the location of the transferred gene sequence in the corn DNA and the consequences of the insertion differ with each insertion. The plant cells that have taken up the inserted gene are then grown in a lab using tissue culture and/or nutrient medium that allows them to develop into plants that are used to grow GM food crops.2
 Natural breeding processes have been safely utilized for the past  several thousand years.  In contrast, "GE crop technology abrogates  natural reproductive processes, selection occurs at the single cell  level, the procedure is highly mutagenic and routinely breeches genera  barriers, and the technique has only been used commercially for 10  years."3
 Despite these differences, safety assessment of GM foods has been based  on the idea of "substantial equivalence" such that "if a new food is  found to be substantially equivalent in composition and nutritional  characteristics to an existing food, it can be regarded as safe as the  conventional food."4  However, several animal studies  indicate serious health risks associated with GM food consumption  including infertility, immune dysregulation, accelerated aging,  dysregulation of genes associated with cholesterol synthesis, insulin  regulation, cell signaling, and protein formation, and changes in the  liver, kidney, spleen and gastrointestinal system.
 There is more than a casual association between GM foods and adverse  health effects.  There is causation as defined by Hill's Criteria in the  areas of strength of association, consistency, specificity, biological  gradient, and biological plausibility.5   The strength of  association and consistency between GM foods and disease is confirmed in  several animal studies.2,6,7,8,9,10,11  
 Specificity of the association of GM foods and specific disease  processes is also supported.  Multiple animal studies show significant  immune dysregulation, including upregulation of cytokines associated  with asthma, allergy, and inflammation. 6,11   Animal studies  also show altered structure and function of the liver, including  altered lipid and carbohydrate metabolism as well as cellular changes  that could lead to accelerated aging and possibly lead to the  accumulation of reactive oxygen species (ROS).  7,8,10    Changes in the kidney, pancreas and spleen have also been documented.   6,8,10   A recent 2008 study links GM corn with infertility,  showing a significant decrease in offspring over time and significantly  lower litter weight in mice fed GM corn.8 This study also  found that over 400 genes were found to be expressed differently in the  mice fed GM corn.  These are genes known to control protein synthesis  and modification, cell signaling, cholesterol synthesis, and insulin  regulation.  Studies also show intestinal damage in animals fed GM  foods, including proliferative cell growth9 and disruption of the  intestinal immune system.6  
 Regarding biological gradient, one study, done by Kroghsbo, et al., has  shown that rats fed transgenic Bt rice trended to a dose related  response for Bt specific IgA. 11 
 Also, because of the mounting data, it is biologically plausible for  Genetically Modified Foods to cause adverse health effects in humans.
 In spite of this risk, the biotechnology industry claims that GM foods  can feed the world through production of higher crop yields.  However, a  recent report by the Union of Concerned Scientists reviewed 12 academic  studies and indicates otherwise: "The several thousand field trials  over the last 20 years for genes aimed at increasing operational or  intrinsic yield (of crops) indicate a significant undertaking.  Yet none  of these field trials have resulted in increased yield in  commercialized major food/feed crops, with the exception of Bt corn."12   However, it was further stated that this increase is largely due to  traditional breeding improvements.
 Therefore, because GM foods pose a serious health risk in the areas of  toxicology, allergy and immune function, reproductive health, and  metabolic, physiologic and genetic health and are without benefit, the  AAEM believes that it is imperative to adopt the precautionary  principle, which is one of the main regulatory tools of the European  Union environmental and health policy and serves as a foundation for  several international agreements.13   The most commonly used  definition is from the 1992 Rio Declaration that states: "In order to  protect the environment, the precautionary approach shall be widely  applied by States according to their capabilities.  Where there are  threats of serious or irreversible damage, lack of full scientific  certainty shall not be used as a reason for postponing cost-effective  measures to prevent environmental degradation."13
 Another often used definition originated from an environmental meeting  in the United States in 1998 stating: "When an activity raises threats  to the environment or human health, precautionary measures should be  taken, even if some cause and effect relationships are not fully  established scientifically.  In this context, the proponent of an  activity, rather than the public, should bear the burden of proof (of  the safety of the activity)."13
 With the precautionary principle in mind, because GM foods have not been  properly tested for human consumption, and because there is ample  evidence of probable harm, the AAEM asks:
- Physicians to educate their patients, the medical community, and the public to avoid GM foods when possible and provide educational materials concerning GM foods and health risks.
- Physicians to consider the possible role of GM foods in the disease processes of the patients they treat and to document any changes in patient health when changing from GM food to non-GM food.
- Our members, the medical community, and the independent scientific community to gather case studies potentially related to GM food consumption and health effects, begin epidemiological research to investigate the role of GM foods on human health, and conduct safe methods of determining the effect of GM foods on human health.
- For a moratorium on GM food, implementation of immediate long term independent safety testing, and labeling of GM foods, which is necessary for the health and safety of consumers.
(This statement was reviewed and approved by the Executive Committee of the American Academy of Environmental Medicine on May 8, 2009.)
Submitted by Amy Dean, D.O. and Jennifer Armstrong, M.D.
 
 
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