The health benefits of folate biofortified rice in China

19 20 Although genetic modification is still a subject of discussion, both in political and research forums, the widespread 21 adoption of biofortified food crops in China is likely to happen. In the scope of biofortification for improving human 22 nutrition, folate biofortified rice was recently developed as a remedy against folate deficiency and its adverse health 23 outcomes, among which neural-tube defects (NTDs). The objective of this paper is to analyze the potential health 24 benefits of folate enriched rice in China, a rice consuming country characterized by large folate deficiencies. The 25 Disability-Adjusted Life Years (DALY) method is used to calculate the impact of biofortification as the number of 26 DALYs saved due to the reduced number of NTDs. A low and high impact scenario are simulated according to the 27 coverage rate of folate enriched rice consumption. Our findings support folate biofortification of rice as a valuable 28 alternative to increase folate intake and reduce folate deficiency in China. Implementing rice with a folate content of 29 1,200 μg per 100 g rice in China would increase the total daily folate intake for Chinese women of childbearing age to 30 1,120 μg, which is almost three times the recommended folate intake. As a consequence, around 116,090 DALYs in the 31 low impact scenario and 257,345 DALYs in the high impact scenario would be saved by implementing biofortified rice. 32 Although rice consumption is lower in northern areas, these regions account for the biggest health impact of 33 biofortification in China. As expected, regions with high NTD prevalence rates, such as Shanxi Province, will benefit 34 most from folate biofortification of rice. Further research is needed to assess the cost-effectiveness of this intervention 35 and to compare different interventions to increase folate intake, such as a campaign to promote folic acid pills intake. 36 Especially in poor, rural regions where other folate interventions are often unsuccessful, folate enriched rice could be an 37 effective, complementary approach to combat folate deficiency. 38 39