Medicine is not health care, food is health care: plant metabolic engineering, diet and human health

Summary Plants make substantial contributions to our health through our diets, providing macronutrients for energy and growth as well as essential vitamins and phytonutrients that protect us from chronic diseases. Imbalances in our food can lead to deficiency diseases or obesity and associated metabolic disorders, increased risk of cardiovascular diseases and cancer. Nutritional security is now a global challenge which can be addressed, at least in part, through plant metabolic engineering for nutritional improvement of foods that are accessible to and eaten by many. We review the progress that has been made in nutritional enhancement of foods, both improvements through breeding and through biotechnology and the engineering principles on which increased phytonutrient levels are based. We also consider the evidence, where available, that such foods do enhance health and protect against chronic diseases. Contents Summary 699 I. Introduction 699 II. The two faces of nutritional enhancement 700 III. Biofortification to address deficiency diseases 700 IV. How successful has metabolic engineering been in biofortification? 706 V. Improving the concentrations of phytonutrients in foods 707 VI.