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KASHI GOLEAN ORIGINAL

Kellogg’s Kashi Cereal Tests Positive for Probable Human Carcinogen and GMO

PLEASE NOTE: The box of Kashi GoLean Original we tested was NOT verified by the Non-GMO Project. While this product has been subsequently verified by the Non-GMO Project, there are still boxes which have not been verified on store shelves. In addition, we release the results of these tests because there are still other unverified products in the Kashi line that likely contain similar ingredients.

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According to the Kashi website: “Progressive nutrition is our approach to food. It means we value whole food and put the inherent nutrition of food first when considering every ingredient. It means we make our food with a plants-first mindset. It means we value not just the foods we make, but how we make them by being mindful of sustainable and ethical farming practices.”

We sent a box of of Kashi GoLean Original cereal that was NOT verified by the Non-GMO Project to independent labs for testing to find out if Kashi is true to their word.

TEST RESULTS: GLYPHOSATE

Glyphosate is the active chemical ingredient in Roundup herbicide as well as many other name brand glyphosate-based herbicides. These herbicides are the most widely used in the world and their use has increased exponentially with the introduction of GM crops. In response to agrichemical industry requests, the EPA has incrementally increased the allowable tolerance levels of glyphosate residues in crops since their introduction into our food supply.

A glyphosate residue test was conducted by an accredited lab using the Specific LC/MS/MS testing method with a minimum detectable level of 0.02 ppm. The test documented the presence of glyphosate in the box of Kashi GoLean Original which was not verified by the Non-GMO Project, at a level of 0.68 ppm, or 0.68 mg/kg. This level is nearly 6 times higher than the levels detected in the independent testing we commissioned on Froot Loops. The test also documented the presence of AMPA (aminomethylphosphonic acid), a metabolite of glyphosate, at an even higher level of 0.81ppm or 0.81mg/kg. This is the first time the lab has documented the presence of AMPA in the products we’ve had tested. The test results give significant reason for concern. There is a growing body of scientific evidence (4) that links glyphosate to health and environmental harm.

Dr. Jeff Ritterman states:

Monsanto’s Roundup, the trade name for the herbicide glyphosate, causes birth defects and cancer and probably triggers a host of chronic diseases. Allowing glyphosate to be present in our food should be a criminal offense. It is basically mass poisoning of the population including our children.

(Note: “Roundup” is Monsanto’s trademarked name for their glyphosate-based herbicide formulation. There are many other brands produced and sold by other companies around the world.)

 

Glyphosate, the carcinogen…

In March, 2015, The International Agency for Research on Cancer (IARC), the specialized cancer agency of the World Health Organization (WHO), concluded that there is sufficient evidence of glyphosate’s carcinogenicity in experimental animals and classified glyphosate as probably carcinogenic to humans (1).

Glyphosate, the endocrine disruptor…

An in-vitro study observed that glyphosate, at minute real-world environmental levels of exposure, was able to effectively substitute for estrogen in stimulating growth of hormone-dependent human breast cancer cells at concentrations starting at 10-12M (169 parts per quadrillion) and peaking at 10-9M (169 parts per trillion) (3). The growth stimulating effect of glyphosate (and the estrogen control) on the breast cancer cells decreased at concentrations higher than 169 ppt, demonstrating a “non-linear” or “non-monotonic” response, which is typical of chemicals that possess an endocrine (hormone) disruptive capability where minute levels can actually cause their own distinct problems.

Studies suggest glyphosate based herbicides at realistic doses may be an endocrine disruptor (5) which may reduce testosterone levels (6,7), impair sperm quality (7), or could cause disturbances in the reproductive development of rats when the exposure was performed during puberty (8).

Glyphosate poses a risk to children prior to conception, throughout pregnancy and in early life…

According to The President’s Cancer Panel:

It is vitally important to recognize that children are far more susceptible to damage from environmental carcinogens and endocrine-disrupting compounds than adults. To the extent possible, parents and child care providers should choose foods, house and garden products, play spaces, toys, medicines, and medical tests that will minimize children’s exposure to toxics. Ideally, both mothers and fathers should avoid exposure to endocrine-disrupting chemicals and known or suspected carcinogens prior to a child’s conception and throughout pregnancy and early life, when risk of damage is greatest (2).

Glyphosate linked to organ damage…

Glyphosate based herbicides may also potentially damage the liver (7,9,10) and cause disturbances of intestine smooth muscle activity (11).

AMPA (aminomethyl-phosphonic acid) more toxic than glyphosate?

In an vitro study, AMPA was observed to be more toxic than glyphosate on human embryonic kidney and placental cells and the combination of glyphosate and AMPA was more toxic than glyphosate or AMPA alone (16).

Glyphosate and AMPA have been detected in air, rain, and water (12,13). AMPA is more persistent than glyphosate in the environment (14). Both glyphosate and AMPA have been detected in food (15) and glyphosate residues may remain on foods several months after spraying (14).

TEST RESULTS: GMO

The quantitative PCR test documented, by DNA analysis, that approximately 55% of the soy in the box of Kashi Go Lean Original contained DNA sequences known to be present in Roundup Ready GMO soy. Approximately 7% of the corn was also GMO, containing DNA sequences known to be present in insecticide-producing Bt corn. Peer reviewed studies show cause for concern.

GMO soy and organ damage…

Studies suggest animals fed Roundup Ready soy had potentially adverse cellular abnormalities or other disturbances in organs such as the pancreas (18,19,20), liver (21,22,23,24), kidneys (25) and adrenal glands (26). Some of these abnormalities were reversed when the animals were switched to non-GMO soy (27,28).

GMO soy linked to reproductive problems, including reduced fertility, lower birthweight and increased mortality…

Animals fed Roundup Ready soy had disturbances in reproductive organs such as the ovaries (29,30) and testes (24,31). Studies have also observed reproductive issues in adult rodents fed Roundup Ready soy (32,33), lower birthweight and increased mortality of their offspring (34,35).

GMO soy linked to other health risks…

It has also been suggested that Roundup Ready soy consumption may reduce immune and endocrine function (36) and increase the risk of intestinal infections (37). A recent study observed that GM soy is not substantially equivalent to Non-GMO soy. Using 35 different nutritional and elemental variables to characterise each soy sample, the authors were able to discriminate GM, conventional and organic soybeans without exception, demonstrating “substantial non-equivalence” in compositional characteristics for ‘ready-to-market’ soybeans. GM soy also contained high residues of glyphosate and AMPA, whereas samples of conventional and organic soy tested contained none of these residues (15). Non-GMO soy has also been observed to have increased, potentially beneficial polyphenolic content and a higher number of sterols, and may be more anticarcinogenic against a colon cancer cell line compared to GM soy (17).

Corn that is a plant incorporated pesticide…

The Bt corn in Kashi GoLean Original produces insecticides from inside every cell of the plant that can’t be washed off, and is regulated by the EPA. The FDA, EPA, and USDA allowed the insecticidal GMO corn discovered in Kashi GoLean Original to be commercialized without ever conducting human safety tests.

The scientific evidence that suggests Bt crops may have deleterious effects on health and the environment continues to increase (38)…

An in-vitro study found that the insecticides in this corn may be toxic to human cells (39). Feeding studies conducted on mammals found adverse effects, including immune system disturbances (40), blood biochemistry disturbances (41), male reproductive organ damage (42), disturbances in the functioning of the digestive system (42), hyperlipidaemia and higher blood glucose levels (43) and signs of organ toxicity (44)(45)(42)(46). Industry claims that these insecticidal proteins are broken down in the digestive tract, yet a study found the proteins circulating in the blood of pregnant and non-pregnant women and the blood supply to fetuses (47). The research team conducting this study concluded, “Given the potential toxicity of these environmental pollutants and the fragility of the foetus, more studies are needed.” To date there has been no follow up study.

CORPORATE DECEPTION

Profits from the Kashi brand go into Kellogg’s fight against our movement for food transparency and food justice. Kellogg’s has spent over $3.6 million to lobby against mandatory GMO labeling in 2013 and 2014. The corporation contributed $2 million to fund deceptive advertising to defeat citizens’ ballot initiatives for mandatory GMO labeling in CA, WA, OR and CO. Kellogg’s is also a member of the Grocery Manufacturers Association (GMA), an industry front group that is pushing for the passage of the DARK Act – a federal bill that would outlaw mandatory GMO labeling at the state and federal level. The DARK Act doesn’t stop there. It would overturn GMO crop cultivation bans passed at the county level such as those in Jackson and Josephine Counties, Oregon, and in many counties in Northern California. It would allow GMOs to be labeled “natural” and allow some GMOs to be labeled as non-GMO. And to further deceive the American People, it would likely do away with the independent nonprofit Non-GMO Project Verified label in favor of a corrupted USDA non-GMO label.

Kelloggs_GMO_Lobbying_OpenSecrets
Click on the graphic to read more about Kellogg’s.

CONCLUSION

Kellogg’s markets their Kashi brand to health conscious consumers who are misled to believe that Kellogg’s sources healthier ingredients for all products in the Kashi line. Based on the results of the above tests, this is not the case. Additionally, the fact that both unverified and Non-GMO Project Verified boxes are being mixed together on store shelves points to an attempt to further deceive consumers.

While Kellogg’s has a number of products in the Kashi product line that are Non-GMO Project Verified (some of which are also organic), the company has made no attempt to make any changes to the products which it directly markets to growing, vulnerable children. This is not acceptable.

TAKE ACTION

1. BOYCOTT all of Kellogg’s products and brands, including Kashi.

2. REPORT any unverified boxes of Kashi GoLean Original mixed with Non-GMO Project Verified boxes to your grocery store manager. Tell them that this is a deceptive practice and to immediately remove the unverified boxes.

3. DONATE to our food testing program, Operation: Label GMOs. We will continue testing processed foods to bring consumers the information they need to make informed food choices and provide the transparency they so deserve.

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Report written by GMO Free USA

References

**Jeff Ritterman, M.D. is vice president of the board of directors of the SF Bay Chapter of Physicians for Social Responsibility. He is the retired chief of cardiology at Kaiser Richmond and a former Richmond, California, city councilman.

Glyphosate Studies

  1. The International Agency for Research on Cancer (2015) IARC Monographs Volume 112: evaluation of five organophosphate insecticides and herbicides. http://www.iarc.fr/en/media-centre/iarcnews/pdf/MonographVolume112.pdf and http://monographs.iarc.fr/ENG/Monographs/vol112/mono112-02.pdf
  1. The President’s Cancer Panel (2010) REDUCING ENVIRONMENTAL CANCER RISK What We Can Do Now. 2008–2009 Annual Report. http://deainfo.nci.nih.gov/advisory/pcp/annualReports/pcp08-09rpt/PCP_Report_08-09_508.pdf
  1. Thongprakaisang S, Thiantanawat A, Rangkadilok N, Suriyo T, Satayavivad J. (2013) Glyphosate induces human breast cancer cells growth via estrogen receptors. Food Chem Toxicol. Sep;59:129-36. http://www.ncbi.nlm.nih.gov/pubmed/23756170
  1. GMO Free USA Glyphosate Studies database: https://toxinfreeusa.org/research/glyphosate-studies/
  1. Gasnier C, Dumont C, Benachour N, Clair E, Chagnon MC, Séralini GE (2009) Glyphosate-based herbicides are toxic and endocrine disruptors in human cell lines. Toxicology. Aug 21;262(3):184-91. http://www.ncbi.nlm.nih.gov/pubmed/19539684
  1. Clair E, Mesnage R, Travert C, Séralini GÉ. (2012) A glyphosate-based herbicide induces necrosis and apoptosis in mature rat testicular cells in vitro, and testosterone decrease at lower levels. Toxicol In Vitro. Mar;26(2):269-79. http://www.ncbi.nlm.nih.gov/pubmed/22200534
  1. Abarikwu SO, Akiri OF, Durojaiye MA, Adenike A.(2015) Combined effects of repeated administration of Bretmont Wipeout (glyphosate) and Ultrazin (atrazine) on testosterone, oxidative stress and sperm quality of Wistar rats. Toxicol Mech Methods. 2015 Jan;25(1):70-80. http://www.ncbi.nlm.nih.gov/pubmed/25403740
  1. Romano RM, Romano MA, Bernardi MM, Furtado PV, Oliveira CA. (2010) Prepubertal exposure to commercial formulation of the herbicide glyphosate alters testosterone levels and testicular morphology. Arch Toxicol. Apr;84(4):309-17. http://www.ncbi.nlm.nih.gov/pubmed/20012598
  1. Benedetti AL, Vituri CdL, Trentin AG, Domingues MA, Alvarez- Silva M. (2004) The effects of sub-chronic exposure of Wistar rats to the herbicide Glyphosate-Biocarb. Toxicol Lett. 153(2): 227–232. http://www.sciencedirect.com/science/article/pii/S0378427404002188
  1. Gilles-Eric Séralini, Emilie Clair, Robin Mesnage, Steeve Gress, Nicolas Defarge, Manuela Malatesta, Didier Hennequin and Joël Spiroux de Vendômois (2014) Republished study: long-term toxicity of a Roundup herbicide and a Roundup-tolerant genetically modified maize. Environmental Sciences Europe , 26:14 http://www.enveurope.com/content/26/1/14
  1. Magdalena Chłopecka, Marta Mendel, Natalia Dziekan, Wojciech Karlik (2014) Glyphosate affects the spontaneous motoric activity of intestine at very low doses – In vitro study. Pesticide Biochemistry and Physiology, Available online 24 June 2014 http://www.sciencedirect.com/science/article/pii/S0048357514000947
  1. Majewski, M. S., Coupe, R. H., Foreman, W. T., & Capel, P. D. (2014). Pesticides in Mississippi air and rain: a comparison between 1995 and 2007.Environmental toxicology and chemistry, 33(6), 1283-1293. http://www.ncbi.nlm.nih.gov/pubmed/24549493
  1. Battaglin, W.A., M.T. Meyer, K.M. Kuivila, and J.E. Dietze, 2014. Glyphosate and Its Degradation Product AMPA Occur Frequently and Widely in U.S. Soils, Surface Water, Groundwater, and Precipitation. Journal of the American Water Resources Association (JAWRA) 50(2): 275-290. http://onlinelibrary.wiley.com/doi/10.1111/jawr.12159/abstract
  1. Caroline Cox (1995) Glyphosate, Part 1: Toxicology Journal of Pesticide Reform, Volume 15, No. 3:14 -20 http://www.terrazul.org/Archivo/Glyphosate_Fact_Sheets.pdf

Roundup Ready Soy Studies

  1. T. Bøhn, M. Cuhra, T. Traavik, M. Sanden, J. Fagan, R. Primicerio (2013) Compositional differences in soybeans on the market: glyphosate accumulates in Roundup Ready GM soybeans. Food Chemistry. Volume 153, 15 June 2014, Pages 207–215 http://www.sciencedirect.com/science/article/pii/S0308814613019201
  1. Benachour, N., & Séralini, G. E. (2008). Glyphosate formulations induce apoptosis and necrosis in human umbilical, embryonic, and placental cells.Chemical research in toxicology, 22(1), 97-105. http://pubs.acs.org/doi/abs/10.1021/tx800218n
  1. Marrelli M, Tudisco R, Mastellone V, Conforti F. (2013) A comparative study of phytochemical composition of genetically and non-genetically modified soybean (Glycine max L.) and evaluation of antitumor activity. Nat Prod Res. 2013;27(6):574-8. http://www.ncbi.nlm.nih.gov/pubmed/22455986
  1. Manuela Malatesta, Chiara Caporaloni, Luigia Rossi, Serafina Battistelli, Marco BL Rocchi, Francesco Tonucci, and Giancarlo Gazzanelli (2002) Ultrastructural analysis of pancreatic acinar cells from mice fed on genetically modified soybean J Anat. November; 201(5): 409–415 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1570979/
  2. Malatesta M., Biggiogera M., Manuali E., Rocchi M.B., Baldelli B., Gazzanelli G.(2003) Fine structural analysis of pancreatic acinar cell nuclei from mice fed on GM soybean. Eur J Histochem. 47,3858. http://www.ncbi.nlm.nih.gov/pubmed/14706936
  3. Magaña-Gómez JA, Cervantes GL, Yepiz-Plascencia G, de la Barca AM. (2008) Pancreatic response of rats fed genetically modified soybean J Appl Toxicol. Mar;28(2):217-26. http://www.ncbi.nlm.nih.gov/pubmed/18041736
  1. Malatesta M, Caporaloni C, Gavaudan S, Rocchi MB, Serafini S, Tiberi C, Gazzanelli G. (2002) Ultrastructural morphometrical and immunocytochemical analyses of hepatocyte nuclei from mice fed on genetically modified soybean. Cell Struct Funct. Aug;27(4):173-80. http://www.ncbi.nlm.nih.gov/pubmed/­12441651
  1. Malatesta M, Boraldi F, Annovi G, Baldelli B, Battistelli S, Biggiogera M, Quaglino D. (2008) A long-term study on female mice fed on a genetically modified soybean: effects on liver ageing. Histochem Cell Biol. Nov;130(5):967-77. http://link.springer.com/article/10.1007/s00418-008-0476-x#page-1
  2. SG Zinoviev (2014) Some Biochemical Parameters of Blood of Pigs Using GM Soy in Their Diets. Animal Biology, 2014, vol. 16, № 1 http://aminbiol.com.ua/20141pdf/10.pdf
  1. Ermakova IV, IV Barskov (2008) Study of the physiological and morphological parameters in rats and their offspring using a diet containing soybean transgenic EPSPS CP4 Biological sciences. 6. p.19-20. http://online.rae.ru/237
  1. GI-Gubin Vakulik, T.V. Gorbach, N.G. Kolousova, HS, Gopkalov (2013) The Metabolic and Histological Changes of Kidneys in Female Rats and the First Generation After Consumption of Genetically Modified Soybeans. Scientific Statements Series Medicine. Pharmacy. 2013. № 11 (154). Issue 22 pages 150-155 http://cyberleninka.ru/article/n/metabolicheskie-i-gistologicheskie-izmeneniya-pochek-krys-samok-i-potomkov-1-go-pokoleniya-pri-upotreblenii-v-pischu
  1. Gubin-Vakulik, S.A. Denisenko, T.V. Gorbach, N.G. Kolousova, T.M. Popova (2012) Morphofunctional State of Adrenal Gland in Female Wistar Rats With Genetically Modified Soy Inclusion in the Diet. Tavrichesky Life Sciences Bulletin 2012, Volume 15, № 3, Part 1 (59) pages 85-88 http://dspace.nbuv.gov.ua/bitstream/handle/123456789/44454/21-Gubina-Vakulik.pdf?sequence=1
  2. Battistelli S., Baldelli B., Malatesta M. (2008), Influence of a GMO-containing diet on pancreatic acinar cells of adult mice: effects of a short-term diet reversion, “Microscopie”, 10, pp. 36-43 http://ftp.clinicsandpractice.org/index.php/microscopie/article/view/4961
  1. Malatesta M, Tiberi C, Baldelli B, Battistelli S, Manuali E, Biggiogera M. (2005) Reversibility of hepatocyte nuclear modifications in mice fed on genetically modified soybean. Eur J Histochem. Jul-Sep;49(3):237-42. http://www.ncbi.nlm.nih.gov/pubmed/16216809
  1. Т. V. Gorbach, I. U. Kuzminа, G. I. Gubina-Vakulik, N. G. Kolousova (2012) Hormonal Regulation of Sexual Function and Ovarian Histological Features in the Experiment With GMO-Soya Use in Food. Tavrichesky Life Sciences Bulletin 2012, Volume 15, № 2, Part 2 (58) pages 235-238 http://repo.knmu.edu.ua/handle/123456789/1392
  1. Brasil FB, Soares LL, Faria TS, Boaventura GT, Sampaio FJ, Ramos CF.(2009) The impact of dietary organic and transgenic soy on the reproductive system of female adult rat. Anat Rec(Hoboken).292(4):587594. http://www.ncbi.nlm.nih.gov/pubmed/19301281
  1. Vecchio L, Cisterna B, Malatesta M, Martin TE, Biggiogera M. (2004) Ultrastructural analysis of testes from mice fed on genetically modified soybean. Eur J Histochem. Oct-Dec;48(4):448-54. http://www.ncbi.nlm.nih.gov/pubmed/15718213
  1. Maligin AG, Ermakova IV (2008) Soy diet suppresses reproductive function rodents. Modern problems of science and education № 6. (Annex “Biological sciences”). – C. 26 http://online.rae.ru/301
  1. Nazarova AF, Ermakova IV (2010) Effect of soy diet on reproductive function and testosterone levels in rats and hamsters. Academy Trinitarism, № 77-6567, publ.15788, 12.02. http://www.trinitas.ru/rus/doc/0016/001c/00161613.htm
  1. Ermakova IV (2006) Genetically modified soy leads to weight loss and increased mortality of pups of the first generation. Preliminary studies. EkosInform. Federal Environmental Law Gazette. a | -1,, p. 4-10. http://eco-irina-ermakova.narod.ru/art/art14.html
  1. Ermakova IV (2009) Influence of soybean gene EPSPS CP4 on the physiological state and reproductive functions of rats in the first two generations Contemporary Problems in Science and Education Number 5, p.15-20. http://www.science-education.ru/33-1224
  1. Zhou Ze-wei et al. (2012) Comprehensive Evaluation on Functions & Safety of Imported GM Soybean Using BDI-GS System Soybean Science Oct. Vol. 31 No 5 http://en.cnki.com.cn/Article_en/CJFDTOTAL-DDKX201205033.htm
  1. S. Battistelli, B.Citterio, B. Baldelli, C. Parlani, and M. Malatesta (2010) Histochemical and morpho-metrical study of mouse intestine epithelium after a long term diet containing genetically modified soybean Eur J Histochem. September 26;54(3): e36 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3167318/

Bt (Bacillus thuringiensis) Studies

  1. GMO Free USA Bt Studies database: https://toxinfreeusa.org/research/glyphosate-studies/
  1. Mesnage R, Clair E, Gress S, Then C, Székács A, Séralini G-E. Cytotoxicity on human cells of Cry1Ab and Cry1Ac Bt insecticidal toxins alone or with a glyphosate-based herbicide. J Appl Toxicol. 2011. http://www.ncbi.nlm. nih.gov/pubmed/22337346
  1. Finamore A, Roselli M, Britti S, et al. Intestinal and peripheral immune response to MON810 maize ingestion in weaning and old mice. J Agric Food Chem. 2008;56:11533–39. doi:10.1021/jf802059w. http://www.ncbi.nlm.nih.gov/pubmed/19007233
  1. Gab-Alla AA, El-Shamei ZS, Shatta AA, Moussa EA, Rayan AM. Morphological and biochemical changes in male rats fed on genetically modified corn (Ajeeb YG). J Am Sci. 2012;8(9):1117–1123.http://www.academia.edu/3405390/Morphological_and_Biochemical_Changes_in_Male_Rats_Fed_on_Genetically_Modified_Corn_Ajeeb_YG_
  1. El-Shamei ZS, Gab-Alla AA, Shatta AA, Moussa EA, Rayan AM. Histopathological changes in some organs of male rats fed on genetically modified corn (Ajeeb YG). J Am Sci. 2012;8(10):684–696.http://www.academia.edu/3405345/Histopathological_Changes_in_Some_Organs_of_Male_Rats_Fed_on_Genetically_Modified_Corn_Ajeeb_YG_
  1. Hasan Kiliçgün, Cebrail Gürsul, Mukadder Sunar, Gülden Gökşen (2013) The Comparative Effects of Genetically Modified Maize and Conventional Maize on Rats J Clin Anal Med ;4(2): 136-9 http://www.jcam.com.tr/files/KATD-983.pdf
  1. Séralini GE, Cellier D, Spiroux de Vendomois J. New analysis of a rat feeding study with a genetically modified maize reveals signs of hepatorenal toxicity. Arch Environ Contam Toxicol. 2007;52:596–602. http://www.ncbi.nlm.nih.gov/pubmed/17356802
  2. De Vendomois JS, Roullier F, Cellier D, Séralini GE. A comparison of the effects of three GM corn varieties on mammalian health. Int J Biol Sci. 2009;5:706–26. http://www.ijbs.com/v05p0706.htm
  1. E. Abdo, O. Barbary and O. Shaltout, “Feeding Study with Bt Corn (MON810: Ajeeb YG) on Rats: Biochemical Analysis and Liver Histopathology,” Food and Nutrition Sciences, Vol. 5 No. 2, 2014, pp. 185-195. http://www.scirp.org/journal/PaperInformation.aspx?paperID=42183#.Uy8XQIVVitM
  2. Aris A, Leblanc S. Maternal and fetal exposure to pesticides associated to genetically modified foods in Eastern Townships of Quebec, Canada. Reprod Toxicol. 2011;31. http://www.ncbi.nlm.nih.gov/pubmed/21338670
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