February 2014 Issue
Arsenic in Baby Foods — What We’ve Learned About the Safety of Rice Products for Infants and Children
By Megan Tempest, RD
Today’s Dietitian
Vol. 16 No. 2 P. 60
After six months of breast-feeding, Kim was delighted to have reached the pivotal milestone of introducing solid foods to her infant daughter. Following tradition and the trusted advice of family and friends, Kim confidently chose rice cereal as her baby’s first solid food.
Shortly thereafter, in early 2012, researchers from Dartmouth College published scientific findings that revealed many baby foods, including rice cereal, contain significant levels of arsenic.1 Like many parents across the nation, the intense media coverage of this discovery caused Kim to fear that she may have harmed her daughter with a seemingly wholesome baby food.
Roughly two years later, the media storm has quieted, but the presence of arsenic in food—particularly rice-containing products for babies and children—remains a significant public health concern. Prolonged exposure to arsenic from water and food has been linked to certain forms of cancer, skin lesions, increased heart disease risk, neurotoxicity, and diabetes.2,3 The potential adverse affects of arsenic on the health and development of babies and children is of utmost concern.
Amy Jamieson-Petonic, RD, a spokesperson for the Academy of Nutrition and Dietetics (the Academy), highlights the good that came from the alarming media coverage on this issue: “Any information regarding the health and well-being of babies and young children should be addressed. The media has shared information about a potential health issue, and that’s an important service to our community and parents.”
Indeed, after the issue of arsenic in baby foods emerged, the medical community, researchers, government agencies, and rice product manufacturers were called to action. As a result, we’re now on the path toward greater understanding of arsenic in our food supply and closer to determining a safe level of consumption.
Our Food Supply
Humans have long been consuming arsenic; it’s a naturally occurring element in our soil and groundwater. Various mechanisms, such as erosion of arsenic-containing rock and the plentiful industrial uses of arsenic, all contribute to arsenic in our environment.4 Fruits, vegetables, poultry, wheat, corn, meat, fish, and eggs all contain arsenic in varying amounts, whether grown organically or conventionally.2
Two forms of arsenic, inorganic and organic, exist and always are present in the food supply. However, only inorganic arsenic is considered toxic to our health and defined as a known human carcinogen.2-4 Julie Miller Jones, PhD, CNS, LN, CFS, offers this encouragement to worried consumers: “What really matters is the form of arsenic. The inorganic form is the toxic form. A high level of arsenic in a food may not mean a high level of the inorganic form.”
Why Rice Is a Significant Source
Unlike most other crops, rice is grown in water-flooded conditions. Its roots readily absorb arsenic from the groundwater and soil, and eventually the grain stores the arsenic. Depending on the geographic region in which the rice is grown, the crops may contain more or less arsenic. Rice grown in the south central states such as Arkansas, from where roughly 50% of rice grown in the United States originates, is said to contain higher amounts of arsenic due to a long history of arsenic-containing pesticide use on cotton crops in that region. Also worth noting is that arsenic concentrates in the outer bran and germ layers of the rice grain, therefore brown rice is said to have a higher total arsenic content than white rice.5
Babies’ and Children’s Products
Americans traditionally feed their babies rice cereal as their first food. Rice also is a primary ingredient in many other baby foods, such as puffed rice snacks, stage 2 dinners for infants, fruit and yogurt smoothies, and even certain infant formulas.
In late 2012, Consumer Reports published results of an internal analysis of 200 samples of rice products in which some infant rice cereals were determined to contain five times or more the level of inorganic arsenic found in alternative grains such as oatmeal. Researchers estimated that infants may eat up to two to three servings of rice per day, an amount that could equate to a cancer risk twice their acceptable level. Subsequently, the researchers recommended babies be fed no more than one serving of an infant rice cereal per day on average and encouraged parents to offer cereals made from wheat, oatmeal, and corn grits because of their lower arsenic content.5 The Environmental Working Group, a nonprofit, nonpartisan health and research advocacy organization, provided similar cautionary recommendations for limiting arsenic exposure in a child’s diet.6
The health effects of arsenic exposure in children remain largely unknown. Evidence suggests that if children consume rice, they’re being exposed to arsenic. One recent study among US children found that for every 1/4-cup increase in cooked rice consumption, there was a 14% increase in urinary arsenic concentration.7 Among two separate studies published in 2013, both of which assessed children in rural Bangladesh, where chronic exposure to high arsenic levels in drinking water is a serious health problem, arsenic exposure early in life was associated with poor growth and other long-term consequences, such as increased blood pressure and compromised kidney function.8-10
When rice-containing baby foods suddenly were vilified for containing arsenic, some manufacturers took immediate action to begin selling safer products. The manufacturer of two infant formulas made with organic brown rice syrup—both of which had been targeted for having high arsenic levels—found a new low-arsenic rice source and worked with its rice supplier to develop a filtration process that would eliminate detectable arsenic levels. Subsequent third-party testing reportedly has confirmed that these formulas now contain undetectable or nearly undetectable arsenic levels.11 Moreover, the makers of a widely popular infant rice cereal have altered their manufacturing practices to exclusively use rice grown in California, a state believed to have the lowest arsenic levels for rice grown in the United States, for all their rice-containing infant cereals.12
FDA Sheds New Light
In September 2013, the FDA published test results to determine the inorganic arsenic content of approximately 1,300 samples of rice and rice products commonly consumed in the United States, including toddler cereals, infant formulas, grain-based bars, and snacks such as rice cakes and cookies. It reported that arsenic levels varied greatly among the products tested, yet the arsenic content was deemed too low to cause immediate or short-term adverse health effects.13
In an official statement, the FDA advised consumers, including pregnant women, infants, and children, to eat a well-balanced diet for the sake of good nutrition and minimize potential health risks from consuming any one food in excess. For parents seeking to diversify their child’s diet, the FDA suggested limiting rice cereal to one serving per week and offering cereals made from other types of grains, including wheat, barley, and oats.13
Acknowledging that Americans traditionally feed infants rice cereal as their first food, the FDA reported that, per the American Academy of Pediatrics, there’s no scientific evidence stating that rice cereal is superior to other grains such as wheat, oats, or barley as the first solid food. Concurrently, the American Academy of Pediatrics issued a public statement in support of the FDA’s recommendations.14
In collaboration with other federal agencies, such as the National Institute of Environmental Health Sciences and the Environmental Protection Agency, the FDA currently is completing a thorough risk assessment to determine the potential long-term effects of arsenic consumption with emphasis on how arsenic may affect children. The results may be published in late 2014.
Dietitians Weigh In
Jamieson-Petonic recommends that concerned parents limit products that have rice or brown rice syrup as one of the first ingredients on the label and avoid foods that list even organic brown rice syrup as a primary ingredient. “Exposing your child to a balanced diet is beneficial in order to ensure a varied amount of vitamins, minerals, and nutrients,” she says.
Likewise, Vandana Sheth, RDN, CDE, a spokesperson for the Academy, says variety is a critical part of a healthful diet for babies and children. “Experimenting with different grains is good for the whole family. When choosing other grain cereals, parents should just make sure they’re iron fortified. As an alternative, parents can consider puréed meats, as they can be a good way of getting that necessary iron to their baby.”
Jones agrees that a varied diet is important for children, but she cautions against putting emphasis on avoiding rice products. “Eliminating rice may give parents a false sense of security and will not protect them or their children,” she says. “Be concerned about whether your child gets enough good-quality protein, adequate dietary fiber, and enough fruits and vegetables. The best offense is a good defense.”
Naturally, parents will continue to have concerns about the presence of arsenic in their children’s food. Dietitians can provide a valuable service to their communities by explaining what the research says and offering sound alternatives to ensure their clients’ children get the nutrients they need for their proper development.
“Any time a study comes out that reveals a product is carcinogenic, we’re concerned. We go into panic mode because we naturally want to protect our kids,” Sheth says. “But we definitely want to make sure the decisions we make about what we feed our children are based on evidence and not fear.”
— Megan Tempest, RD, is a dietitian at Boulder Community Hospital in Colorado and a freelance writer.
References
1. Jackson BP, Taylor VF, Punshon T, Cottingham KL. Arsenic concentration and speciation in infant formulas and first foods. Pure Appl Chem. 2012;84(2):215-223.
2. Arsenic. US Food and Drug Administration website. http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm280202.htm. Updated July 7, 2013. Accessed November 8, 2013.
3. Arsenic. World Health Organization website. http://www.who.int/mediacentre/factsheets/fs372/en. Updated December 2012. Accessed November 24, 2013.
4. Arsenic compounds. US Environmental Protection Agency website. http://www.epa.gov/ttnatw01/hlthef/arsenic.html. Accessed November 24, 2013.
5. Arsenic in your food. Consumer Reports website. http://consumerreports.org/cro/arsenicinfood.htm. November 2012. Accessed November 24, 2013.
6. Reducing arsenic in your diet. Environmental Working Group website. http://www.ewg.org/release/reducing-arsenic-your-diet. September 19, 2012. Accessed November 24, 2013.
7. Davis MA, Mackenzie TA, Cottingham KL, Gilbert-Diamond D, Punshon T, Karagas MR. Rice consumption and urinary arsenic concentrations in U.S. Children. Environ Health Perspect. 2012;120(10):1418-1424.
8. Hawkesworth S, Wagatsuma Y, Kippler M, et al. Early exposure to toxic metals has a limited effect on blood pressure or kidney function in later childhood, rural Bangladesh. Int J Epidemiol. 2013;42(1):176-185.
9. Gardner RM, Kippler M, Tofail F, et al. Environmental exposure to metals and children’s growth to age 5 years: a prospective cohort study. Am J Epidemiol. 2013;177(12):1356-1367.
10. Flanagan SV, Johnston RB, Zheng Y. Arsenic in tube well water in Bangladesh: health and economic impacts and implications for arsenic mitigation. Bull World Health Organ. 2012;90(11):839-846.
11. Nature’s One: organic formula manufacturer leads in eliminating arsenic. Nature’s One website. http://www.naturesone.com/pdf/N1-Organic_Formula_Manufacturer_Leads_in_Eliminating_Arsenic_3-13.pdf - view=FitH,0. March 5, 2013. Accessed November 24, 2013.
12. Gerber reassures parents of rice cereal safety. Gerber website. http://news.gerber.com/in_the_news/gerber-safety-statement-238803. Accessed November 24, 2013.
13. FDA statement on testing and analysis of arsenic in rice and rice products. US Food and Drug Administration website. http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm367263.htm. September 6, 2013. Accessed November 25, 2013.
14. AAP offers advice for parents concerned about arsenic in food. American Academy of Pediatrics website. http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Offers-Advice-For-Parents-Concerned-About-Arsenic-in-Food.aspx. September 6, 2013. Accessed November 25, 2013.