Arsenic and Rice: Translating Research to Address Health Care Providers' Needs

Lai, Pui Y.; Cottingham, Kathryn L.; Steinmaus, Craig; Miller, Mark D.

doi:10.1016/j.jpeds.2015.07.003

Cited by 41 publications

(27 citation statements)

References 49 publications

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“…2,3,9,11,20,21,36,37 Rice ( Oryza sativa L.) appears to accumulate As more than other cereal crops, 38,39 especially when grown in flooded paddies. 40 Both the total concentration of As and the proportion of inorganic As present in commercial rice vary widely owing to differences in rice cultivars and geographical locations.…”

Section: Discussionmentioning

confidence: 99%

Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life

et al. 2016

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IMPORTANCE Rice-a typical first food and major ingredient in various infant foods-contains inorganic arsenic (As), but the extent of As exposure from these foods has not been well characterized in early childhood.OBJECTIVE To determine the types and frequency of rice and rice-containing products consumed by infants in the first year of life and the association with As biomarker concentrations.DESIGN, SETTING, AND PARTICIPANTS Included were infants from singleton births of pregnant women enrolled in the New Hampshire Birth Cohort Study from 2011 to 2014 whose parents were interviewed during their first year of life. Enrolled women from selected clinics were aged 18 to 45 years, living in the same residence since their last menstrual period, in households served by a private water system, and had no plans to move during pregnancy. Data on infants' intake of rice and rice products were collected from interviews with their parents at 4, 8, and 12 months' follow-up and from a 3-day food diary at 12 months from March 2013 to August 2014.EXPOSURES Infants' intake of rice and rice products. MAIN OUTCOMES AND MEASURESTotal urinary As and the sum of As species measured using inductively coupled mass spectrometry and high-performance liquid chromatography with inductively coupled mass spectrometry. Commonly reported infant rice snacks were tested for As. RESULTSWe obtained dietary data on 759 of 951 infants (79.8% participation rate). Of these, 391 infants (51.7%) were male, and the mean (SD) gestational age was 39.4 (1.7) weeks. An estimated 80% were introduced to rice cereal during their first year. At 12 months, 32.6% of infants (42 of 129) were fed rice snacks. Among infants aged 12 months who did not eat fish or seafood, the geometric mean total urinary As concentrations were higher among those who ate infant rice cereal (9.53 μg/L) or rice snacks (4.97 μg/L) compared with those who did not eat rice or rice products (2.85 μg/L; all P < .01). Infant rice snacks contained between 36 and 568 ng/g of As and 5 to 201 ng/g of inorganic As. CONCLUSIONS AND RELEVANCEOur findings indicate that intake of rice cereal and other rice-containing foods, such as rice snacks, contribute to infants' As exposure and suggest that efforts should be made to reduce As exposure during this critical phase of development.

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Section: Discussionmentioning

confidence: 99%

Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life

et al. 2016

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“…We expect that the transition to solid foods, which typically occurs beginning at ~6 months, presents an additional source of exposure to arsenic for the typical NHBC infant, since many foods commonly fed to infants during weaning, such as infant rice cereal, contain elevated concentrations of arsenic 31,47,48 . Thus, future work should seek to quantify daily arsenic intake during this critical period of development.…”

Section: Discussionmentioning

confidence: 99%

Contribution of breast milk and formula to arsenic exposure during the first year of life in a US prospective cohort

Carignan¹,

Punshon

Gilbert‐Diamond

et al. 2015

J Expo Sci Environ Epidemiol

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Arsenic is a carcinogen that can also affect the cardiac, respiratory, neurological and immune systems. Children have higher dietary arsenic exposure than adults due to their more restricted diets and greater intake per unit body mass. We evaluated the potential contributions of breast milk and formula to arsenic exposure throughout the first year of life for 356 infants in the prospective New Hampshire Birth Cohort Study (NHBCS) using infant diets reported by telephone at 4, 8 and 12 months of age; measured household water arsenic concentrations; and literature data. Based on our central-tendency models, population-wide geometric mean (GM) estimated arsenic exposures in the NHBCS were relatively low, decreasing from 0.1 μg kg−1 d−1 at 4 months of age to 0.07 μg kg−1 d−1 at 12 months of age. At all three time points, exclusively formula-fed infants had GM arsenic exposures ~8 times higher than exclusively breastfed infants due to arsenic in both tap water and formula powder. Estimated maximum exposures reached 9 μg kg−1 d−1 among exclusively formula-fed infants in households with high tap water arsenic (80 μg/L). Overall, modeled arsenic exposures via breast milk and formula were low throughout the first year of life, unless formula was prepared with arsenic-contaminated tap water.

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“…A European study found that dietary exposure was about 3 times as great for children under 3 years of age compared with adults (European Food Safety Authority, 2014). Certain ethnic groups may receive greater exposure as average rice consumption and urinary iAs were both higher in Asian/other, Mexican, and Black children than in white children age 6–17 according to NHANES 2003–2008 data (Lai et al, 2015). The fetus and young children may be at particular risk as a result of developing organ systems and expected years of life in which to develop cancer and other chronic outcomes (Miller et al, 2002).…”

Section: Defining the Scope Of The Problemmentioning

confidence: 99%

“…Food manufacturers have sought to reassure consumers either through dismissal of the presence of a significant health concern (USA Rice Federation, 2016) or by distinguishing their product in the marketplace through producer-initiated arsenic testing (Lundberg Farms, 2016). Healthcare providers face particular challenges in responding to their patients’ concerns about current and prior exposures to arsenic, particularly in the perinatal period and infancy, when research suggests heightened vulnerability (Lai et al, 2015). …”

Section: Existing Assessment Management and Communication Effortsmentioning

confidence: 99%

“…Consumers have been confronted with media reports about the presence of arsenic in food, most notably with respect to apple juice and rice (Consumer Reports, 2012a; Consumer Reports, 2012b). Currently available information does not give consumers enough information to make informed choices about arsenic in the diet (Lai et al, 2015). Taken together, the emerging evidence regarding iAs’s association with myriad adverse outcomes combined with the importance of diet as a key exposure source underscore the need for regulatory oversight, mitigation strategies, and enhanced risk communication.…”

Section: Introductionmentioning

confidence: 99%

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Mitigating dietary arsenic exposure: Current status in the United States and recommendations for an improved path forward

Nachman

Ginsberg

Miller

et al. 2017

Science of The Total Environment

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Inorganic arsenic (iAs) is a well-characterized carcinogen, and recent epidemiologic studies have linked chronic exposures to non-cancer health outcomes, including cardiovascular disease, diabetes, skin lesions and respiratory disorders. Greater vulnerability has been demonstrated with early life exposure for health effects including lung and bladder cancer, immunotoxicity and neurodevelopment. Despite its well-known toxicity, there are important gaps in the regulatory oversight of iAs in food and in risk communication. This paper focuses on the US regulatory framework in relation to iAs in food and beverages. The state of existing regulatory agency toxicological assessments, monitoring efforts, standard setting, intervention policies and risk communication are explored. Regarding the approach for standard setting, risk-based evaluations of iAs in particular foods can be informative but are insufficient to create a numeric criterion, given current uncertainties in iAs toxicology and the degree to which traditional risk targets can be exceeded by dietary exposures. We describe a process for prioritizing dietary exposures for different lifestages and recommend a relative source contribution-based approach to setting criteria for arsenic in prioritized foods. Intervention strategies begin with an appropriately set criterion and a monitoring program that documents the degree to which this target is met for a particular food. This approach will promote improvements in food production to lower iAs contamination for those foods which initially do not meet the criterion. Risk communication improvements are recommended to ensure that the public has reliable information regarding sources and alternative dietary choices. A key recommendation is the consideration of meal frequency advice similar to what is currently done for contaminants in fish. Recent action level determinations by FDA for apple juice and infant rice cereal are evaluated and used as illustrations of how our recommended approach can further the goal of exposure mitigation from key sources of dietary iAs in the US.

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Arsenic and Rice: Translating Research to Address Health Care Providers' Needs

Cited by 41 publications

References 49 publications

Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life

Association of Rice and Rice-Product Consumption With Arsenic Exposure Early in Life

Contribution of breast milk and formula to arsenic exposure during the first year of life in a US prospective cohort

Mitigating dietary arsenic exposure: Current status in the United States and recommendations for an improved path forward

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