How Much Arsenic in Rice Is Too Much?

What are some strategies to reduce arsenic exposure from rice?

Those who are exposed to the most arsenic in rice are those who are exposed to the most rice, like people who are eating plant-based, gluten-free, or dairy-free. So, at-risk populations are not just infants and pregnant women, but also those who may tend to eat more rice. What “a terrible irony for the health conscious” who are trying to avoid dairy and eat lots of whole foods and brown rice—so much so they may not only suffer some theoretical increased lifetime cancer risk, but they may actually suffer arsenic poisoning. For example, a 39-year-old woman had celiac disease, so she had to avoid wheat, barley, and rye, but she turned to so much rice that she ended up with sky-high arsenic levels and some typical symptoms, including “diarrhea, headache, insomnia, loss of appetite, abnormal taste, and impaired short-term memory and concentration.” As I discuss in my video How Much Arsenic in Rice Is Too Much, we, as doctors, should keep an eye out for signs of arsenic exposure in those who eat lots of rice day in and day out.

As you can see at 1:08 in my video, in its 2012 arsenic-in-rice exposé, Consumer Reports recommended adults eat no more than an average of two servings of rice a week or three servings a week of rice cereal or rice pasta. In its later analysis, however, it looked like “rice cereal and rice pasta can have much more inorganic arsenic—a carcinogen—than [its] 2012 data showed,” so Consumer Reports dropped its recommendation down to from three weekly servings to a maximum of only two, and that’s only if you’re not getting arsenic from other rice sources. As you can see from 1:29 in my video, Consumer Reports came up with a point system so people could add up all their rice products for the week to make sure they’re staying under seven points a week on average. So, if your only source of rice is just rice, for example, then it recommends no more than one or two servings for the whole week. I recommend 21 servings of whole grains a week in my Daily Dozen, though, so what to do? Get to know sorghum, quinoa, buckwheat, millet, oatmeal, barley, or any of the other dozen or so common non-rice whole grains out there. They tend to have negligible levels of toxic arsenic.

Rice accumulates ten times more arsenic than other grains, which helps explain why the arsenic levels in urine samples of those who eat rice tend to consistently be higher than those who do not eat rice, as you can see at 2:18 in my video. The FDA recently tested a few dozen quinoa samples, and most had arsenic levels below the level of detection, or just trace amounts, including the red quinoas that are my family’s favorite, which I was happy about. There were, however, still a few that were up around half that of rice. But, overall, quinoa averaged ten times less toxic arsenic than rice. So, instead of two servings a week, following the Consumer Reports recommendation, you could have 20. You can see the chart detailing the quinoa samples and their arsenic levels at 2:20 in my video.

So, diversifying the diet is the number-one strategy to reduce exposure of arsenic in rice. We can also consider alternatives to rice, especially for infants, and minimize our exposure by cooking rice like pasta with plenty of extra water. We found that a 10:1 water-to-rice ratio seemed best, though the data suggest the rinsing doesn’t seem to do much. We can also avoid processed foods sweetened with brown rice syrup. Is there anything else we can do at the dining room table while waiting for federal agencies to establish some regulatory limits?

What if you eat a lot of fiber-containing foods with your rice? Might that help bind some of the arsenic? Apparently not. In one study, the presence of fat did seem to have an effect, but in the wrong direction: Fat increased estimates of arsenic absorption, likely due to the extra bile we release when we eat fatty foods.

We know that the tannic acid in coffee and especially in tea can reduce iron absorption, which is why I recommend not drinking tea with meals, but might it also decrease arsenic absorption? Yes, by perhaps 40 percent or more, so the researchers suggested tannic acid might help, but they used mega doses—17 cups of tea worth or that found in 34 cups of coffee—so it isn’t really practical.

What do the experts suggest? Well, arsenic levels are lower in rice from certain regions, like California and parts of India, so why not blend that with some of the higher arsenic rice to even things out for everybody?

What?!

Another wonky, thinking-outside-the-rice-box idea involves an algae discovered in the hot springs of Yellowstone National Park with an enzyme that can volatize arsenic into a gas. Aha! Researchers genetically engineered that gene into a rice plant and were able to get a little arsenic gas off of it, but the rice industry is hesitant. “Posed with a choice between [genetically engineered] rice and rice with arsenic in it, consumers may decide they just aren’t going to eat any rice” at all.


This is the corresponding article to the 11th in a 13-video series on arsenic in the food supply. If you missed any of the first ten videos, watch them here:

You may also be interested in Benefits of Turmeric for Arsenic Exposure.

Only two major questions remain: Should we moderate our intake of white rice or should we minimize it? And, are there unique benefits to brown rice that would justify keeping it in our diet despite the arsenic content? I cover these issues in the final two videos: Is White Rice a Yellow-Light or Red-Light Food? and Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Arsenic in Rice Milk, Rice Krispies, and Brown Rice Syrup

I recommend people switch away from using rice milk

For kids and teens, the amount of arsenic flowing through their bodies was found to be about 15 percent higher for each quarter cup of rice consumed per day, and a similar link was found in adults. A study of pregnant women found that consuming about a half cup of cooked rice per day could raise urine arsenic levels as much as drinking a liter of arsenic-contaminated water at the current upper federal safety limit. These findings “suggest that many people in the United States may be exposed to potentially harmful levels of arsenic through rice consumption.” which I explore in my video Arsenic in Rice Milk, Rice Krispies, and Brown Rice Syrup.

Do you know where Americans get most of their rice arsenic? From Rice Krispies, though brown rice crisps cereal may have twice as much, as I discuss in my video Arsenic in Rice Milk, Rice Krispies, and Brown Rice Syrup.

“Organic brown rice syrup (OBRS) is used as a sweetener in organic food products as an alternative to high-fructose corn syrup.” Big mistake, as organic brown rice syrup products “may introduce significant concentrations” of toxic arsenic into people’s diets. For example, two energy chews sweetened with brown rice syrup might hit the provisional upper daily arsenic intake based on the water standards.

“Toddler formulas with added organic brown rice syrup have 20 times higher levels of inorganic [toxic] arsenic than regular formulas,” and in older children, thanks to brown rice syrup, a few cereal bars a day “could pose a very high cancer risk.”

What about rice milk? A consensus statement of both the European and North American societies for pediatric nutrition recommends the “avoidance of rice drinks for infants and young children,” and, generally, toxic “inorganic arsenic intake in infancy and childhood should be as low as possible.”

To this end, the United Kingdom has banned the consumption of rice milk for young children, a notion with which Consumer Reports concurred, recommending no servings a week of rice milk for children and no more than half a cup a day for adults, as you can see at 1:56 in my video.

The arsenic in various brands of rice milk ranges wildly—in fact, there’s a 15-fold difference between the highest and lowest contamination, suggesting manufacturers could make low arsenic rice milk if they wanted. As you can see at 2:16 in my video, Consumer Reports found rice drinks from Pacific and Rice Dream brands were right about average, though, for Rice Dream, it appears the vanilla or chocolate flavors may be lower. It doesn’t seem we have anything to worry about with rice vinegar, but rice pasta and rice cakes end up similar to pure rice in terms of arsenic levels, which makes sense because that’s pretty much what they are—pure rice. However, pasta is boiled, so we’d expect the levels to be cut 40 to 60 percent, like when you boil and drain rice.

If you just couldn’t live without rice milk for some reason, you could make your own using lower arsenic rice, like brown basmati from India, Pakistan, or California, but then your homemade rice milk might have even less nutrition, as most of the commercial brands are at least fortified. Better options might be soy, oat, hemp, or almond milk, though you don’t want kids to be drinking too much almond milk. There have been a few case reports of little kids drinking four cups a day and running into kidney stone problems due to its relatively high oxalate content, which averages about five times more than soy milk. More on oxalates in my video series starting with Oxalates in Spinach and Kidney Stones: Should We Be Concerned?

I have about 40 videos that touch on soy milk, discussing such topics as how it may normalize development in girls and reduce breast cancer risk, as well reduce prostate cancer risk in men. Some of the latest science on soy milk includes an association with better knee x-rays, suggesting protection from osteoarthritis, and an interventional study suggesting improved gut health by boosting the growth of good bacteria. However, drinking 3 quarts a day, which is 10 to 12 daily cups, for a year may inflame your liver, but two cups a day can have an extraordinary effect on your cholesterol, causing a whopping 25 percent drop in bad cholesterol after just 21 days.

An ounce and a half of almonds, about a handful, each day, can drop LDL cholesterol 13 percent in six weeks and reduce abdominal fat, though a cup of almond milk only contains about ten almonds, which is less than a third of what was used in the study. So, it’s not clear if almond milk helps much, but there was a study on oat milk compared to rice milk. As you can see at 4:37 in my video, five weeks of oat milk lowered bad cholesterol, whereas rice milk didn’t, and even increased triglycerides and may bump blood pressure a bit. However, the oat milk only dropped LDL about 5 percent and that was with three cups a day. As plant-based alternatives go, it appears soy milk wins the day.

So, why drink rice milk at all when there are such better options? There really isn’t much nutrition in rice milk. In fact, there are case reports of severe malnutrition in toddlers whose diets were centered around rice milk due to multiple food allergies. Infants and toddlers have increased protein requirements compared to adults, so if the bulk of a child’s diet is rice milk, coconut milk, potato milk, or almond milk, they may not get enough, as you can see at 5:23 in my video. In fact, cases of kwashiorkor—that bloated-belly protein- and calorie-deficient state of malnutrition—due to rice milk have been reported in Ethiopia…and Atlanta, Georgia, because literally 99 percent of the child’s diet was rice milk. So, these malnutrition cases were not because they drank rice milk, but rather because they drank rice milk nearly exclusively. I just use these examples to illustrate the relative lack of nutrition in rice milk. If you’re going to choose a milk alternative, you might as well go for one that has less arsenic—and more nutrition.

I have released several videos on soy milk, but only one on almond milk video so far: Prostate Cancer and Organic Milk vs. Almond Milk. I plan on producing many more on choosing between various milk options, so stay tuned.


If you’ve missed any of the useful material on dietary arsenic I’ve also shared, please see:

The final four videos in this series take all of this information and try to distill it into practical recommendations:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

Arsenic in Infant Rice Cereal

When it comes to rice and rice-based products, pediatric nutrition authorities have recommended that arsenic intake should be as low as possible.

“The US Food and Drug Administration (FDA) has been monitoring the arsenic content in foods” for decades, yet despite the “well-established science describing the health risks associated with arsenic exposure, no standards have been set limiting the amount of arsenic allowable in foods” in the United States. In 2001, the EPA “adopted a new stricter standard for arsenic in drinking water,” and in 2013, the FDA proposed a legal limit for apple juice. “There are still no standards for arsenic in food products despite the fact that food sources are our main source of exposure.”

Unlike the United States, China has standards. As of 2014, China set a maximum threshold of inorganic arsenic at 150 parts per billion, stricter than the World Health Organization’s limit of 200 ppb. In the United States, a 200 ppb limit wouldn’t change the cancer risk much. If we had China’s safety limits of 150 ppb, though, cancer risk would be reduced up to 23 percent and a maximum threshold of 100 ppb would lower cancer risk up to 47 percent—but that could seriously affect the rice industry. In other words, U.S. rice is so contaminated with arsenic that if a safety standard that really cut down on cancer risk were set, it “would wipe out the U.S. rice market.” However, with no limits, what’s the incentive for the rice industry to change its practices? Setting arsenic limits would not only directly protect consumers but also encourage the industry to stop planting rice paddies on arsenic-contaminated land.

Those cancer estimates are based on arsenic-contaminated water studies. Might the arsenic in rice somehow have a different effect? You don’t know…until you put it to the test. We know rice has a lot of toxic arsenic that urine studies have shown we absorb into our body, but there hadn’t been any studies demonstrating “deleterious health impacts” specific to rice arsenic—until now. Since arsenic causes bladder cancer, the researchers figured they would see what kind of DNA mutations the urine of rice eaters can have on human bladder cells growing in a petri dish. And, indeed, they clearly demonstrated that eating a lot of arsenic-contaminated rice every day can “give rise to significant amounts of genetic damage,” the kind that‘s associated with cancer. Yes, but the study used pretty contaminated rice. However, only about 10 percent of the rice in certain parts of Asia might ever reach those levels of contamination, though a quarter of rice in parts of Europe might and more half in the United States, making for considerable public health implications.

So, “there remains little mystery surrounding the health risks associated with arsenic levels in rice. The remaining mystery is why long-overdue standards for arsenic levels in rice have not been set by the FDA” in the United States, but that may be changing. In 2016, the FDA proposed setting a limit on toxic arsenic—at least in infant rice cereal, which I discuss in my video Arsenic in Infant Rice Cereal.

As you can see at 3:24 in my video, infants and children under four years of age average the highest rice intake, in part because they eat about three times the amount of food in relation to their body size, so there’s an especially “urgent need for regulatory limits” on toxic arsenic in baby food.

Pediatric nutrition authorities have recommended that when it comes to rice and rice-based products, “arsenic intake should be as low as possible,” but how about as early as possible? Approximately 90 percent of pregnant women eat rice, which may end up having “adverse health effects” on the baby.

You can estimate how much rice the mother ate while pregnant by analyzing arsenic levels in the infant’s toenail clippings. “Specifically, an increase of 1/4 cup of rice per day was associated with a 16.9% increase in infants toenail [arsenic] concentration,” which indicates that arsenic in rice can be passed along to the fetus. What might that arsenic do? A quarter cup of rice worth of arsenic has been associated with low birth weight, increased respiratory infections, and, above that, a 5- to 6-point reduction in IQ, among other issues. So, “based on the FDA’s findings, it would be prudent for pregnant women to consume a variety of foods, including varied grains (such as wheat, oats, and barley),” which is code for cut down on rice. Saying eat less of anything, after all, is bad for business.

Once the baby is weaning, “what’s a parent to do?” Asks Consumer Reports, “To reduce arsenic risks, we recommend that babies eat no more than 1 serving of infant rice cereal per day on average. And their diets should include cereals made of wheat, oatmeal, or corn grits, which contain significantly lower levels of arsenic”—that is, rely on other grains, which are much less contaminated than rice. As the American Academy of Pediatrics has emphasized, “there is no demonstrated benefit of rice cereal over those made with other grains such as oat, barley, and multigrain cereals, all of which have lower arsenic levels than rice cereal.” As you can see at 5:28 in my video, reducing consumption of infant rice cereal to just two servings per week could have an even more dramatic effect on reducing risk.

 The proposed limit on toxic arsenic in infant rice cereals would end up removing about half of the products off the shelves. The FDA analyzed more than 500 infant and toddler foods, and the highest levels of toxic arsenic were found in organic brown rice cereals and “Toddler Puffs.” Based on the wording in the report, these puffs appear to be from the Happy Baby brand. Not-so-happy baby if they suffer brain damage or grow up to get cancer. A single serving could expose infants to twice the tolerable arsenic intake set by the EPA for water. I contacted the Happy Baby company and was told they “are not able to provide any comments” on the FDA’s results.

“Eliminating all rice and rice products from the diets of infants and small children up to 6 years old could reduce the lifetime cancer risk from inorganic arsenic in rice and rice products by 6% and 23% respectively.” That is, there would be a 6 percent lower chance of developing lung or bladder cancer later in life if infants stopped, and a 23 percent lower chance if young kids stopped. However, switching to other grains is a move described as “drastic and dramatic,” creating “a huge crisis”—for the rice industry, presumably—and therefore “not feasible at all.”

I was hoping Happy Baby, upon learning of the concerning FDA arsenic toddler puffs data (regardless of whether the data were about its brand or not) would have kicked its own testing and potential remediation into high gear like Lundberg did (see Which Brands and Sources of Rice Have the Least Arsenic?). But, unfortunately, in my email correspondence with the company, I got no sense that it did.


For more videos on this topic, see:

And here are five more:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Which Brands and Sources of Rice Have the Least Arsenic?

Arsenic levels were tested in 5,800 rice samples from 25 countries.The arsenic found in five servings of rice a week poses a hundred times the acceptable cancer risk. What did the rice industry have to say about that? When the story first broke in the media that U.S. rice had some of the highest arsenic levels in the world, the USA Rice Federation said, “Enough nonsense about arsenic already!” in the August 9, 2005, issue of USA Rice Daily, its daily newsletter. The study, in its mind, was “not only inaccurate in the highest degree, but also maliciously untrue.” One of the researchers responded, “By not addressing this problem [of arsenic] that has been ignored for decades, the U.S. cotton-belt rice industry is doing itself an injustice. “Had the problem been addressed in the past, given that it is well known that arsenic in paddy soils was a problem in the U.S….safe soils would have been identified and low grain arsenic rice varieties developed.” Instead, arsenic-resistant varieties have been developed that build up excessive levels of arsenic without dying themselves. I discuss arsenic levels in rice in my video Which Brands and Sources of Rice Have the Least Arsenic?.

Not all rice producers have been so dismissive, though. After a subsequent Consumer Reports exposé, one rice company detailed “how it is taking matters into its own hands.” Lundberg Farms started testing hundreds of samples of its rice to share the results with the FDA. “We’re committed to providing safe food,” said the CEO, “to really listening to our consumers, and dealing with this problem very openly….” Lundberg Farms isn’t just sharing its results with the FDA, but with everyone.

If you visit its website or go to 1:37 in my video, you can see it apparently followed through on its testing promise for its brown rice. Lundberg Farms use parts per million (ppm) instead of parts per billion (ppb) to make it look better than it is, but compared with the average U.S. brown rice level of 154 ppb, Lundberg does do better. In fact, at 80 ppb, its aromatic brown rice, presumably its brown basmati and brown jasmine, averages less than national white rice levels, as do, apparently, Lundberg’s red and black rices, at 90 ppb. In fact, none of its samples even reached the average U.S. brown rice level.

Consumer Reports found most other brands to be pretty comparable to the U.S. average arsenic levels in brown rice, as you can see at 2:15 in my video, including Uncle Ben’s and Walmart’s Great Value brand. Whole Foods, however, scored the worst with its 365 Everyday Value long grain brown rice, about a third higher than these others and exceeding the national average.

In the largest review to date, based on 5,800 rice samples from 25 countries, the highest total arsenic average came from the United States. U.S. studies averaged overall about double that of rice out of Asia, with the high levels in the United States blamed on “the heavy [historical] use of arsenic-based pesticides.” But arsenic levels were not the same across the United States. Yes, U.S. rice averages twice the arsenic of Asian rice and nearly all rice samples tested in upstate New York that were imported from India or Pakistan had arsenic levels lower than 95 percent of domestically produced rice. But, “[r]ice grown in the U.S. showed the widest overall range…and the largest number of outliers,” due primarily to where it was grown, as you can see at 3:01 in my video. There is significantly more arsenic in Texas and Arkansas rice than rice from California. California rice is comparable to rice produced around the rest of the world. These are presumably some of the data that led Consumer Reports to suggest brown basmati from California, India, or Pakistan might be among the safer rice choices.If the arsenic is from pesticides, would organic rice have less than conventionally grown rice? No, because arsenic pesticides were banned about 30 years ago. It’s just that 30,000 tons of arsenic chemicals had already been dumped onto cotton fields in the southern United States, “so it is understandable that arsenic residues still remain in the environment” even if you don’t add an ounce of new pesticides. That’s why the industry specifically selects for arsenic-resistant varieties of rice plants in the South. If only there were arsenic-resistant humans.

What about other brands of rice? That was the subject of Which Rice Has Less Arsenic: Black, Brown, Red, White, or Wild?.


For even more background, see:

 You may also be interested in:

Kudos to Consumers Union, the wonderful organization that publishes Consumer Reports, for its pioneering work on this and so many other topics.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

The Effects of Too Much Arsenic in the Diet

Even at low-level exposure, arsenic is not just a class I carcinogen, but may also impair our immune function and increase our risk of cardiovascular disease and diabetes.

When people hear about arsenic, they think of it as an acute poison, and, indeed, a tiny amount—a hundred milligrams, about one-tenth the weight of a paperclip—could kill you in an hour. But, there is also chronic arsenic poisoning, where even a dose 10,000 times as small can be harmful if you’re exposed day-after-day for years at a time as I discuss in my video The Effects of Too Much Arsenic in the Diet. Chief among the concerns is cancer.

Arsenic is classified as a class I carcinogen, which is the highest level and includes things known to cause cancer in humans. Other class I carcinogens are asbestos, cigarette smoke, formaldehyde, plutonium, and processed meat (the consumption of bacon, ham, hot dogs, deli meat, and the like). So, arsenic is pretty bad, to say the least, implicated in tens of thousands—or even hundreds of thousands—of cancer cases worldwide every year.

Of course, cancer is our number-two killer. What about heart disease, our leading cause of death? “Long-term exposure to low to moderate arsenic levels was associated with cardiovascular disease incidence and mortality,” meaning heart attacks and strokes.

Arsenic is also considered an immunotoxicant, meaning it’s toxic to our immune system. How do we know that? There’s a virus called varicella, which is what causes chickenpox—the first time we get it. Our immune system is able to stamp it down but not stamp it out. The virus retreats into our nerve cells where it lies in wait for our immune function to dip. And, when it does, the virus re-emerges and causes a disease called shingles. We’ve all been exposed to the virus, but only about one in three of us will get shingles because our immune system is able to keep it at bay. However, the virus can slip its muzzle as we get older or immunosuppressed, for instance, if we’re given arsenic chemotherapy. Shingles is a common side effect, because the arsenic drugs not only kill the cancer but also some of our immune cells, too. That’s at high doses, though. Might even low doses of arsenic, like the kind we’re exposed to in our daily diet, impact our immune function? Researchers tested the levels of arsenic in the urine of thousands of Americans, along with their levels of anti-virus antibodies, and, indeed, they found that the more arsenic the subjects had flowing through their bodies, the lower their defenses.

And, if you’re pregnant, arsenic can pass to your baby, possibly increasing the risk of miscarriage or infant mortality, and “may affect an infant’s immune development and susceptibility to infections early in life.” Indeed, a study out of New Hampshire on infant infections in relation to prenatal arsenic exposure found that the more arsenic the mom was exposed to during pregnancy, the higher the baby’s risk of infection during infancy. However, “it’s unknown whether arsenic-induced epigenetic changes are transgenerational”—that is, whether changes in gene expression can impact the health of not only your own children but your grandchildren as well. Regardless, arsenic exposure isn’t good for mom’s own health, as it is associated with increasing blood pressure.

Hold on. If arsenic suppresses immune system function, then, as a silver lining, would we, for example, have fewer allergies, which is a kind of over-reaction of the immune system? Apparently not. Those with higher arsenic levels tend to have higher rates of food allergies, tend not to sleep as well, and tend not to feel as well. When people were asked how they would rate their health, those reporting “excellent” or “very good” tended to have lower levels of arsenic, compared to those who reported their general health condition as “good,” “fair,” or “poor,” who tended to have higher arsenic levels.

What about diabetes? You can see the results of two dozen population studies on arsenic exposure and confirmed diabetes at 4:07 in my video. Any result above one suggests increased risk for diabetes, and any result below one suggests lower risk. The findings? “Our results support an association between ingested arsenic and DM [diabetes] in humans.” Population studies can’t prove cause and effect, though. “While it would be nice to demonstrate a cause and effect relationship…is it necessary?”

We know arsenic is a carcinogen. We know it causes cancer. What more do we need to take steps to decrease our exposure?

Where is arsenic found in our diet? See my videos Where Does the Arsenic in Chicken Come From?  and Where Does the Arsenic in Rice, Mushrooms, and Wine Come From?.


 Ready for a deep dive into the rice issue? Check out:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: