Arsenic in Food - AAP.org · • Everyone should eat a varied diet. Further study. FDA announces ....
Transcript of Arsenic in Food - AAP.org · • Everyone should eat a varied diet. Further study. FDA announces ....
-
Co-Director, Western States Pediatric Environmental Health Specialty Unit University of California San Francisco*
Director, CA EPA Children’s Environmental Health Center(Comments do not represent state of California)
Director COTC,Center for Integrative Research on Childhood Leukemia and the Environment
UC Berkeley
Arsenic in Food
*Funded by Agency for Toxic Substances Disease Registry and US EPA through ACMT
Mark Miller MD, MPHECHO April 2018
-
No disclosuresThis material was supported by the American College of Medical Toxicology (ACMT) and funded (in part) by the
cooperative agreement FAIN: U61TS000238-04 from the Agency for Toxic Substances and Disease Registry (ATSDR).
Acknowledgement: The U.S. Environmental Protection Agency (EPA) supports the PEHSU by providing partial
funding to ATSDR under Inter-Agency Agreement numberDW-75-95877701-4. Neither EPA nor ATSDR endorse the
purchase of any commercial products or services mentioned in PEHSU publications
Thank you - Pui Lai, Craig Steinmaus, Margaret Karagas, Keeve Nachman
-
As in water still an issue in the US
-
Toxicologic Profile ArsenicATSDR 2007
iAs metabolized to MMA and DMA
arsenobetaine
-
Rice is unique in ability to incorporateinorganic As
By "Oryza sativa of Kadavoor" © 2009 Jee & Rani Nature Photography is used here under a Creative Commons Attribution-ShareAlike 4.0 International License, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=30677472
Butte County CA
J Patrick Fisher Wikipedia Creative Commons Share Alike 2.0
-
Part of the image collection of the International Rice Research Inst. Creative Commons
-
Origin Mean total inorganic As Min/Max total inorganic Asppb μgm/serving ppb μgm/serving
California* 43.1 1.9 27-56 1.2-2.5India/Pakistan* 52.9 2.4 21-144 1.0-6.5Arkansas/Texa
s79.3 3.6 40-107 1.8-4.8
U.S. 94.3 4.2 77-112 3.5-5.1
*Values significantly different from others
Analysis of Arsenic in Rice and other Grains, Food Safety and Sustainability CenterConsumers Reports 2014
Rice Arsenic Varies by Location of Productionand varies significantly within regions
-
Adapted from table 4.2 - Arsenic in Rice and Rice Products Risk Assessment Report, FDA 2016
Type N Inorganic As(mean-ppb)
Inorganic As (range ppb)
Brown Basmati 13 122.7 66-200
Brown Jasmine 2 132.5 114-151
Brown Long/Short 98 160.5 34-249
White Basmati 40 61.8 20-144
White Jasmine 11 78.4 34-110
White Long 148 103.3 23-196
Concentration of inorganic As in Ricemeasured by FDA
-
Alternative grains - 1/10th the As
Arsenic in Rice and Rice Products Risk Assessment Report, FDA 2016
-
Rice containing foods (iAs per serving)
Average levels of inorganic arsenic
Brief summary of rice grain and rice products sampled by the FDA and the corresponding amount of inorganic arsenic per serving, based on data published in 2013 (FDA and Consumers Reports).
Product Inorganic arsenic (mcg/serving)
Bakery mixes and pudding
4.1
Beverages (incl. protein and rice drinks, beer)
2
Cereals 2.6Grain-based bars 1.8
Rice cakes 4.3White rice 4.2Brown rice 7.2
Basmati rice 3.5
-
Dewi Sri – Indonesian rice goddess
Tropenmuseum, part of the National Museum of World Cultures [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
Phosop – ThailandPo Ino Nogar – CambodiaNang Khosop - Laos
History of rice cultivation- interdependantculture
Wheat cultivation - independant
-
Adverse Health Effects from Arsenic Exposure
Sheet1
Organ SystemEffectsReferencesOrgan SystemEffects
SkinKeratosis, MelanosisArgos 2011, Haque 2003, Naujokas 2013SkinKeratosis, Melanosis
Skin CancerTseng 1977, Yu 2006Skin Cancer
Impaired intellectual functionHamadani 2011, Wasserman 2004, 2007Impaired intellectual function
NeuroImpaired motor functionParvez 2011NeuroImpaired motor function
Peripheral neuropathyVahidnia 2007Peripheral neuropathy
Pulmonary tuberculosisSmith 2011Pulmonary tuberculosis
BronchiectasisSmith 2006Bronchiectasis
RespiratoryLung cancerMarshall 2007, Smith 2009RespiratoryLung cancer
Lower Respiratory Tract Infections
Decreased lung functionDauphine 2011Decreased lung function
CardiovascularCoronary/ischemic heart diseaseChen 2011, Gong 2012CardiovascularCoronary/ischemic heart disease
Acute myocardial infarctionYuan 2007Acute myocardial infarction
HypertensionAbhyankar 2012, Abir 2012Hypertension
GastrointestinalLiver cancerChen 2004, Chiu 2004GastrointestinalLiver cancer
RenalKidney cancerBates 2004RenalKidney cancer
GenitourinaryBladder cancerMarshall 2007GenitourinaryBladder cancer
ReproductiveLow birth weight
ImmuneDecreased immune functionRaqib 2009, Ahmed 2011ImmuneDecreased immune function (T cell ratios, IL2 levels, expression immune response genes
EndocrineDiabetesRahman 1998EndocrineDiabetes, impaired glucose tolerance in pregnant women
Sheet2
Sheet3
-
Low dose exposure studies are proliferatingFetal immune function (in utero exposure)
• Changes in CD4+/CD8+ ratios in cord blood• IL1β levels positively related to As
IQ - >5 vs.
-
Early life exposure: greater lung and bladder cancer risk
Lung cancer
Bladder cancer
Craig SteinmausFrom Lai et. al. J Peds 2015
-
Courtesy Craig Steinmaus, OEHHA, CA EPALai et. al., J Peds 2015
-
Rice predominates as dietary source for high end childhood As consumers
21
20
27
514
18
percent dietary contribution (mean
intake)
Juice/fruit
Based on data from Yost et. al. Human and Ecologic Risk Ass. 2004
20
50
12
39
8
percent dietary contribution
juice/fruitrice/rice productother grainsvegetablesdairyother
95 % intake
based on USDA food consumption dataand modeling
-
Who are at risk?
Children / Infants High rice consumers
• Asian American and others with tradition of rice based diet
• Poor• Celiac disease / Gluten Free Diets• Food allergies• Macrobiotic Diet
-
I
Maintain infant rice cereal below As 100 ppb• Proposed regulatory limit• EU standard for rice destined for use in products for
infants and young children 0.1 mcg/kg
Same dietary guidance as previous• Rice cereal should not be sole source of supplementation
for infants• Everyone should eat a varied dietFurther study
FDA announces draft guidance on arsenic in riceApril 2016
Commission Regulation (EU) 2015/1006 of 25 June 2015 amending Regulation (EC) No 1881/2006 as regards maximum levels of inorganic arsenic in foodstuffs
-
Arsenic in Rice and Rice Products Risk Assessment Report, FDA 2016
-
Arsenic in Rice and Rice Products Risk Assessment Report, FDA 2016
-
Arsenic in Rice and Rice Products Risk Assessment Report, FDA 2016
-
Consumer Reports 2014 – point system
http://www.consumerreports.org/cro/magazine/2015/01/how-much-arsenic-is-in-your-rice/index.htm
-
Arsenic readily crosses placenta
Low birth weightStill birthInfant mortality
BUT• Limited amount in breast
milk even in areas with As in water As by predominant feedingWater As 2 ppb
Carignan et. al. EHP 2015
-
Choose varieties of rice lower in iAs• White over brown (nutrition tradeoffs) • Basmati, California/India/ Pakistan (caveats)
Cooking method• Rinse and cook in excess water
• 40-60% reduction, 70% reduction thiamine, Fe, folate, etc. (enriched rice)
Limit number of servings• Consumers Reports point scale
What can I do?
-
Minimize use of infant rice cereal • Use alternative grains
Rare use of rice beverages, rice pasta, and hot rice cereals in children• Gluten free, allergic
Avoid products with rice syrup sweeteners Encourage breast feeding
Special messages for children
-
Target High Consumers?
High rice consumers• Asian American and others with tradition of rice
based diet• Poor• Celiac disease / Gluten Free Diets• Food allergies• Macrobiotic Diet
-
Does not fit traditional “Health Based” regulatory scheme
Establish mandatory or voluntary limits• “Best Methods” limits (beyond infant cereal) that
over time could decrease?• Labeling requirements, monitoring “targets” met
Programs to improve food production for foods not meeting minimum standards
Risk communication – reliable info on sources and dietary alternatives
Regulatory actions
-
Questions?
Arsenic in Food�Slide Number 2Slide Number 3iAs metabolized to MMA and DMASlide Number 5Slide Number 6Slide Number 7Slide Number 8Slide Number 9Rice containing foods (iAs per serving)Slide Number 11Adverse Health Effects from Arsenic Exposure Slide Number 13Early life exposure: �greater lung and bladder cancer riskSlide Number 15Slide Number 16Who are at risk?Slide Number 18Slide Number 19Slide Number 20Slide Number 21Consumer Reports 2014 – point system�Slide Number 23Slide Number 24Slide Number 25Slide Number 26Slide Number 27Slide Number 28