Arsenic in Rice & Gluten-Free Diet

By Amy Burkhart MD, RD

Should Gluten-Free Dieters Be Worried?

Arsenic in rice-should you be worried? Rice is a staple component of the gluten-free diet, so many who follow the diet are concerned. A Consumer Reports video segment titled “Why Your Child Should Eat Less Rice” includes words like: “dangerous,” “toxic,” “cancer.” Does the average rice eater need to pay attention? What about people on a gluten-free diet? The topic can be complicated and confusing. Let’s simplify it and give you guidelines to follow regarding rice consumption in general and for those on a gluten-free diet.

I don’t recommend panic over this topic or banning rice from your diet. I do think it is important to know the basic facts about arsenic in rice and reduce our risk and our children’s risk. Because rice is grown in flooded fields, it absorbs more arsenic from the environment than other crops. For anyone on a gluten-free diet, and especially for children, this is important. Rice and rice flour are among the most common ingredients in gluten-free products, often consumed multiple times a day.

Arsenic is a chemical found naturally in our environment. It is present in water, soil, and air. It has two different forms: inorganic and organic. Both occur in nature, and the classification depends on what metals the arsenic is bound to. In this context, “organic” does not refer to the absence of pesticides.

Inorganic:

This is the most common and most toxic form of arsenic. Chronic exposure has been linked to an increased risk of cancer. Rocks are a common source of inorganic arsenic.

Organic:

Organic arsenic is used in pesticides and weed killers. It is typically not deemed as dangerous as the inorganic form. But, it may be poisonous to humans in high concentrations. Organic arsenic is not generally believed to be associated with an increased risk of cancer, but this is still a debate point.

Aside from poisoning unsuspecting victims in murder mysteries, arsenic is used in pesticides, fertilizers, semiconductors, and, until recently, as a preservative for wood in construction.

Before 2013, when manufacturers and the FDA voluntarily withdrew some animal feed drugs containing arsenic from the market, chicken products contained worrisome arsenic levels. Turkey may still contain arsenic. The FDA is studying the drug used in turkey feed. When used as a pesticide, arsenic can exist in soil for many years after harvesting. Much of the rice grown in the South Central USA, for example, is grown in former cotton fields, where farmers used arsenic-based pesticides to control boll weevils.

High-Risk Populations

Arsenic levels in food and water are a concern for the general population. This is particularly true in countries where drinking water may be contaminated and where the diet is rice-based. Infants and children are at higher risk of arsenic toxicity. Pregnant women should also be concerned about fetal exposure to arsenic in rice. People who eat much rice and rice-based products, typical of a gluten-free diet, are also at higher risk.

Symptoms of High Arsenic Levels

– Long-Term, Low-Level Exposure  (e.g., dietary intake on a gluten-free diet)
The gastrointestinal tract, skin, and nervous system can be affected by chronic, low-level exposure to arsenic. Potential symptoms include nausea, stomach pain, diarrhea, and numbness of the hands and feet. Higher skin, bladder, and lung cancer rates are reported with chronic exposure.  It can also increase the risk of heart disease. Skin changes and discolorations may appear on the hands and nails. (Similar nail bed lines can also occur with trauma and vitamin deficiencies.)

– Acute High-Level Exposure (e.g., in a chemical plant exposure)
Symptoms of acute, high-level exposure to arsenic include nausea, vomiting, diarrhea, shock, and death.  (I won’t be discussing acute exposure further, as this article focuses on chronic, low-level exposure.)

Testing for Arsenic

If you are concerned about consuming a high level of arsenic, you may want to ask your doctor about testing. Testing is not recommended for everyone on a gluten-free diet but should be used based on the overall clinical picture and symptoms.

• Arsenic 24-hour urine test: Preferred screening test. If elevated, you must differentiate between inorganic and organic. Inorganic is more toxic.
• Rapid urine spot test:  This is not as accurate as of the 24-hour urine test and does not differentiate between the two arsenic forms.
• Blood test: May be used in conjunction with the 24-hour urine test to detect acute and recent exposure. It is also used to monitor levels.

Treatment For High Arsenic Levels

The treatment for elevated arsenic from chronic, low-level food exposure is decreasing arsenic intake in the diet. Typically, only acute high-level exposure is treated with binding agents and medications.

The Food and Drug Administration (FDA) does not have standards for arsenic levels in food. The allowed level of arsenic in water is 10 ppb, including for bottled water.  In July 2014,  Codex (a branch of the United Nations that establishes safety standards for international trade in food) proposed arsenic standards in rice. Consumer advocates are calling for the FDA to act quickly to regulate arsenic in rice. For more information, see Arsenic in Rice: Consumer Advocates Call for Regulation.

Arsenic in Foods

Arsenic is found in many foods since it exists naturally in our environment. It is found in higher concentrations in groundwater in areas that have used arsenic in industry, including mining and metal production. Some foods such as rice, wine, and fruit juices can contain high amounts of arsenic.

Apple juice has been found to have higher than average levels of arsenic. In a 2011 Consumer Reports study, 10% of 88 samples of apple juice contained more than 10 ppb arsenic (the level allowed for drinking water). In 2013, the FDA proposed a limit of 10 ppb for arsenic in apple juice. This was the first proposed federal standard for arsenic in a food product. Consumers Reports recommends lowering this further and limiting children’s consumption of apple juice.

Arsenic In Organic Foods

Since arsenic is found naturally in the soil, organically grown foods may contain arsenic. To date, there is no information to indicate that organic foods contain less arsenic than their conventionally grown counterparts. (However, I recommend organic products over conventional ones when possible, for other reasons.)

Rice Cereal for Infants

In the USA, it is common to introduce rice cereal as a baby’s first food. Some infants eat up to two to three servings per day. Because infants are at higher risk for arsenic toxicity, this practice is being questioned simply because of ta child’s small size. The FDA recommends parents consider foods other than rice as an infant’s first solid food. Consumer Reports recommends that babies eat no more than one serving per day of rice cereal and that their diets include cereals made from other grains.

Rice Pasta, Rice Milk and Other Rice-Based Products for Children

Toddlers and children are also at risk of higher arsenic exposure. According to Consumer Reports, one serving of rice pasta or two cups of a rice drink can put a child over the recommended weekly maximum arsenic consumption.

Consumer Reports suggest that children do not consume rice milk regularly. The UK Food Standards Agency recommends that children under five not be given rice milk as a substitute for breast milk, infant formula, or cow’s milk. It’s easy to imagine the increased risk for children on a gluten-free diet, who are also consuming rice-based bread, cookies, pancakes, cake, muffins, crackers, and other products.

Brown Rice vs. White Rice

Brown rice contains 30-80% more arsenic compared to white rice. During growth, arsenic concentrates in the outside part (bran/germ) of the rice kernel. These parts are removed when brown rice is processed into white rice. The health benefits of consuming brown rice, such as increased fiber and vitamins, should be considered when choosing whether to consume brown or white rice. According to rice testing results by the FDA and Consumer Reports, choosing brown basmati will minimize arsenic if you prefer brown rice.

Arsenic is found in many foods since it exists naturally in our environment. It is found in higher concentrations in groundwater in areas that have used arsenic in industry, including mining and metal production. Some foods such as rice, wine, and fruit juices can contain high amounts of arsenic.

Apple juice has been found to have higher than average levels of arsenic. In a 2011 Consumer Reports study, 10% of 88 samples of apple juice contained more than 10 ppb arsenic (the level allowed for drinking water). In 2013, the FDA proposed a limit of 10 ppb for arsenic in apple juice. This was the first proposed federal standard for arsenic in a food product. Consumers Reports recommends lowering this further and limiting children’s consumption of apple juice.

1. Rinse rice before cooking: This lowers arsenic content 25-30% since arsenic is water-soluble.

2. Alternate grains:  Rotate the rice in your diet with alternatives such as quinoa, amaranth, corn, buckwheat, and millet.

3. For infants: Introduce fruits or vegetables as a first food, instead of rice cereal. Pureed peas, bananas, or squash are a great choice. Limit regular intake of rice. Choose a rice-free infant formula if you are not breastfeeding, and avoid giving rice milk an alternative to dairy.

4. Rotate or replace baked goods and snacks with rice or rice flour as a primary ingredient: For example, instead of rice crackers, use carrots, zucchini, cucumbers, or peppers, combined with hummus or a yogurt dip for a healthy snack, or choose rice-free crackers.

5. Dairy-free kinds of milk:  Choose milk alternatives made from ingredients other than rice, such as hemp, nut, oat, or coconut.

6. Limit apple and grape juice:  If you drink apple juice or grape juice, limit the portion size to 4 oz.

7. Find a substitute for brown rice syrup:  Brown rice syrup may be a hidden arsenic source. Instead of using it as a sweetener, choose organic cane sugar, maple syrup, honey, or stevia.

8. Check your local water supply:  If it contains arsenic, consider a water filtering system for your drinking water.

9. Cook rice with large volumes of water, then drain it off:  This can reduce arsenic by up to 50%, but unfortunately will also eliminate valuable nutrients that are water-soluble, such as B vitamins. Compensate for the reduction in nutrients by making sure you are getting a well-balanced diet elsewhere.

10. Choose rice that is lowest in arsenic (see above recommendations from Consumer Reports)

Long-term studies about the health impact of chronic low doses of arsenic are just beginning. Given the lack of data on acceptable levels of arsenic in food and potential long-term effects, there are no widely agreed-upon recommendations for “safe” amounts or overall intake quantity. It is challenging to avoid rice on a gluten-free diet completely and not necessary to do so. However, I do recommend limiting rice intake for everyone on a gluten-free diet, especially children. Use the tips above to get started today.

With additional research and progress in regulation, this issue will become easier to understand and navigate. In the meantime, parents, pregnant women, and people on a rice-based or gluten-free diet should keep a vigilant eye on evolving information surrounding arsenic in our food supply. Understanding the arsenic’s realities in your diet will allow you to make more informed decisions for yourself and your family.