Arsenic in Gluten Free Foods

We received the following question from one of our members:

I am concerned with the gluten free article in Consumers Report Magazine this month stating that the inorganic arsenic can be a problem in all types of rice and is higher in brown rice. It can increase the risk of several cancers and heart disease when eating too much. It is disheartening to me because of all the brown rice flour that I am using in these gluten free recipes and of course all the store ­bought gluten free bread and crackers are made with brown rice flour. What is your take on this?

This is a very good question and one that researchers are trying to answer (the article was originally published in Consumer Report November 2012 which also looked into arsenic levels in apple juice).

The first thing to emphasize is that there is no reason to be extremely alarmed, to think that your health has already been jeopardized, or believe that you can never eat rice products. Although there is a lot of information available, the final word on arsenic in rice and rice products has not yet been written.

Anyone with concerns about the amount of arsenic in their diet should read this article in its entirety. There is a lot of good information in it. However, the magazine made assumptions about how much low ­level arsenic is unsafe when in fact, that is not known with any certainty.

They decided to use the arsenic limit that New Jersey set for tap water, 5 ppb (parts per billion), as the amount of arsenic that is safe. New Jersey’s limit on arsenic in water is lower than the rest of the United States which has a limit of 10 ppb. The Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) did a lot of research to reach the conclusion that 10 ppb is a safe cutoff.

In any case, people drink more water than eat any one particular food, so the ppb The Consumer Reports’ listings of arsenic amounts in servings of rice and rice products were printed in red if there was more than 5 ppb of arsenic in any of the samples. The red is meant to be alarming and it is, taken by itself. But that is not the whole story. Even if science could say absolutely how much arsenic a day is dangerous, the amount of a particular food or drink consumed has to be considered along with how much arsenic is in it. Right now, there are only are only guidelines.

The title of the Consumer Reports article actually emphasizes part of the problem. It is, “Arsenic In Your Food. Our findings show a real need for federal standards for this toxin.”  In fact, the FDA and EPA have been monitoring the arsenic (and its toxicity) in water and certain foods for many years.  Both the FDA and the EPA have made regulations and recommendations about arsenic in various forms but admit that they have a lot more to do.

As noted previously, the EPA set limits for the amount of arsenic allowed in drinking water of 10 ppb (10 parts per billion). The FDA set the same limit for bottled water in 2005. Water providers must test for arsenic and cannot have higher amounts than the limits. 10 ppb is a tiny amount. The amount can also be stated as 0.010 mg/l (milligrams per liter) or 0.010 mg/k (milligrams per kilogram).

The FDA says that the levels of arsenic in most food and drinking water in the United States are not high enough to cause any short ­term concern. They are doing research to try and assess long-term risk. There are also holes in the regulations of arsenic. For example, private well water does not have to be checked and anyone living in the wrong place could have contaminated well water.

While the FDA and Consumer Reports found some similar levels of arsenic in rice, the FDA is trying to put the amounts in perspective. They do not believe it is enough to be dangerous by itself. Even some of the samples tested by Consumer Reports did not contain what they consider a dangerous amount of arsenic.

Why worry about arsenic?

Arsenic is a naturally occurring chemical that exists in both an organic state and an inorganic state. Inorganic arsenic is much more dangerous to human health than organic arsenic. It is unclear if organic arsenic alone poses a significant risk. Frequently, total arsenic amounts will be mentioned when measurements are reported, but the inorganic total is what is most important.

At very high doses, arsenic is a poison, as in the movie “Arsenic and Old Lace.” In the United States, arsenic in the water and food supply is at a very low level in most places, and acute poisoning is not a concern for the majority of people. The amount needed to cause death is estimated to be 60,000 ppb in water.

In other parts of the world where the arsenic levels in water and/or food are so high that people can get acute as well as long ­term poisoning. One of these is Bangladesh and another is Taiwan. There is an illness related to arsenic found only in Taiwan (blackfoot disease) that does not occur anywhere else. It has been suggested that there may be other factors at work there. In fact, in areas with arsenic contamination, there are frequently other dangerous substances in the same area, and figuring out what damage is caused by arsenic alone may be impossible.

Many countries have established maximum levels of arsenic in food at 1 ppm, which is parts per million, much higher than parts per billion.

The question without a definite answer yet is, at what amount do low levels of arsenic exposure over a number of years cause cancer, or any other health problems?  Known or suspected cancers include lung and urinary tract cancer as well as skin cancer. Arsenic may also cause damage to the heart, nervous system, kidneys, gastrointestinal tract, skin and blood cells, and may also pose a risk to developing fetuses.

According to the FDA, cancer is the main concern for people exposed to low levels of arsenic over a long period of time, with the other health problems much less likely to be found. The level of arsenic at which damage occurs and the length of time it takes is not known with any certainty. While the FDA has been measuring arsenic in water and food since 1991, methods have improved and new information is still being gathered.

Information about this has also come from other countries where much higher levels of arsenic have contaminated the food and/or water supply. The World Health Organization and other international groups have been looking at this issue and are still calling for more research.

In many places only total arsenic levels have been measured, making comparisons difficult since high levels of organic arsenic are not as dangerous as high inorganic levels. Also, in many places where arsenic contamination from mining and smelting or from pesticide or other chemical use is found, there are also other substances that have polluted the water or soil and have gotten into the food chain. Some countries report arsenic in food but do not report arsenic from water. Research into cancers related to arsenic exposure in many countries has shown that smokers are at much greater risk than non-­smokers. An additive effect seems to be possible, with arsenic and cigarette smoke together causing more cancers. In some cases, an increased risk of cancer from arsenic has not been seen in non ­smokers.

How do we get exposed to arsenic?

Arsenic gets into water because it exists in many types of rock near water tables, lakes and other places where water is found. Natural erosion of rock can release more arsenic, as can human activities like mining and smelting metal ores. In addition to the naturally ­occurring arsenic which gets into water, arsenic-containing pesticides as well as arsenic in wood preservatives and other chemicals can also find their way into water. In the United States, pesticides containing inorganic arsenic are not supposed to be in use. However, arsenic from past use can be found in toxic waste sites.

Most arsenic exposure occurs from taking in food or water with arsenic in it. However, it can also get into the body by way of the lungs and through the skin. The people exposed in this way are those that work with arsenic­ containing compounds or in areas where there is a lot of arsenic in the immediate environment, whether occurring naturally or because of contamination.

Multiple agencies, including OSHA, mandate protection and education of people who are exposed to hazardous materials like arsenic in the workplace. People who are getting this type of exposure should know. There are certain foods that naturally contain arsenic, although it is frequently in the less-dangerous organic form. Since all living things need water, arsenic can get into almost all food.

Forms of arsenic that occur naturally in food may not all pose a risk for humans. Seafood is one of the sources that contains high levels of organic arsenic but groups who consume large amounts of fish do not seem to suffer any ill effects. Arsenic can also be found in fruits and vegetables. The FDA monitors many foods for arsenic levels. Apple juice, as well as some other juices can contain a higher level of arsenic than desired. The FDA focuses a lot of its efforts at checking food or drink that is frequently consumed by babies and children because they are less likely to be able to handle contaminants that adults. Arsenic in apple juice is in the public eye for that reason.

The FDA has been monitoring the arsenic in apple juice since 1991. They consider the safe limit for apple juice to be the same as water, which is 10 ppb. The total levels of arsenic in the hundreds of apple juice samples it has tested have usually been below the limit. There have been occasional results higher than this over the years but almost always organic arsenic levels. Since most manufacturers have been able to keep the arsenic levels low, the FDA believes all apple juice can be manufactured with levels below 10 ppb arsenic.

Arsenic in the news

In addition to apple juice, the amount of arsenic in rice is currently in the news. It makes sense that rice would be high in arsenic since it is grown in water, more so than just about any other food. This is especially important to anyone eating a rice­ based diet, and currently that includes people with celiac disease since rice is one of the main sources of gluten ­free flour and therefore used to make all types of foods. Babies are also in this group because rice cereal is their traditional first food.

Different kinds of rice have been found to contain varying amounts of arsenic. Brown rice has the most arsenic. White rice, which is obtained by removing the outside layers of brown rice has much less arsenic. The FDA has tested hundreds of rice batches for arsenic. The levels of arsenic in rice have been consistently low enough that they do not believe that people on a normal diet will suffer from short ­term acute toxicity. They are continuing to test rice and to follow this over the years to come, which is the only way to detect long ­term effects.

Babies just starting solid foods and people with celiac disease need to learn how to eat enough different foods that they do not take in too much rice.

Rice is a good example of the difficulty scientists are having detecting the risk to people from arsenic. Researchers look for cancer in populations exposed to arsenic over the long term. Places in the world where rice is consumed in very high amounts, such as China and Japan have lower rates of cancer than places like the United States where less rice is consumed. Why this is true is unclear, but the FDA and other groups are considering this as they try and determine how much rice can safety be eaten.

All of this information needs to be considered by anyone who is on a gluten ­free diet and is consuming a lot of rice, rice flour, and other products made with rice.

People with celiac disease who consider their gluten ­free diet to be rice based are understandably concerned about arsenic exposure due to the recent Consumer Report article. There has been considerable attention given to the idea that rice contains relatively large amounts of arsenic.

But if you are on a gluten ­free diet, do not panic. You are not in immediate danger. It is reasonable to find ways to lower your exposure to arsenic. In fact there is no evidence that the arsenic in water and food (including rice) in the United States is actually causing any illness. There are places in the world where arsenic has contaminated water and food in such high amounts that it does cause serious damage, but this is not happening in the United States.

The Federal Drug Administration (FDA) has been monitoring arsenic in the food and water since 1991. They stepped up their testing after the public scares caused by some reports of high levels of arsenic in rice and apple juice. While the FDA has found low levels of arsenic in most foods, there are higher levels in rice than many other foods. Still, the FDA is confident that the amount of arsenic is not an immediate health danger. They are suggesting that people should eat a balanced diet, because removing one particular type of food will not necessarily change the overall amount of arsenic in the diet. This is because arsenic can be found in fruits and vegetables, fish and chicken among other items. Since arsenic is found in water, it can make its way into anything people eat or drink.

Not everyone needs to avoid these types of foods

Nevertheless, there are certain groups of people who have more potential exposure to arsenic than others, including people on a gluten ­free diet. If you have celiac disease, your diet is already limited. It will be more difficult to vary foods and eat a balanced diet when you are gluten ­free and now also have to limit rice and rice products. Keep in mind that no one is suggesting that people should completely stop eating rice. In fact, there is less cancer and less cardiovascular disease in many of the areas in which rice is the main staple of the diet.

So what can a person who needs to be on a gluten ­free diet do? Rice is not the only source of arsenic. People on a gluten ­free diet need to limit all of their arsenic exposure. Many of these suggestions were in the Consumer Report article in 2012.

Ways to reduce arsenic exposure

1. Check your drinking water. If you drink tap water, and the tap water is from a water company, there should not be more than 10 ppb arsenic in the water. You can call your water company and ask to see a report of their water analysis. If your tap water comes from a well (but not your own well), the same regulation is in effect. If you drink your own well water, depending where you live, you could be taking in a lot of arsenic. You are responsible for testing your own well water. Contact an environmental laboratory in your area to obtain sample bottles, and follow the instructions for proper sampling procedures. If your water is found to be high in arsenic, you need to drink bottled water.
2. Forego the apple juice and eat an actual apple instead. Apple juice has also been in the news as being high in arsenic, although the FDA tested apple juice and found that 100% of 94 samples had less than 10 ppb inorganic arsenic. 95% had less than 10 ppb total arsenic. The FDA is proposing to regulate apple juice to try and make sure none of it has too much arsenic.
3. Use other gluten­ free flours. If you prefer flour made with brown rice you will not be happy to have to remove it from your diet. But you do not have to stop eating it. You just need to eat it less often. Other gluten free flours you can use instead of (or blend with the rice) are  sorghum, garbanzo beans, coconut,  and quinoa.You can look at some of the links below which show the amounts of arsenic in rice and rice-containing foods to help guide you. You will see that foods made essentially entirely of rice, such as rice flour pasta have much more arsenic per serving than baked goods.
4. Eat a balanced and varied diet, and do not eat the same foods all of the time. This is always a better choice because there is more opportunity to get all the different nutrients needed. Also, some vitamins and other substances in fruits and vegetables can actually interact with arsenic in a number of ways to make it less toxic. Rice is not the only food with high levels of arsenic. The Codex Alimentarius Commission is tasked by the World Health Organization (WHO) to find safe levels of contaminants in food. Their published report of 2011 showed that the arsenic content of some foods in other countries was as high as or higher than the arsenic content of rice. For example, many meat samples had more arsenic than some of the rice samples. Maximum organic arsenic levels in dried seaweed, fish and fish products were higher than maximum organic arsenic levels in rice, and vegetables had similar levels of organic arsenic as rice.
5. Choose rice products from the United States when possible. Arsenic gets into rice because it is grown in water, and water all over the world is contaminated with arsenic. The levels of arsenic in rice vary by type of rice as well as location where the rice is grown. Based on a number of different tests, it appears that rice grown in the United States has significantly less arsenic in it than rice grown in other places. Rice grown in California may have less arsenic in it than rice grown in the southern United States. Both white and brown rice of many types are grown in the United States. Other rice may say that it was grown in Thailand, or India, and it is best not to eat rice from another country when given a choice. It is probably not possible to find the location of the rice source used to make rice flour that is then used in baked goods, but products that contain a lot of other ingredients already have less arsenic. There are some manufacturers that are trying to lower the arsenic in their products and are buying rice from areas with less arsenic contamination. It seems likely that this information will probably be advertised on labels at some point in the future.
6. Try to avoid a rice­ based diet. White rice has less arsenic than brown rice, so it would be better to eat white rice if you really want rice. For many it might be best to save the amount of rice products eaten for favorite baked goods that can’t yet be replaced.
7. Cooking rice in a large amount of water, 4 to 5 times the amount needed, and then discarding the water after the rice is cooked may get rid of a significant amount of arsenic. This would be similar to the way pasta is made, in extra water that gets drained off. However, some of the nutritional content of rice would be lost along with the arsenic. Also, this only works if you know your water is not high in arsenic.

There is not complete consensus about where the rice with the lowest amount of inorganic arsenic is found. The Codex Alimentarius Commission 2011 report said, “… arsenic in rice varies between different regions, with a higher inorganic content in rice grown in Asia compared with the USA and EU, but higher total arsenic levels in rice from US and EU except the contaminated areas such as Bangladesh and Chile.”

However, the Codex Commission noted in its March 2012 report that rice from the United States “…has the lowest average inorganic levels (0.091mg/kg) and the lowest maximum level of inorganic arsenic reported (0.157 mg/kg).”

The FDA is studying the effects of low levels of arsenic over time in the United States. Similar research is going on all over the world. The Codex Alimentarius Commission is trying to come to a consensus about how much arsenic should be allowed in rice. Eventually more specific limits will be suggested or set here as regulations. In 2012, the suggested maximum levels of arsenic in rice were 0.3 mg/kg (0.3 mg/l) for raw brown rice (inorganic or total) and 0.2 mg/kg of inorganic arsenic in polished (white) rice. Other levels have been suggested, but no absolute level agreed upon in the rest of the world or in the United States.

In the meantime, explore all your food options. Any new regulations will be seen on the FDA website and will undoubtedly reported on by the press.

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References
FDA-Arsenic
FDA-Arsenic in Rice and Rice Products
U.S. Food and Drug Administration. Analytical Results from Inorganic Arsenic in Rice and Rice Products Sampling. September 2013
Arsenic In Your Food. Our findings show a real need for federal standards for this toxin. Consumer Reports. November 2012
Julie Jones, PhD, CNS, LN. Food, Rice and Arsenic: What Health Professionals Need to Know
An Online Resource for Information on Arsenic in Rice
Supporting Document for Action Level for Arsenic in Apple Juice. Food. U.S. Food and Drug Administration. July 2013, draft. Last Updated 1/30/2015
Guidance for Industry: Bottled Water: Arsenic; Small Entity Compliance Guide. April 2009.
WHO Technical Report Series. EVALUATION OF CERTAIN CONTAMINANTS IN FOOD. 2010
Public Health Service Agency for Toxic Substances and Disease Registry. Toxicological Profile for Arsenic. August 2007
U.S. Food and Drug Administration. Analytical Results from Inorganic Arsenic in Rice and Rice Products Sampling. September 2013.
Consumer Report Results
WHO Technical Report Series. EVALUATION OF CERTAIN CONTAMINANTS IN FOOD. 2010
Some rice ­based foods for people with celiac disease contain relevant amounts of arsenic. ScienceDaily. ScienceDaily, 16 October 2014.
JOINT FAO/WHO FOOD STANDARDS PROGRAMME CODEX COMMITTEE ON CONTAMINANTS IN FOODS. 5th Session. The Hague, The Netherlands, 21 – 25 March 2011. DISCUSSION PAPER ON ARSENIC IN RICE
JOINT FAO/WHO FOOD STANDARDS PROGRAMME CODEX COMMITTEE ON CONTAMINANTS IN FOODS. 6th Session. Maastricht, The Netherlands, 26 – 30 March 2012. PROPOSED DRAFT MAXIMUM LEVELS FOR ARSENIC IN RICE
Sandra Munera­Picazo, Amanda Ramírez­Gandolfo, Francisco Burló, Ángel Antonio Carbonell-Barrachina. Inorganic and Total Arsenic Contents in Rice­Based Foods for Children with Celiac Disease. Journal of Food Science, 2014; 79 (1): T122.
Sandra Munera­Picazo, Francisco Burló, Ángel Antonio Carbonell­Barrachina.Arsenic speciation in rice­based food for adults with celiac disease. Food Additives & Contaminants: Part A, 2014; 31 (8): 1358