Parents are being advised to vary the types of cereal grains fed to young children after extensive testing found higher-than-expected levels of arsenic in infant rice cereals.
As a result of the testing, the Food and Drug Administration (FDA) today proposed a limit or "action level" of 100 parts per billion (ppb) of inorganic arsenic (IA) for all types of infant rice cereal, a move supported by the Academy. This is consistent with levels recently set by the European Commission.
To decrease exposure to arsenic from rice, the FDA recommends parents also serve infants iron-fortified cereals made of oat, barley or multigrain, which aligns with AAP guidance. Toddlers should be provided with a well-balanced diet that also includes a variety of grains.
"The AAP encourages parents to speak with their pediatrician about their children's nutrition," said AAP President Benard P. Dreyer, M.D., FAAP. "Pediatricians can work with parents to ensure they make good choices and informed decisions about their child's diet."
In releasing its new data, the FDA reported finding from 20 to 170 ppb of inorganic arsenic in infant rice cereal, which, on average, is more than double that found in other toddler foods.
Relative to body weight, rice intake for infants is about three times greater than that for adults, according to the FDA. Yet rice has the highest levels of IAs relative to other foods measured by the FDA.
"We really should be (adding) other grains for our infants — not just rice," said Frank Greer, M.D., FAAP, former chair of the AAP Committee on Nutrition and a member of the AAP Arsenic in Rice Expert Work Group.
Long-term effects of arsenic exposure include a higher risk for bladder and lung cancer. Currently, there is no federal limit on arsenic in most foods, which usually is measured in micrograms per serving.
Arsenic is absorbed by some food crops as they grow. It's not an additive/ingredient in crops and cannot be completely eliminated from food.
The FDA said the new limits being proposed are both prudent and achievable. In 76 tested samples of infant rice cereals, 47% already meet the proposed limit, while 78% were at or below 110 parts per billion.
Pregnant women also should be consuming a variety of foods, including varied grains, the FDA noted. Developing brains are "particularly vulnerable" to harms from neurotoxic chemicals like inorganic arsenic, as IA readily crosses the placenta. The science on pregnancy and development was based on a systematic review for adverse pregnancy outcomes and effects on early childhood, including more than 30 peer-reviewed studies mostly from the last decade.
FDA's testing of arsenic in foods has been ongoing. In 2012 and 2013, the FDA released preliminary results of tests of arsenic in numerous rice and rice products, finding variable results that did not rise to a level of concern. At that time, both the FDA and the Academy recommended families eat a wide variety of foods for a well-balanced diet.
Rice cereal has long been a popular first food for infants, but there is no evidence to support this practice. Other choices as first foods are finely chopped meat, vegetable purees or cereals made from other grains. The Academy does not recommend rice milk for infants.
Public comments on the proposal will be accepted for 90 days on the FDA website.