Ask the Doctors

Dear Doctor: I want to start feeding my baby solid food, but I read that rice cereal is contaminated with arsenic. What should I do?

Dear Reader: Your concern is understandable. The inorganic form of arsenic, found throughout nature in both the soil and water, is highly carcinogenic -- leading to an increased risk of bladder, skin and lung cancers. Areas with high levels of arsenic in the drinking water, such as Bangladesh, see higher rates of some cancers as a result.

In the United States, arsenic levels in drinking water are tightly regulated, which limits our overall risk from arsenic. That doesn't mean we're not exposed, however. Inorganic arsenic is still prevalent in our environment, and organic arsenic, which is much less toxic, can be found in most plants and animals in small amounts.

Rice poses a particular risk, as it concentrates inorganic arsenic more than other types of foods do. That's because rice is grown in stagnant water, which leads to conditions of low oxygen and allows arsenic to dissolve more easily into the water. The rice plant then more readily absorbs the arsenic. In fact, the level of uptake is 10 times that of wheat or barley.

The amount of arsenic in rice depends upon the type of rice and where it was grown. Rice grown in California appears to have less arsenic then rice grown in Texas and Louisiana. Sushi rice and basmati rice have lower amounts of arsenic, while organic brown rice concentrates more arsenic.

Rice cereals have traditionally been used to transition infants from milk to more solid foods because, for the most part, rice is hypoallergenic and a good alternative for children with allergies or intolerance to wheat-based cereals. But no one wants to worry that the foods meant to help children grow might actually be harming them.

So what should be done? Focus on the total risk.

To that end, the European Food Safety Authority has created the benchmark lower-dose limit, meaning the dose that would increase the risk of cancer by 1 percent. Consuming more than 2 servings of rice cereal per day would equal this dose. So, if you are transitioning your child to solid foods and they're consuming 3 or 4 servings of rice cereal per day, you should reassess your child's diet. This is especially true if you feed your child organic brown rice.

A big caveat is that the specific risk of cancer from rice consumption is not known. Researchers have not studied the connection between rice consumption in infants and cancer. Although a study of 200,000 people, published in the International Journal of Cancer, found no link between rice consumption and cancer, infants can concentrate more arsenic due to their smaller size.

My sense is that if you're transitioning your child to solid foods, rice cereal at 1 to 2 servings per day should be fine. What may be better is to balance rice cereals with other types of cereals, such as barley cereal or oatmeal cereal. Even better than cereals can be foods such as bananas, egg yolks and pureed vegetables.

It may get a little messy, so be prepared.

(Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.)

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)

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