Caroline Helwick

October 24, 2012

NEW ORLEANS — Organic foods are essentially no more nutritious than conventionally produced foods, but whether they are safer is still an unanswered question, according to a new policy statement from the American Academy of Pediatrics (AAP) released here during its 2012 National Conference and Exhibition.

The AAP conducted an extensive analysis of scientific evidence surrounding organic produce, dairy products, and meat. The conclusion was mixed: Although organic foods have the same vitamins, minerals, antioxidants, proteins, and other nutrients as conventional foods, they also have lower pesticide levels and, in the case of meat, are less likely to be contaminated with drug-resistant bacteria, because antibiotics are not used in these animals.

"In the long term, there is currently no direct evidence that consuming an organic diet leads to improved health or lower risk of disease," AAP officials said in a statement.

The new recommendations were presented at a press conference during the meeting and concurrently published online October 22 in the journal Pediatrics.

"We found no significant difference in nutrients in organic vs conventional foods, with the caveat that such studies are very difficult to conduct due to many confounding factors," said Joel Forman, MD, associate professor of pediatrics at Mount Sinai School of Medicine, New York City. Dr. Forman was on the AAP Council on Environmental Health when the effort was initiated.

Because such studies are "problematic," he acknowledged that "we don't have 100% of the answers."

Organic Milk No Better

Organic milk also does not offer significant health benefits, the authors concluded.

Many parents buy organic milk out of concerns over growth hormones and estrogen that may be fed to conventionally raised cows. But Dr. Forman said bovine growth hormone has no effect on humans, nor does estrogen appear to cause health concerns.

"There is no reason to think there is a clinical impact on people," he said. "And as for estrogen, breast milk has higher levels. We don't think there is a health impact from organic vs conventional milk."

He suggested that a better way to avoid estrogen exposure is to drink nonfat milk, because the more fat content in milk — organic or not — the higher the concentration of estradiol.

Steven Abrams, MD, professor of pediatrics and neonatology at Baylor College of Medicine, Houston, Texas, and Medical Director of the Neonatal Nutrition Program, weighed in at the press briefing. He said parents can choose to buy organic products "for issues of social dynamics," but buying organic milk to avoid hormones "is not justified, based on the evidence."

Dr. Abrams added that organic infant formulas also hold no additional benefit over conventional formulas, and "the standard is still breast milk."

He further noted another reason to stick to conventional dairy products: cost. "Organic milk, especially, can be expensive, as our report states, and this is an issue for many families," he said.

Organic Meats Reduce Drug-Resistant Bacteria Risk

Purchasing meat from organic farms that do not use antibiotics for nontherapeutic uses has the potential to reduce antibiotic resistance in bacteria, the report further stated.

Between 40% and 80% of antimicrobials used in the United States are used in farm animals, three quarters of which are for nontherapeutic uses. Many of these drugs are identical or similar to drugs used in humans. This nontherapeutic use promotes the development of drug-resistant organisms in the animals, and these microbes then colonize in humans.

Pesticide Exposure May Be Lower in Organic Foods

Organic foods may, however, offer some benefit in terms of a reduced exposure to pesticides, the authors concluded.

The report stated, "Organic diets have been convincingly demonstrated to expose consumers to fewer pesticides associated with human disease...[but] additional data are needed to identify relationships between diet and pesticide exposure and individual health outcomes."

"We feel clearly that conventionally grown fruits and vegetables do have additional pesticide exposure. The levels are low, but there are real differences," Dr. Forman said.

He commented on 2 related studies of interest. A large prospective birth cohort study measured pesticide exposure in pregnant farm workers in California and found in their offspring lower mental development index scores at 24 months and attentional problems at 3.5 and 5 years of age (Marks AR et al, Environ Health Perspect 2010;118:1768-1774).

In another small study of children consuming conventional produce, urinary pesticide residues could be reduced to almost nondetectable amounts when they were switched to an organic produce diet for 5 days (Lu C et al, Environ Health Perspect 2006;114:260-263).

Interestingly, he said, the level of urinary pesticide residues when these children consumed a conventional diet were similar to the levels found in the offspring of the pesticide-exposed farm workers in the first study.

"We don't know if these findings are clinically meaningful," he acknowledged, "but we think they may be."

Dr. Forman said that organic farming is more valuable for some produce more than others, and he would guide parents to be selective. "For example, the risk of pesticide exposure is much higher for apples than corn," he noted.

Simply Eat Healthy

Dr. Abrams stressed that the message to parents should be simple: consume a healthy diet, whether it is conventional or organic.

"We simply need to emphasize the importance of fruits, vegetables, and dairy in children's diets," he said.

Janet Silverstein, MD, professor of pediatrics at the University of Florida, Gainesville, agreed. "Many families have a limited food budget, and we do not want families to choose to consume smaller amounts of more expensive organic foods and thus reduce their overall intake of healthy foods, like produce."

Gary Mallis, MD, a solo practitioner in Scottsdale, Arizona, was glad to hear the AAP-issued guidance on this topic, and he said he would find this useful in his practice.

"Parents ask me all the time about organic foods, and I'm at something of a loss for words. I don't want to recommend they eat products that are cost-prohibitive. I do get a good number of questions, especially about organic milk and starting when the child is only 1 year of age. That's the big one," he said. "It's good to have these data. Patients like to have information that is based on studies."

Dr. Forman, Dr. Abrams, Dr. Silverstein, and Dr. Mallis have disclosed no relevant financial relationships.

American Academy of Pediatrics (AAP) 2012 National Conference and Exhibition. Presented October 22, 2012.

Pediatrics. 2012;130:e1406 - e1415. Full text

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