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The American Academy of Pediatrics acknowledges that organic food may have fewer unhealthy contaminants, but tells parents to give priority to a diet rich in conventional produce if they can't afford the extra cost of many organic foods.

Nutrition first, organic second: American Academy of Pediatrics

by Corinne Chin
Oct 24, 2012


Corinne Chin/MEDILL

Apples rank first in pesticide contamination, according to the Environmental Working Group. The American Academy of Pediatrics recommends purchasing organic apples.


Corinne Chin/MEDILL

Conventional strawberries like this one are ranked fifth on the EWG's "Dirty Dozen" list for pesticide contamination.

Don’t sacrifice fruits and vegetables if you can’t afford the extra cost of organic. That’s the advice of the American Academy of Pediatrics, breaking its silence on organic foods Tuesday with release of a clinical report.

The report shows that organic foods may offer fewer contaminants, but they do not have more nutritional value. The AAP recommends consuming larger amounts of conventional produce over smaller portions of organic produce.

“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,” stated report co-author Dr. Janet Silverstein, of the University of Florida, in an AAP release.

At Jewel this week, for instance, organic broccoli is $2.49 per pound, a dollar more than conventional broccoli. Organic pears are $1.79 per pound, 30 cents more than conventional. But organic romaine hearts, on sale for $2.29 per bag, are cheaper than conventional romaine at $2.99.

The report, in the works for three years, advises that current scientific evidence doesn’t reflect any significant nutritional advantages or shortfalls from eating organic.

However, organic choices can have many benefits, according to the AAP. Because of stipulations governing organic certification, organic produce must be grown without the use of synthetic pesticides and herbicides, which have been linked to cancer in large doses. Organic meat is grown without non-therapeutic antibiotics, lowering the risk of contamination with drug-resistant bacteria. The AAP recommended purchasing these organic products, if possible. However, organic milk was shown to have little benefit over conventional milk in recent studies, according to the AAP.

There’s very strong evidence that organic produce reduces exposure to pesticides, said report co-author Dr. Joel Forman, a pediatrician at the Mount Sinai Medical Center in New York. “The remaining question is, does that matter enough to have an important clinical impact? We certainly know these are carcinogens, and we know that at large doses, there’s a real risk. At low doses, it’s hard to know.”

Chuck Benbrook, a researcher at Washington State University’s Center for Sustaining Agriculture and Natural Resources, said the risks should be taken into account, however, despite a lack of conclusive evidence.

“A person’s decision to buy organic food will not bring about, with a high level of reliability, a clinically significant improvement in health outcomes, especially not in the near-term and in the absence of other changes in dietary patterns. But does this mean there are no health benefits from consumption of organic food? No, it does not,” Benbrook wrote in an email. “In the meantime, an ounce of prevention makes a lot of sense to many people, but for the most part remains an afterthought in clinical practice and biomedical research.”

Forman said there would be no clear winner in the organic versus conventional debate until more longitudinal studies are conducted, such as the National Children’s Study, currently in its initial phase. The National Institute of Child Health and Human Development is conducting the study and will track environmental exposures and consequent diseases in children from before birth until age 21.

“It takes a lot of time to do studies like that, and it’s very expensive,” Forman said. “It will take time to get really definitive answers, certainly on things like neurodevelopment and cancer.”

For parents who want to play it safe, the AAP recommends referencing the Environmental Working Group’s “Dirty Dozen” and “Clean 15” lists. Government studies have shown the “Dirty Dozen,” including apples, celery and bell peppers, have the highest pesticide residue levels and should be the priority when swapping for organic produce. Pesticides are most often found on the outer layer of produce, so peeling apples can significantly reduce contaminants on the surface of the fruit.

The “Clean 15,” including onions, corn and pineapple, are safer to eat, even if conventionally grown.

Christine Bushway, CEO and executive director of the Organic Trade Association, said many organic foods are less expensive than parents might believe.

“I find that many, many times, particularly when it comes to fruits and vegetables, the price differential between conventional and organic is lowering. I’ve found organic carrots, for example, priced exactly the same as conventional,” Bushway said. “Look for seasonal produce, and you can get close to conventional prices.”

The Organic Trade Association originally called the report a major milestone for the $31 billion industry, but Bushway said she has mixed feelings.

“It was ambiguous,” Bushway said. “If I were the average person, what conclusion would I draw? It is confusing to the average parent.”

Forman compared the debate on organic food to the controversies over mercury levels in fish. While mercury is hazardous, the nutritional value of most fish outweighs the risks of low-level mercury contamination.

“There’s no question there’s mercury in some fish, and there’s no question there is a small impact on brain development and intelligence. Is that such a negative that you wouldn’t eat any fish? The answer is, absolutely not,” Forman said. “We should do everything we can to reduce the amount of pollution in the environment. And then we won’t have to talk about it.”

Forman said the AAP is hesitant to make recommendations without strong, complete evidence behind them. However, he said he feels certain about his own decisions.

“If I were a parent faced with the choice and there was no cost differential, I would buy organic. There is no question at all,” Forman said.