The DOI matches its Crossref record; 262 of the 262 references it cites were found in a registry or an index.
Are Organic Foods Safer or Healthier Than Conventional Alternatives?: A Systematic Review
Abstract
BACKGROUND: The health benefits of organic foods are unclear. PURPOSE: To review evidence comparing the health effects of organic and conventional foods. DATA SOURCES: MEDLINE (January 1966 to May 2011), EMBASE, CAB Direct, Agricola, TOXNET, Cochrane Library (January 1966 to May 2009), and bibliographies of retrieved articles. STUDY SELECTION: English-language reports of comparisons of organically and conventionally grown food or of populations consuming these foods. DATA EXTRACTION: 2 independent investigators extracted data on methods, health outcomes, and nutrient and contaminant levels. DATA SYNTHESIS: 17 studies in humans and 223 studies of nutrient and contaminant levels in foods met inclusion criteria. Only 3 of the human studies examined clinical outcomes, finding no significant differences between populations by food type for allergic outcomes (eczema, wheeze, atopic sensitization) or symptomatic Campylobacter infection. Two studies reported significantly lower urinary pesticide levels among children consuming organic versus conventional diets, but studies of biomarker and nutrient levels in serum, urine, breast milk, and semen in adults did not identify clinically meaningful differences. All estimates of differences in nutrient and contaminant levels in foods were highly heterogeneous except for the estimate for phosphorus; phosphorus levels were significantly higher than in conventional produce, although this difference is not clinically significant. The risk for contamination with detectable pesticide residues was lower among organic than conventional produce (risk difference, 30% [CI, -37% to -23%]), but differences in risk for exceeding maximum allowed limits were small. Escherichia coli contamination risk did not differ between organic and conventional produce. Bacterial contamination of retail chicken and pork was common but unrelated to farming method. However, the risk for isolating bacteria resistant to 3 or more antibiotics was higher in conventional than in organic chicken and pork (risk difference, 33% [CI, 21% to 45%]). LIMITATION: Studies were heterogeneous and limited in number, and publication bias may be present. CONCLUSION: The published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods. Consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria. PRIMARY FUNDING SOURCE: None.
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In the citing paper
“As a result, there is still considerable controversy as to whether the use of organic production standards results in significant and consistent changes in the concentrations of potentially health-promoting (e.g. antioxidants, (poly)phenolics, vitamins and certain minerals) and potentially harmful (e.g. Cd and Pb) compounds in crops and crop-based foods( 7 , 19 – 22 ).”
In the citing paper
“However, these systematic reviews (1) used different methodologies (e.g. weighted and unweighted meta-analyses) and inclusion criteria, (2) did not cover most of the large amount of information published in the last 4–5 years, (3) provided no structured assessment of the strength of the evidence presented, and (4) came to contrasting conclusions.”
In the citing paper
“However, there is increasing evidence and more widespread acceptance that the consumption of organic foods is likely to reduce exposure to pesticide residues( 21 , 23 , 24 ).”
In the citing paper
“Several systematic literature reviews have recently analysed the available published information, using both qualitative and quantitative methods, with the aim of identifying the potential effects of organic and conventional production protocols on the nutritional quality of crops( 19 – 21 ).”
In the citing paper
“There are, to our knowledge, only two human dietary intervention studies in which contrasting antioxidant/(poly)phenolic intake levels were generated by providing diets based on conventional and organic crops; both studies focused on assessing antioxidant status in humans and were inconclusive with respect to the identification of potential health impacts of organic food consumption( 21 , 42 , 43”
In the citing paper
“The finding of a four times higher frequency of occurrence of pesticide residues in conventional crops confirms the results of the study of Smith-Spangler et al. ( 21 ), in which a very similar set of studies (nine of the ten publications used in the present study) were used for analysis.”
In the citing paper
“However, it contradicts the results of the systematic reviews/meta-analyses by Dangour et al. ( 19 ) and Smith-Spangler et al. ( 21 ), which indicated that there are no significant composition differences between organic and conventional crops.”
In the citing paper
“This supports previous studies that have concluded that organic food consumption can reduce exposure to pesticide residues( 21 – 23 ).”
In the citing paper
“In contrast to previous literature reviews( 19 – 21 ), the larger number of studies now available allowed separate meta-analyses to be carried out for different crop types (e.g. fruits, vegetables and cereals), but only for a limited number of composition parameters.”
In the citing paper
“As has been mentioned in previous reviews( 19 – 21 ), pooling diverse information was necessary, because for most of the composition parameters, the number of published studies available was not sufficient to carry out separate meta-analyses for specific countries/regions and crop types and species.”
In the citing paper
“Similar to the results of the present study, a recent literature review by Smith-Spangler et al. ( 21 ) has also reported that of the seventy-seven comparative data sets (extracted from fifteen publications), twenty-one indicated significantly lower and only one significantly higher Cd concentrations in organic foods.”
In the citing paper
“However, they concluded that the currently available data do not allow clear trends with respect to health markers and outcomes to be identified.”
In the citing paper
“A recent review by Smith-Spangler et al. ( 21 ) has analysed the results of fourteen studies in which the effects of organic and conventional food (both crop and livestock product) consumption on clinical outcomes (e.g. allergic symptoms and Campylobacter infections) and health markers (e.g. serum lipid and vitamin concentrations) were studied.”
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Metadata
- Authors
- Smith-Spangler, C., Brandeau, M. L., Hunter, G. E., Bavinger, J. C., Pearson, M., Eschbach, P. J., Sundaram, V., Liu, H., Schirmer, P., Stave, C., Olkin, I., & Bravata, D. M.
- Affiliations
- VA Palo Alto Health Care System (US)
- From Veterans Affairs Palo Alto Health Care System, Palo Alto, California; Division of General Medical Disciplines and Lane Medical Library, Stanford School of Medicine, Stanford, California; and Center for Health Policy/Center for Primary Care Outcomes Research, Department of Management Science & Engineering, and Department of Statistics, Stanford University, Stanford, California.
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2012-09-04
- Volume
- 157
- Issue
- 5
- Pages
- 348-366
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2107875538
- Cited by
- 602
- References
- 262
- Citations by year
- 2026: 19 · 2025: 40 · 2024: 32 · 2023: 34 · 2022: 39 · 2021: 53 · 2020: 49 · 2019: 36 · 2018: 35 · 2017: 52 · 2016: 61 · 2015: 48 · 2014: 49 · 2013: 40 · 2012: 14
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Annals of Internal Medicine
- Topics
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Organic Food and Agriculture
- Life Sciences › Agricultural and Biological Sciences › Food Science › Agricultural safety and regulations
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pesticide Exposure and Toxicity
- Keywords
- organic food, conventional food, food safety, food nutrition, pesticide residues, antibiotic-resistant bacteria, Escherichia coli contamination, phosphorus, campylobacteriosis, children's diet
- MeSH terms
- Food Contamination, Food Microbiology, Humans, Nutritive Value, Pesticide Residues, Vitamins, Drug Resistance, Bacterial, Food, Organic
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