Cited by 602Organic Food and AgricultureAgricultural safety and regulationsPesticide Exposure and Toxicity

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.

Overview

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Crossref · 10.7326/0003-4819-157-5-201209040-00007

Cites

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Citations

Cites

Show all 262 references

Research works printed but not linked: 36

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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.
Venue
Annals of Internal Medicine
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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