Risk assessmentindependent cross-checkabstract checked I-VEG-115 standard review
EFSA on nitrate in spinach for babies
Statement on possible public health risks for infants and young children from the presence of nitrates in leafy vegetables
Overview
EFSA Panel on Contaminants in the Food Chain (CONTAM). EFSA Journal 2010 · DOI 10.2903/j.efsa.2010.1935
EFSA judged spinach nitrate unlikely to be a concern for most infants, but could not exclude risk for some, and warned that badly stored cooked vegetables form nitrite.
Does the study support the specific claim? Yes · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Assess infant nitrate risk from leafy vegetables.
- How was the study done?
Risk assessment.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Some infant risk; storage key; avoid spinach during GI infections.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Use fresh or frozen vegetable purees; be careful with spinach for small children.
- What are the study's limitations?
Modelling-based.
- What does it say about Elawady's specific claim?
Supports infant-specific claim.
- Do the results apply to Germany and Europe?
EU.
- What can explicitly not be concluded from this study?
No outcome data.
Scientific in-depth review
1. Full reference
- Authors
- EFSA Panel on Contaminants in the Food Chain (CONTAM)
- Journal
- EFSA Journal
- Year
- 2010
- Identifier
- DOI 10.2903/j.efsa.2010.1935
- Verification
- verified – Crossref record and abstract fetched 2026-10-26 (EFSA web page returned HTTP 403)
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
EFSA (public agency)
2. Research question
Are nitrates in lettuce and spinach a health risk for infants and young children?
3. Study design and population
- Study design
- Risk assessment – Scientific risk assessment statement
- Population
Infants and young children (EU)
- Country
European Union
- Period
2010
- Sample size
not applicable
- Inclusion and exclusion criteria
not stated in abstract
4. Methods and endpoints
- Exposure / intervention
Nitrate in spinach and lettuce at current/proposed maximum levels
- Comparator
Health-based reference values
- Endpoints
Risk characterization
- Statistical methods
Exposure scenarios
5. Actual results
- Results
Nitrate exposure from spinach cooked from fresh at current or proposed maximum levels is unlikely to be a health concern for infants, although a risk for some infants eating more than one spinach meal a day cannot be excluded; lettuce not a concern for children; spinach may raise exposure to levels of concern for some young children; inappropriate storage of cooked vegetables converts nitrate to nitrite and increases methaemoglobinaemia potential; recommended against feeding spinach to children with bacterial gastrointestinal infections.
- Absolute risks
not reported
- Authors' conclusion
As stated in results.
6. Strengths
- Official EU risk assessment
7. Weaknesses
- 2010; exposure modelling rather than outcome data
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Agency risk assessment.
9. Assessment of the statistical interpretation
not applicable
10. Relevance to the specific claim
Confirms infant-specific nitrate concern, the role of storage, and extra caution with gastrointestinal infection.
11. Independent contrary findings
none
12. Transferability to Germany and Europe
EU.
13. Overall methodological judgement
Supports the claim for infants; does not support avoidance by older children or adults.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
none
15. Linked fact checks
- Nitrate-rich vegetables (e.g. courgette soup) given to young infants can cause severe methaemoglobinaemia. – Studies supporting the claim