The Panel concludes that levels of nitrate in these vegetables are not of health concern for most children. It notes, however, that infants and young children aged 1-3 years who consume high amounts of spinach with high nitrate levels could at times reach an intake level for which a risk of methaemoglobinaemia - a condition that reduces oxygen supply to the body - cannot be excluded.
The Panel also provides advice to the European Commission on maximum levels of nitrate in leafy vegetables. This statement complements EFSA’s scientific opinion of 2008 in which the CONTAM Panel compared risks and benefits of exposure to nitrates in vegetables.
Nitrate is converted into nitrite, which at high levels can lead to methaemoglobinaemia. Based on the analysis of new and more detailed food consumption data now available for children, the Panel concludes that levels of nitrate in lettuce are not of health concern for children; however, infants and young children aged 1-3 years who eat large amounts of spinach (over 200g) on a given day could be exposed to high levels of nitrates.
Furthermore, it recommends that children suffering from bacterial gastrointestinal infections should not be given spinach because these infections result in a higher conversion of nitrate to nitrite, thereby increasing the risk of methaemoglobinaemia. The Panel indicates that inappropriate storage of cooked leafy vegetables can also result in the conversion of nitrate to nitrite. Furthermore, the conversion of nitrate to nitrite is accelerated when vegetables are pureed Spinach and lettuce are subject to EU legislation, which establishes maximum levels of nitrate in foods. In answer to the Commission’s request, the Panel advises that replacing derogations in place in certain Member States with slightly higher maximum levels for nitrate in leafy vegetables would have a minor impact on the exposure of young children.