Supplementary Online Content

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1 Supplementary Online Content Karagas MR, Punshon T, Sayarath V, Jackson BP, Folt CL, Cottingham KL. Association of rice and rice-product consumption with arsenic exposure early in life. JAMA Pediatr. Published online April 25, doi: /jamapediatrics etable 1. Summary of arsenic concentrations (ranges of total, inorganic and methylated forms) reported for selected rice products consumed by infants etable 2. Summary statistics for the measurements of urinary arsenic concentration, in µg/l a etable 3. Parameters from the general linear model for log 10 -transformed total urinary arsenic concentration and rice product intake categories (n=129) etable 4. Parameters a from the generalized linear model of log 10 -transformed summed speciated urinary arsenic (n=48) efigure 1. Cumulative percent of infants introduced to rice cereal by age (months) at first consumption efigure 2. Log 10 -transformed sum of urinary arsenic species (SUAs) increased with the total number of servings of rice and rice products infants consumed (t 45 =4.19, P=0.0009) ereferences.

2 etable 1. Summary of arsenic concentrations (ranges of total, inorganic and methylated forms) reported for selected rice products consumed by infants Arsenic concentration range (ng/g) Product category N Total a Inorganic b Methylated c References Whole grain rice White Brown Rice-containing Cereals Crackers Rice cakes BDL-273 d Infant foods Rice cereal Formula 14 BDL BDL Sweet puffed grain snacks 2 BDL ,46,55 9, ,9,46 16,46 46 a Includes all measurable forms of arsenic b Includes As III and As V c Includes DMA and MMA d BDL indicates a value below the limit of detection

3 etable 2. Summary statistics for the measurements of urinary arsenic concentration, in µg/l a Type of Urinary Arsenic Minimum Q 1 Median Q 3 Maximum Speciated (n=48) ias (As III + As V ) BDL BDL MMA V BDL BDL DMA V BDL SUAs (ias+mma V +DMA V ) Total (n=129) TUAs a BDL indicates a value below the method detection limit; Q1 indicates the median of the first quartile; Q 2 indicates the median of the third quartile.

4 etable 3. Parameters from the general linear model for log 10 -transformed total urinary arsenic concentration and rice product intake categories (n=129) Parameter Estimate 95% CI P Intercept (-44.11, ) <.0001 Specific gravity (29.24, 44.31) <.0001 Infant rice cereal 0.22 (0.11, 0.34) Rice-based snacks 0.10 (0.04, 0.15) Infant foods mixed with rice (-0.11, 0.07) Rice (-0.11, 0.09) Adult food mixed with rice (-0.15, 0.07) Non-baby rice-containing cereals 0.07 (-0.23, 0.38)

5 etable 4. Parameters a from the generalized linear model of log 10 - transformed summed speciated urinary arsenic (n=48) Parameter Estimate 95% CI P Intercept (-40.15, ) <.0001 Specific gravity (22.70, 40.49) <.0001 Infant rice cereal 0.35 (0.19, 0.51) <.0001 Rice-based snacks 0.09 (0.02, 0.16) Infant food mixed with rice 0.00 (-0.13, 0.14) Rice 0.01 (-0.11, 0.13) Adult food mixed with rice (-0.17, 0.15) a none of the infants in the speciated urinary arsenic sub-sample consumed non-baby mixed cereal, so that term does not appear in this model

6 efigure 1. Cumulative percent of infants introduced to rice cereal by age (months) at first consumption

7 efigure 2. Log 10 -transformed sum of urinary arsenic species (SUAs) increased with the total number of servings of rice and rice products infants consumed (t 45 =4.19, P=0.0009).

8 ereferences. 1. US Food and Drug Administration. Analytical results from inorganic arsenic in rice and rice products sampling pdf. Accessed September 4, Signes-Pastor AJ, Carey M, Meharg AA. Inorganic arsenic in rice-based products for infants and young children. Food Chem. 2016;191: Sun GX, Williams PN, Zhu YG, et al. Survey of arsenic and its speciation in rice products such as breakfast cereals, rice crackers and Japanese rice condiments. Environ Int. 2009;35(3): Meharg AA, Sun G, Williams PN, et al. Inorganic arsenic levels in baby rice are of concern. Environ Pollut. 2008;152(3): Jackson BP, Taylor VF, Punshon T, Cottingham KL. Arsenic concentration and speciation in infant formulas and first foods. Pure Appl Chem. 2012;84(2):