Is Cinnamon Unsafe?

Poor Cinnabon.

The company just wants to sell you overpriced pastries in airports and shopping malls, plus some "cinnaswag" on their website. But they get so much bad press! Nutritional criticism (a single roll can have more than thousand calories). Abuse from comedians (Jim Gaffigan: "Ever eat at Cinnabon? You have to take a nap halfway through"). Backlash over tasteless tweets. And now, an investigation from Consumer Reports flagging high levels of lead in 12 brands of cinnamon powder. "Just a quarter teaspoon of any of those products has more lead than you should consume in an entire day" says the report.

CR's report, published one week ago today, has already created a stir. The New York Times, The Washington Post, CNN, and Fox have covered the story, as have a bunch of local outlets and blogs. Two companies reviewed by CR (Paras and EGN) have even removed their products from store shelves.

This is not the first time we've been warned about lead in cinnamon. In March, July, and August, the FDA issued public health alerts about lead in a total of 17 other ground cinnamon products. An outbreak of lead poisoning in August 2023 was eventually traced to the cinnamon in three brands of apple puree.

These alerts and incidents raise questions about the extent of the problem. Experts often say there are no safe levels of lead exposure. Since even products that CR deemed "Okay" and "Best" contain some lead, we might ask: Should we be avoiding cinnamon altogether?

Why is there lead in cinnamon?

Cinnamon trees absorb lead from soil and water. The lead may be naturally occurring and/or the result of industrial activity. As the bark of the tree dries, the concentration of lead increases.

The problem isn't just with the trees. To save money, manufacturers sometimes adulterate cinnamon with lead-containing substances – including lead. Processing and packaging may contribute to the problem. And there are regulatory issues: Cinnamon is mainly grown in Indonesia, Vietnam, Sri Lanka, and China, where quality standards may be inconsistently applied. In the U.S., there are no federal limits on heavy metals in spices, and state-level regulations only exist in New York.

(If you're a foodie, this newsletter focuses on cassia, the type of cinnamon found in every product on the market labeled "cinnamon". But you can't buy your way out of the problem. Concerns about lead also apply to the more expensive stuff labeled "true cinnamon", aka Ceylon or Sri Lanka cinnamon, in part because it's often adulterated with cassia.)

Why is this important?

Unlike metals such as iron, lead has no nutritional value. Sufficient exposure can harm anyone, but prenatally and in the early years of life, vulnerability is especially acute. Low levels of lead exposure have been linked to impairments in cognition and learning, attention-related behavioral problems such as ADHD, and other more or less permanent neurodevelopmental effects.

Meanwhile, that quarter teaspoon of cinnamon mentioned by Consumer Reports isn't very much. To give you a taste of what that means in practical terms, I googled "cinnamon roll recipes" this morning.

For each of the first five recipes that googled up, I divided the amount of cinnamon by the number of rolls. (Most recipes use tablespoons as a unit. I've converted the data to teaspoons; 1 tbs = 3 tsp.) Here's what I found:

As you can see, a single roll made from any one of these recipes approaches or exceeds .25 teaspoons of cinnamon and therefore, according to Consumer Reports, contains more lead than you should be eating in a single day.

(How much cinnamon in a Cinnabon roll? The company doesn't say. But on the popular site Allrecipes, a well-reviewed recipe for "Clone of a Cinnabon" – perhaps the closest we can get to the real thing – calls for .625 teaspoons per roll.)

The problem of course isn't just cinnamon rolls, but all the dishes and drinks that incorporate the spice. Chinese 5-spice powder and garam masala contain substantial amounts of cinnamon too, and we don't know where restaurants and grocery-shelf foods source the cinnamon they use.

Are we overreacting?

We can thank statistics for our concerns about cinnamon. Although people have known or suspected for centuries that lead can be harmful, only through statistical methods developed in the 20th century have we been able to link very low levels in the body to adverse outcomes.

At the same time, these statistics attempt to tease out complicated dose-response relationships involving very low doses, so it's worth taking a moment to ask whether we're overreacting.

Each of us absorbs at least trace amounts of lead from soil, water, air, clothing, consumer products and food – just about every sort thing we come in contact with. For this reason, safety standards for food and water acknowledge that zero lead content may not be realistic. For instance, the FDA recommends a maximum of 0.1 ppb (one part per billion) of lead in candy that children may consume.

To illustrate what an overreaction might look like, consider the recent panic over a scientific report that tampons contain lead. In a July post to her Substack Immunologic, Dr. Andrea Love noted that the researchers went to absurd lengths to extract lead from the tampons, heating them to 350F degrees in an environment 2,000 times more acidic than a vagina, and that even the amount of lead extracted in this way is far less than what we're exposed to every day in our food, water, and clothing.

My point is that the fact that some product contains a small amount of lead should not automatically be a source of concern. We need a close look at the data.

Mixed messaging

In the case of lead, we should also be especially attentive to what seems like an inconsistency in expert messaging. On the one hand, we often hear that there's no safe level of lead exposure. All the major health organizations (WHO, CDC, FDA, EPA, etc.) concur on this. And yet, safety guidelines recommended by the same organizations (and assumed by Consumer Reports) identify levels that seem to be viewed as safe, or at least not actionable.

In other words, some messaging indicates a continuum: Any amount of lead exposure is harmful. Other messaging, from the same sources, implies thresholds: Lead exposure below a certain level is not a source of concern.

You can't have it both ways.

(In fairness, some organizations, like the CDC, note that their lowest thresholds call for action without ruling out the possibility that even lower levels are harmful. Nonetheless, it's pretty easy to cherrypick statements from any of these organizations and find the mixed messaging I've described here. I'll circle back to this issue after I discuss CR's new report.)

The Consumer Reports review

In The 12 Cinnamon Powders You Should Never Use, published on September 12, consumers are warned to throw away 12 of the 36 cinnamon powders CR tested for lead. (I've listed the 12 products in my Appendix.)

Given the hundreds of cinnamon powders on the market, the first thing I wanted to know is: Why were these particular products tested? Is this a representative sample, or did Consumer Reports find a way to suss out the only 12 products we should be worried about? I emailed Dr. James Rogers, Consumer Reports' Director of Food and Product Safety Testing and Research for more details. Here's his reply:

"We asked our market analysts what were the best-selling brands and we chose from that list. We also went into neighborhood markets, ethnic and international markets to purchase products from smaller labels and manufacturers in the tri-state area [Connecticut, New Jersey, New York – and online]. And yes, we could only test what our budget allowed, which means we could not test all the brands available."

Not a representative sample, but from a consumer perspective, it's a useful one, because it taps into a variety of sources – and hints that CR hasn't identified all products that would be concerning. In fact, I found one product in my own kitchen that Consumer Reports would classify as "Don't Use" if they had tested it. (In the next section, I'll explain how I know they would've labeled it that way.)

What were Consumer Reports' safety standards?

My next question was why CR decided that 12 of the cinnamon powders shouldn't be used.

CR relied on New York's regulatory maximum of 1 part per million (1 ppm). New York is the only state that regulates heavy metals in spices ­– more than 1 ppm of lead in a product automatically triggers a recall.

Ppm is a measure of concentration. Imagine a million tiny spheres of exactly the same size and weight, gathered together in a pile. If one of those spheres is lead, then the concentration of lead in this pile is 1 ppm.

To obtain practically useful information, we need to know more than just ppm concentration. We also need assumptions about how much cinnamon consumers might actually eat. (If you ate one speck of cinnamon the size of a grain of sand, even a relatively high ppm of lead might not hurt you.)

Consumer Reports assumed daily consumption of a quarter teaspoon of cinnamon as a reference. Why that amount? Because 1 ppm of lead in a quarter teaspoon of cinnamon would equal 5 micrograms of lead, and, as noted in the CR article, that happens to be the state of California's maximum allowable dose level (MADL) for daily consumption.

(If you're wondering about the math, Dr. Rogers explained to me that the mass of a quarter teaspoon is 0.0005 kg. Multiplying ppm values by that number yields microgram values for a quarter teaspoon.)

In short, Consumer Reports created a bridge between two different guidelines. New York prohibits the sale of products with more than 1 ppm of lead. California says we shouldn't be ingesting more than 5 micrograms of lead per day. If you have a cinnamon product with exactly 1 ppm of lead, then a quarter teaspoon of it contains exactly 5 micrograms, and California would consider that unsafe.

CR divided the 36 products they reviewed into three categories: "Don't Use", "Okay to Use", and "Best to Use". CR even tells you how much of the "Okay" and "Best" products you can use per day, so that you can stay under that 5 microgram value. For instance, a quarter teaspoon of Trader Joe's Organic Ground Cinnamon or Kirkland's Organic Saigon Cinnamon (i.e., the Costco brand) would be "Okay".

As for the Wise Wife Ground Chinese Five Spice from my own kitchen (see above), which CR did not review, there's a "Prop. 65 Warning for California Residents" label on the back, indicating that some MADL has been exceeded. In this case, it's the 5 micrograms of lead per day maximum. So, had CR reports reviewed this product, they would've labeled it "Don't Use." (If you have lots of time, you can peruse a list of Prop. 65 complaints about food here.)

Of course, we ingest lead from other sources besides spices, so you have to take any of CR's advice with a grain of salt (or cinnamon, I suppose).

Is there a safety threshold for lead?

I want to dig into the messaging a bit. As the grandparent of two very young people, my heart and my head both tell me that the details are essential.

New York doesn't explain why they chose 1 ppm as their upper limit. All one can tell from publicly available documents, including a peer-reviewed article by the relevant agency director, is that the 1 ppm threshold represents an evidence-based group decision. (I reached out to the director for clarification but haven't heard back.)

As for California's 5 microgram daily maximum, like other MADLs this is an extremely conservative value that represents 1/1000 of the amount of lead shown in scientific studies to cause harm. However, this particular MADL is based on outdated research extending back to the 1980s. Both experts I consulted with for this newsletter noted that in recent decades, lower and lower levels of lead have proven dangerous.

In fact, most experts, and every major organization with an interest in young peoples' health (WHO, UNICEF, CDC, FDA, EPA, AAP, etc.) articulate some version of the following statements:

• There is no known safe level of exposure to lead.

• There is no known safe blood level concentration of lead.

This brings me back to the issue of mixed messaging. If the statements above are true, how do we account for the thresholds, such as those used by California and New York, which hint that lead is only unsafe above a certain level? And why did Consumer Reports follow their lead? After all, if the statements above are true, we should be avoiding all cinnamon products. Anyway, what exactly is meant by "no known safe level"? That the smallest possible amount of lead exposure is dangerous? That we're uncertain about the effects of very low levels? Or that the smallest levels we can measure are harmful, but smaller amounts may be present in the body, and we're unsure whether they cause harm? Those are three different things.

Dr. Aaron Specht at Purdue, an expert in the measurement of trace metals in the body, shared the following with me via email:

"No safe level of lead means that every study we have found where there are detectable levels of lead, the detectable levels are associated with health detriment. This is somewhat limited by instrumentation, but now our instruments detect well below what the general public is exposed to in most cases. The health outcomes of focus can vary, but generally this is focused on early life neurological development manifesting as ADHD symptoms or IQ declines measured directly."

In other words, the lowest levels that have been measured are linked to health problems, particularly during prenatal and early childhood development. We can't be sure about even lower levels that the instruments are unable to detect, but we know at least that harm accrues from unusually low levels.

Dr. Lisa Gatzke-Kopp, a professor of human development at Penn State who has studied the impact of lead on children's development, concurred:

"As we continue to do research we keep finding that exposure correlates with adverse outcomes including lower IQ, reduced cognitive functions, and higher impulsivity. Accordingly, guidance on "safe" lead levels have been lowered several times. Ultimately researchers have argued that this is a continuous effect, not a threshold effect. A threshold effect would indicate that the lead has no impact on neural function unless it reaches a certain minimum.  A continuous effect means a little exposure hurts a little, a lot of exposure hurts more." 

Both Dr. Specht and Dr. Gatzke-Kopp noted that research keeps identifying harms at ever lower levels of exposure. The implication seems to be that any cinnamon powder would be unsafe, because they all contain at least trace amounts. This includes the products CR deemed "Okay" and "Best".

Should we give up cinnamon?

Some experts who've responded already to the CR report suggest that we should just be cautious rather than foregoing cinnamon altogether.

I didn't pose the question directly to those I interviewed, but their responses also highlight a need for caution and perhaps even restrictions for young people. For instance, Dr. Gatzke-Kopp commented

"A small amount of exposure may have a small enough effect that you don't really see a life altering change.  For instance, the effect of a small amount of exposure may be 1 or 2 IQ points.  This probably isn't creating serious impairment in someone's life trajectory. However, if we get cavalier about environmental toxins that each have a small effect - we may be missing the cumulative risk that children face, particularly those in more vulnerable socioeconomic and geographic regions.  If we know something is neurotoxic - why allow its presence in developing brains?

"The other way to think about it is like the risk of alcohol on safe driving.  We set a limit, below which we expect that you can drive safely enough...This could be seen as a behavioral management approach, but could also be an acknowledgement that the same numerical value has a different impact on a younger person's brain than an older person's brain."

Not to put words in her mouth, but Dr. Gatzke-Kopp's point seems to justify the argument that we should treat cinnamon like alcohol – i.e., restrict its use among young people owing to the especially harmful effects it can have on their neurodevelopment.

In the end, I don't think the data allows for simple conclusions. I wish it did, but since it doesn't, I'd rather struggle with nuance than oversimplify.

Part of the reason why simple conclusions don't work is that studies linking the lowest levels of lead exposure to neurodevelopmental harm rely on blood lead levels (BLLs). There's no simple way of translating how much lead one is exposed to into a BLL. How much lead you absorb from your food, for instance, depends on your age (very young people have higher rates of absorption), and a bunch of other individual-level variables, including the fullness of your stomach (emptier stomachs promote more absorption).

An additional complexity is that BLLs themselves are snapshots. A person takes a blood test and the amount of lead in their bloodstream at that moment is then estimated. But lead accumulates for months in soft tissue, and for decades in bone, and it can then undermine health over time. As Dr. Specht explained

"BLLs only get at acute exposures and really much of the detriment is cumulative and permanent. Lead will stay in the body for many decades in bone and be released into blood again and again over time with more chances to produce harm."

In short, even if we know how much lead a person is exposed to, it's difficult to know how their BLLs will be affected, how much lead will be present in their body over an extended period of time, and whether extremely low levels of exposure will harm them. All we can say is that there's a clear need for caution around low levels. Both Specht and Gatzke-Kopp refer to cumulative effects which imply that studies relying on BLL measurements may underestimate harm.

Practical advice

1. Read carefully.

A number of media reports misrepresented what Consumer Reports was saying. For instance, the headline of a Food & Wine article reads "Only 6 Cinnamon Brands Were Deemed Safe for Consumption, According to a New Investigation by Consumer Reports."

Actually, Consumer Reports identified 6 cinnamon products (not brands) as "Best", and an additional 18 as "Okay".  CR intentionally avoided terms like "safe", instead simply describing how much of the "Best" and "Okay" products could be eaten in a day without exceeding the MADLs we might view as safety thresholds. (For instance, if you use Morton & Bassett San Fransisco brand, CR says you can use up to 6 teaspoons per day of their organic powder but only a quarter teaspoon of the non-organic version.)

This is a minor example of how bad journalism can undermine public health. If you trust Food & Wine, you might buy 365 Whole Foods Market ground cinnamon, because it's in CR's "Best" category. But if you used more than CR's stated limit of two teaspoons per day for that particular product, you wouldn't be "safe."

Even CR's advice needs to be read carefully. As the organization itself acknowledges, there will be variability in the exact lead content of a product each time you purchase it. A product that's "Okay" today might exceed the 1 ppm cut-off when you buy it again a month later. Until we get the federal regulations on lead in spices that the FDA is pushing for, we have to expect inconsistency in product content (and even with regulations in place, variability is likely).

2. Be cautious.

Over the past three centuries, humans have crapped up the earth and, almost as rapidly, developed techniques for measuring the harms our crap causes.

I don't think we should ignore the crap or the measurements.

For instance, I think we should be careful about exposure to heavy metals in food products such as fish, chocolate, and spices. (I've written about chocolate here.) We should look at data of the sort that Consumer Reports provided, and recognize that some products are less safe than others (particularly when consumed by young people).

On the other hand, the measurements themselves call for scrutiny. Although low levels of lead exposure are truly dangerous, the data doesn't show that literally any non-zero amount of exposure harms young people. Researchers extrapolate from very low levels to even lower ones (and from the historical trend that studies continue to find lower and lower levels harmful). This leads me to one final piece of advice.

3. Don't stress.

Below, a single graph from the EPA depicts one of the greatest public health achievements of the past half-century. This graph shows blood lead levels for American children between ages 1 and 5 from 1976 through 2020. The red line shows BLLS for children at the 95th percentile. The blue line shows median BLLs. Both lines drop precipitously as lead was removed from gasoline and house paint, among other legislatively-driven changes.

Although children living in poverty and Black children still exhibit higher 95th percentile and median BLLs than their peers, all groups have shown substantial improvement since the 1970s. In fact, I've seen no clear evidence that the highest median BLLs for any group at present (0.8 µg/dL) is linked to adverse health outcomes, nor does any agency call for action at such a level. (The CDC, for instance, encourages intervention at 3.5 μg/dL.)

My point here is not that we shouldn't worry about lead. High levels of exposure are still harming young people, particularly the most vulnerable ones, and questions remain about the effects of relatively low exposure. Rather, I just want to highlight the enormous progress that has been made. With respect to lead, our environment is safer now than before. Instead of getting stressed out by data on lead in commercial products, what we need to do over and above the progress of the past half century is to take the usual precautions against individual exposure to lead in water, old house paint, and other sources. (The EPA offers a useful guide here.)

Those precautions include thinking about where your cinnamon comes from, sticking to brands with lower lead levels (with the understanding that any measurements are fallible), avoiding bulk cinnamon purchases when you travel internationally, and being cautious about using cinnamon as a supplement, since recommended amounts tend to be pretty high (and since the benefits are overblown, as I may discuss in some future newsletter). All of this advice is especially important if small children are among the consumers.  

Also, don't eat Cinnabon every day. Just don't.

Thanks for reading!

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Appendix: Consumer Reports' "Don't Use" cinnamon powder products

Paras Cinnamon Powder, EGN Cinnamon Powder, Mimi's Products Ground Cinnamon, Bowl & Basket Ground Cinnamon, Rani Brand Ground Cinnamon, Zara Foods Cinnamon Powder, Three Rivers Cinnamon Stick Powder, Yu Yee Brand Five Spice Powder, BaiLiFeng Five Spice Powder, Spicy King Five Spices Powder, Badia Cinnamon Powder, Deep Cinnamon Powder.