We all know that fruits and vegetables are a cornerstone of a healthy diet. They are associated with a reduced risk of heart disease, improved metabolic health, and an overall contribution to longevity. But a new study reminds us that there is another question to ask: Not only how many fruits and vegetables we eat, but also what “chemical load” may arrive with them on our plate?
The study, recently published in the journal International Journal of Hygiene and Environmental Health, sought to answer a very practical question: Is it possible to assess cumulative exposure to pesticides through diet, and does this assessment actually reflect what is measured in the body? To do this, the researchers developed a “pesticide load index” for fruits and vegetables, and then calculated for each participant a “dietary exposure score” based on the types of produce they consumed.
For the purpose of the study, the researchers used American monitoring data on pesticide residues on 44 types of fruits and vegetables, collected mainly between 2013 and 2018, and combined them with dietary data and urinary biomarkers from 1,837 participants in the American national health survey NHANES from the years 2015-2016.
The index they built did not rely on just one question, but combined several factors: How often residues were found, how many different pesticides were found on each food, what the total amount was, and also data related to the relative toxicity of those substances.
In simple terms, the researchers tried to get a bit closer to reality. Instead of looking at only one pesticide, they sought to assess what actually happens in real life: Repeated exposure to a mixture of substances, through different foods, over time.
What did the study find?
The main finding of the study was simple: Not all fruits and vegetables are “equal” in terms of exposure to pesticides.
At first, the results appeared less conclusive. When examining all types of produce together, the researchers did not find a clear connection between the amount of pesticides participants were expected to consume through food and the levels of markers found in their urine.
But then they conducted a more precise analysis, and the picture began to become clearer.
When the researchers focused only on pesticides that could be identified both on the food itself and in urine tests, the connection already appeared stronger. And when they excluded potatoes from the analysis, an even clearer picture emerged: The more people ate fruits and vegetables with a higher load of pesticide residues, the higher the levels of exposure markers found in their bodies.
In other words, the study indicates that the type of produce we eat may actually affect our level of exposure to pesticides.
This connection was particularly evident in several common groups of pesticides, and in the group of people with the highest exposure, marker levels were about 17% higher compared to the group with the lowest exposure.
Another important message from the study is that it is not enough to say “I eat a lot of fruits and vegetables.” The question of which fruits and vegetables are eaten also matters. The researchers showed that produce considered “high in pesticide residues” was more associated with an increase in exposure indicators, compared to produce considered “low in pesticide residues.”
Among the foods with a higher pesticide load, according to the American data in the study, were spinach, kale, strawberries, potatoes, nectarines, peaches, apples, cherries, raisins, and grapes. In contrast, at the lower end of the scale were corn, onions, frozen peas, cabbage, asparagus, cauliflower, broccoli, and mushrooms.
It is important to emphasize: This list is based on data from the United States, and therefore cannot be automatically applied to Israel. But the general message can be clearly understood: Even within a diet considered healthy, there are choices that may expose us to more pesticides, and others to less.
What does this study not say?
It does not say that you should stop eating fruits and vegetables. That would be an incorrect conclusion. The researchers themselves clarify that the goal is not to deter people from plant-based foods, but to better understand how to reduce unnecessary chemical exposure, especially in sensitive populations such as children and pregnant women. They also write that better methods are needed to assess exposure to mixtures of pesticides in order to better understand the health risks and reduce them.
The study also has limitations. This is an observational study, not an interventional trial. It was based on only a 24-hour dietary report, and exposure to pesticides can also come from additional sources, such as water, household use, or proximity to agricultural spraying. In addition, not all pesticides found in food were also measured in urine. Nevertheless, even with these limitations, the study shows that certain eating patterns may measurably affect exposure levels in the body.
What does this mean for consumers?
Not panic, but precision.
The practical conclusion is not to stop eating fruits and vegetables, but to aim for as much real, natural, and minimally processed food as possible. Vegetables, fruits, high-quality animal protein, healthy fats, and cooking based on simple raw ingredients, not industrial products that disguise themselves as health food. Even within the world of agricultural produce, there are cleaner foods and less clean ones, so it is worth choosing carefully what and where you purchase, diversifying, and not relying every day דווקא on the same foods that tend to carry a higher pesticide residue load. Where possible, you can also consider preferring organic options for some of the more problematic foods. The logic here is simple: Not only what you eat matters, but also the quality of the food and the level of pesticide exposure it brings with it.
In Israel, this issue is also very relevant, but one must be careful about automatically copying American data.
In Israel, the picture is far from perfect. A State Comptroller report from 2023 determined that the extent of pesticide use in Israel is very high compared to the European countries examined, and noted a ratio of 1.57 tons of active substance per 1,000 tons of plant produce: The highest among the countries examined. The same report also warned of gaps in supervision, enforcement, and transparency to the public. In addition, it noted that in the years 2019-2021 significant deviations in pesticide residues were found in certain crops, including green onions, celery, lettuce, dill, cucumbers, and grapes, and in Ministry of Health tests also in herbs and in some additional fruits and vegetables.
Therefore, the answer to the question of whether pesticides are used in Israel “in a similar way” to what occurs in the United States is yes, in the broad sense. Here too, conventional agriculture makes extensive use of pesticides, and here too, regular agricultural produce is a central exposure route for the public. But not in an identical way: The types of substances, types of crops, climate conditions, spraying patterns, and regulation are not identical to those in the United States.
The bottom line: This study does not aim to frighten people about fruits and vegetables. It aims to remind us that it is not enough to ask whether a food is “healthy”, we must also ask how clean it is, how processed it is, and what else comes with it to the plate.
If we want a diet that truly promotes health, the goal should be clear: As much real food as possible, as little industrial food as possible, and as much awareness as possible also of the chemical load that comes along with the food. In Israel, as in many other places, the challenge is not only to eat more fruits and vegetables, but to ensure that the healthiest choice is also the cleanest choice.
Dr. Dalit Draiman-Medina is a specialist in family medicine and integrative and functional medicine.