Chia Seed Alert: Superfood, Yes, But They Landed One Man In The ER

photo: Rachel Zimmerman/WBUR

photo: Rachel Zimmerman/WBUR

Confession: I eat chia seeds everyday. I feed them to my children. They make me feel full and satisfied and, yes, I’m a sucker for foods touted as “super” even though I know deep down it’s just marketing.

I may be crazy, but I’m also trendy: chia seeds are everywhere, in energy bars and smoothies, atop yogurt parfaits and at the core of crunchy kid snacks. Good Morning America called chia seeds the “it” food of 2013.

And they really are good for you: “a rich source of fiber, protein and heart-healthy omega-3 fatty acids,” according to an NIH publication.

But this week, my chia euphoria took a hit. “Despite potential health benefits, chia seeds may pose a risk if they are not consumed properly, according to new research,” said the Medline headline.

A case report presented by a North Carolina GI doctor describes a scary case of chia seeds gone bad: a 39-year-old man spent several hours in the emergency room under anesthesia after eating no more than a tablespoon of dry chia seeds followed by a glass of water.

The seeds, which can absorb up to 27 times their weight in water, apparently expanded post-ingestion and completely blocked the man’s esophagus, according to the doctor who handled the case, Rebecca Rawl, MD, MPH, a gastroenterology fellow at Carolinas Medical Center in Charlotte, North Carolina.

I spoke to Rawl, and she told me the story of the chia seed blockage — believed to be the first report of its kind. She presented her poster, titled “Watch It Grow: Esophageal Impaction With Chia Seeds,” earlier this week at the American College of Gastroenterology’s annual meeting in Philadelphia. It began innocently enough, she said:

The man arrived at the hospital and said he had this feeling of pain at the top of his stomach and couldn’t swallow anything — “not even his own saliva.” Hospital staff took him in for an upper endoscopy and the imaging clearly showed the culprit: puffed up chia seeds.

What did it look like?

Rawl said:

It was a gel of these seeds, the consistency was similar to Playdoh — not solid, but not a liquid.

That’s what made it very difficult to remove the obstruction — we initially tried using an adult endoscope…We tried to push the mass or gel of chia seeds through to the stomach. But because of the consistency, the seeds would just go around the scope.

After trying unsuccessfully with a variety of other medical implements to move the sloshing mass of seeds, Rawl said she switched to a neonatal or baby endoscope with a smaller diameter: “And we were able to get past the obstruction to see what was ahead and we used the tip of instrument to push a few seeds at a time into the stomach,” she said.

Little by little, then, over several hours, doctors were able to clear the man’s esophagus. “Afterwards, she said, “he was fine.”

The Michael Pollan-y moral here would go something like this:

Beware Chia.
Eat Them Wet
Chew A Lot.

A more nuanced moral, from Rawl, also urges caution:

“Nobody should be eating these seeds dry,” said Rawl, who has never personally eaten a single one of the tiny, oval-shaped seeds. “I don’t think it’s a good idea. Let them expand fully in some kind of liquid first — especially for people who have this sensation of food getting stuck. Chia seeds are tiny, so people would not necessarily think there are problems, but some people do have underlying “strictures” or narrowing of the esophagus.”

And of course, added Rawl, whose primary research focuses on irritable bowel disease, anyone who has recurring swallowing problems — whether from hot dogs or chicken or chia — should see a doctor.

But chia seeds — “which come from a species of flowering plant in the mint family native to central and southern Mexico and Guatemala” — are already so pervasive in the foodosphere, it may be hard to get that “proceed with caution” message across.

Nina Manolson, one of my go-to health coaches here in the Boston area told me she loves, loves, loves chia seeds. Here’s her response to the quasi-ominous medical report:

Chia seeds live up to their superfood name. They are high in Omega 3’s (healthy fat that is an anti-inflammatory), they are an antioxidant, contain important micro-nutrients like magnesium, calcium and manganese and they are also loaded with protein. But possibly Chia’s biggest claim to fame is its fiber content. In 1 oz of chia seeds there are 11 grams of fibre – including both soluble and insoluble fiber.

Insoluble fiber is the kind of fiber that acts like a scrub brush in your colon. Soluble fibre absorbs water so it creates bulk and it makes us feel full.

The interesting thing about Chia seeds is that it can absorb A LOT of water – claims vary from 8-27X their weight in water, which makes it a great food to add to your diet if you’re looking to feel satisfied for a long time without needing to eat a lot – as in trying to lose weight.

Chia seeds are also great at keeping dehydration at bay because it holds so much liquid. However, if you eat dry chia seeds, without giving them any liquid to absorb before ingesting them, they’ll absorb the water within your system and potentially cause a blockage. I can imagine, although I’ve never seen it happen, if you ate a lot of chia seeds without any liquid and they got stuck in your throat or windpipe, it could cause a blockage. But so could flax seeds, which also absorbs water and become gelatinous.

But the fact that you could choke on chia seeds – really, you could choke on any food – should definitely NOT be a reason to avoid them.

Chia seeds (and flax seeds) have huge nutritional benefits, and should definitely be included in a healthy diet. But, they should be eaten accompanied by a liquid, either while eating them or allowing them to soak in advance.

My favorite recipe: Raspberry chia seed pudding

Photo: Nina Manolson

Photo: Nina Manolson

I must say, after reading about the medical case, I’ve taken a bit of a chia seed hiatus. And at $19.99 for a 15-ounce package at my neighborhood Whole Foods, maybe I’ll go seedless for a little while longer.

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