You're in the supermarket eyeing a basket of sweet, juicy plums. You reach for the conventionally grown stone fruit, then decide to spring the extra $1/pound for its organic cousin. You figure you've just made the healthier decision by choosing the organic product -- but new findings from Stanford University cast some doubt on your thinking. "There isn't much difference between organic and conventional foods, if you're an adult and making a decision based solely on your health," said Dena Bravata, MD, MS, the senior author of a paper comparing the nutrition of organic and non-organic foods, published in the Sept. 4 issue of Annals of Internal Medicine.

A team led by Bravata, a senior affiliate with Stanford's Center for Health Policy, and Crystal Smith-Spangler, MD, MS, an instructor in the school's Division of General Medical Disciplines and a physician-investigator at VA Palo Alto Health Care System, did the most comprehensive meta-analysis to date of existing studies comparing organic and conventional foods. They did not find strong evidence that organic foods are more nutritious or carry fewer health risks than conventional alternatives, though consumption of organic foods can reduce the risk of pesticide exposure.

The popularity of organic products, which are generally grown without synthetic pesticides or fertilizers or routine use of antibiotics or growth hormones, is skyrocketing in the United States. Between 1997 and 2011, U.S. sales of organic foods increased from $3.6 billion to $24.4 billion, and many consumers are willing to pay a premium for these products. Organic foods are often twice as expensive as their conventionally grown counterparts.

Although there is a common perception -- perhaps based on price alone -- that organic foods are better for you than non-organic ones, it remains an open question as to the health benefits. In fact, the Stanford study stemmed from Bravata's patients asking her again and again about the benefits of organic products. She didn't know how to advise them.

So Bravata, who is also chief medical officer at the health-care transparency company Castlight Health, did a literature search, uncovering what she called a "confusing body of studies, including some that were not very rigorous, appearing in trade publications." There wasn't a comprehensive synthesis of the evidence that included both benefits and harms, she said.

"This was a ripe area in which to do a systematic review," said first author Smith-Spangler, who jumped on board to conduct the meta-analysis with Bravata and other Stanford colleagues.

For their study, the researchers sifted through thousands of papers and identified 237 of the most relevant to analyze. Those included 17 studies (six of which were randomized clinical trials) of populations consuming organic and conventional diets, and 223 studies that compared either the nutrient levels or the bacterial, fungal or pesticide contamination of various products (fruits, vegetables, grains, meats, milk, poultry, and eggs) grown organically and conventionally. There were no long-term studies of health outcomes of people consuming organic versus conventionally produced food; the duration of the studies involving human subjects ranged from two days to two years.