Macaroni: ordinary pasta, judged by the portion

A meta-analysis that searched for weight trials of pasta on its own found none. What it could pool instead was 32 trial comparisons in 2,448 adults where pasta was eaten inside low glycemic index diets for at least 3 weeks. Those diets lowered body weight against higher-GI diets by a mean of 1.4 lb (95% CI 0.93 to 1.9; metric: 0.63 kg, 0.42 to 0.84). That is a small effect of a whole eating pattern. Cohort data from 17 studies and more than 875,000 people did not link refined grains, pasta among them, with cardiovascular disease (HR 1.08, 95% CI 0.99 to 1.18), and residual confounding is likely. What moves intake in trials is the plate. When 20 young adults were served a double portion of macaroni and cheese, they ate 20 oz (578 g) instead of 453 g, about 170 calories more in one meal.

The numbers, per 3.5 oz (100 g)

How much is actually in it

• US rules require enriched macaroni to contain 0.9 to 1.2 mg of folic acid and 13 to 16.5 mg of iron per pound. — Enriched macaroni products sold in the United States Evidence E source
  Per pound: thiamin 4.0-5.0 mg, riboflavin 1.7-2.2 mg, niacin 27-34 mg, folic acid 0.9-1.2 mg, iron 13-16.5 mg
• According to the NIH fact sheet, since 1998 the FDA has required folic acid to be added to enriched pastas and other grain products to lower neural tube defect risk. — Enriched grain products in the United States Evidence E source
  140 mcg folic acid per 3.5 oz (100 g) in enriched grain products; mean US folic acid intake up about 190 mcg/day

What a real portion looks like

• In a crossover trial in 77 preschool children, a macaroni and cheese entree 30% lower in energy density cut energy eaten from it by 25%. — 2- to 5-year-old children (37 boys and 40 girls), weekly lunches for 6 weeks (n = 77) Evidence B source
  Entree energy -25% (72.3 calories), total lunch energy -18% (71.8 calories)
• In a randomized trial in 20 young adults, doubling a macaroni and cheese meal raised intake from 453 g to 578 g. — Seventeen women and three men, 30-minute meals (n = 20) Evidence B source
  577.9 g vs 453.1 g and 903.9 vs 734.6 calories in LARGE vs SMALL
• In a crossover RCT in 48 adults eating elbow macaroni with sauce, adding salt increased food and energy intake by 11%. — 48 healthy adults aged 18-54 y, four lunches (n = 48) Evidence B source
  Food and energy intake +11% with high salt (P = 0.022)
• In the US dietary survey database one cup of cooked pasta weighs 4.9 oz (140 g), and 1 oz of dry pasta yields 80 g cooked. — FNDDS food code 56130000 Pasta, cooked Evidence E source
  1 cup cooked = 140 g; 1 oz dry yields 80 g

What your body absorbs

• In a randomized trial in 8 healthy men, adding 6 g of salt to 50 g of carbohydrate as boiled macaroni did not change the blood glucose response. — 8 healthy male volunteers, four test meals (n = 8) Evidence B source
  No significant difference in peak glucose or glucose AUC

What cooking and storage change

• In a randomized crossover trial in 14 healthy men, slowly processed pasta gave the same glucose and insulin response as normally processed pasta. — 14 healthy male volunteers, single 100 g pasta meal each (n = 14) Evidence B source
  No difference in glucose tolerance, insulin or incretins
• Pooled measurements from 28 studies found acrylamide at 136.29 micrograms per kg in wheat-based foods such as bread, cookies and pasta. — 28 studies measuring processing contaminants in wheat-based foods (n = 28 studies) Evidence C source
  Acrylamide 136.29 ug/kg, HMF 70.59 ug/kg, PAHs 0.11 ug/kg
• By the USDA table for pasta boiled and drained, about 65% of thiamin and niacin, 70% of folate and 75% of iron remain. — USDA Retention Factors Release 6, Cereal Grains and Pasta, method 381 Evidence E source
  Retained: thiamin 65%, niacin 65%, folate 70%, iron 75%, riboflavin 75%, potassium 30%

What it does to your health

• According to a meta-analysis of 32 trial comparisons in 2448 adults, low-GI diets that included pasta lowered body weight by 1.4 lb (0.63 kg) versus higher-GI diets. — Adults in randomized trials of at least 3 weeks, pasta within low-GI dietary patterns (n = 2448) Evidence A source
  Body weight MD -1.4 lb (95% CI -1.9 to -0.93; metric: -0.63 kg, -0.84 to -0.42), BMI MD -0.26 kg/m2 (95% CI -0.36 to -0.16)
• Observational data from 17 cohorts do not link refined grain intake, including pasta, with cardiovascular disease. — 17 prospective cohort studies, more than 875,000 participants (n = >875,000) Evidence C source
  CVD HR 1.08 (95% CI 0.99 to 1.18)

Safety, limits and interactions

• A case report traced emetic food poisoning in eight cafeteria diners to macaroni and cheese contaminated with Bacillus cereus. — Eight members of a lunch group (n = 8) Evidence D source
  Nausea, cramps, vomiting, recovery within 48 hours
• Observational data from a US outbreak link macaroni salad and other hand-prepared salads to enterotoxigenic E. coli illness in an estimated 3300 people. — 612 attendees of 11 catered events (n = 612) Evidence C source
  At least 3300 estimated cases
• FDA links vomiting-type B. cereus outbreaks mainly to rice products, with pasta and other starchy foods also implicated. FDA advises keeping food refrigerated at 40 F or lower, because cooking may kill the bacteria but might not disable the toxin that causes vomiting. — General population (home food handling) (n = -) Evidence E source
  Refrigerate at 40 F or lower, cooking may not disable the emetic toxin

What people believe that the data does not support

• The EU register lists the claim that carbohydrates in pasta give a low and slow blood sugar response as non-authorized. — Food labeling in the EU Evidence E source
  Claim not authorized
• In a crossover RCT in 13 healthy adults, macaroni and cheese made with gluten-free rice and corn pasta raised 30-minute blood glucose 57% more than wheat pasta. — 13 healthy non-smoking adults (n = 13) Evidence B source
  30-min plasma glucose 57% higher for GF rice and corn pasta (p = 0.011)

Who this works differently for

• A systematic review of 8 US studies found most Hispanic women of reproductive age get folic acid only from enriched grain products such as pasta. — Hispanic women of reproductive age in the US, 8 studies (n = 20,123) Evidence C source
  Total folic acid 244 vs 332 mcg daily compared with non-Hispanic White women

The bottom line

In the US survey database a cup of cooked pasta weighs 4.9 oz (140 g), and 1 oz of dry pasta cooks up to 80 g. Two more meal trials show how easily that cup grows. In 48 adults eating elbow macaroni with sauce, adding salt raised food and energy intake by 11% at a single lunch. In 77 preschool children at one day-care center, a macaroni and cheese dish made 30% lower in energy density cut the energy they ate from it by 25%, about 72 calories. Enriched macaroni in the United States must carry 0.9 to 1.2 mg of folic acid and 13 to 16.5 mg of iron per pound of product, which applies only to products labeled enriched. That standard sits inside a wider FDA rule from 1998 that adds 140 mcg of folic acid per 3.5 oz (100 g) to enriched grain products, to reduce the risk of neural tube defects. For many people that label matters. A systematic review of 8 US studies found that most Hispanic women of reproductive age got their folic acid only from enriched grain products such as pasta. Boiling and draining costs part of what was added. The USDA retention table for boiled, drained pasta keeps about 65 percent of thiamin and niacin, 70 percent of folate and 75 percent of iron, and only 30 percent of potassium. Those factors come from 1975 data for pasta as a group. The EU register lists as non-authorized the claim that carbohydrates in pasta give a low and slow blood sugar response. For people who do not need to avoid gluten, gluten-free pasta is no improvement on that score. In 13 healthy adults, macaroni and cheese made with rice and corn pasta raised blood glucose at 30 minutes 57% more than the same dish made with wheat pasta. Adding 6 g of salt to boiled macaroni did not change the glucose response in 8 healthy men, and slowly dried pasta behaved the same as normally processed pasta in 14 healthy men. Pooled measurements across bread, cookies and pasta found acrylamide at 136.29 micrograms per kg, a figure that is not specific to pasta. Who should be careful comes down to food safety in the cards we have. Macaroni and cheese contaminated with Bacillus cereus made eight lunch diners vomit in one case report. In a US outbreak, macaroni salad and other hand-prepared salads were linked to an estimated 3,300 cases of E. coli illness. Both reports concern cooked, prepared dishes rather than dry pasta from the packet, which is where the risk sits. We have no card yet on how cooked pasta should be cooled and stored, so this page cannot tell you how long a cooked dish is safe to keep. Standard macaroni is wheat pasta, so this page is not a guide for anyone with celiac disease or wheat allergy, and we have no card on either.

Sources

1. macr-r6-13 · Regulation
   Each such food contains in each pound not less than 4.0 milligrams (mg) and not more than 5.0 mg of thiamin, not less than 1.7 mg and not more than 2.2 mg of riboflavin, not less than 27 mg and not more than 34 mg of niacin or niacinamide, not less than 0.9 mg and not more than 1.2 mg of folic acid, and not less than 13 mg and not more than 16.5 mg of iron (Fe)
   21 CFR 139.115, Enriched macaroni products · checked 2026-09-28
2. macr-r6-17 · Agency fact sheet
   In January 1998, the U.S. Food and Drug Administration (FDA) began requiring manufacturers to add 140 mcg folic acid/100 g to enriched breads, cereals, flours, corn meals, pastas, rice, and other grain products [13] to reduce the risk of neural tube defects (NTDs).
   NIH Office of Dietary Supplements, Folate fact sheet for health professionals · checked 2026-09-28
3. macr-r6-06 · Crossover RCT
   Decreasing the energy density of the entrée by 30% significantly (P<0.0001) reduced children's energy intake from the entrée by 25% (72.3+/-8.3 kcal) and total lunch energy intake by 18% (71.8+/-7.9 kcal).
   J Am Diet Assoc, 2008 · checked 2026-09-28
4. macr-r6-07 · RCT
   Participants consumed more grams (577.9 ± 150.5 g vs. 453.1 ± 96.6 g; p < 0.001) and energy (903.9 ± 270.4 kcal vs. 734.6 ± 187.1 kcal; p < 0.001) in LARGE as compared to SMALL.
   Appetite, 2017 · checked 2026-09-28
5. macr-r6-08 · Crossover RCT
   Salt increased food and energy intakes by 11%, independent of fat concentration (P= 0.022).
   J Nutr, 2016 · checked 2026-09-28
6. macr-r6-14 · Reference dataset
   Pasta, cooked (FNDDS 56130000, fdc_id 2708357, WWEIA Pasta, noodles, cooked grains): 1 cup, cooked = 140 g; 1 oz, dry, yields = 80 g
   USDA FNDDS 2021-2023, food code 56130000 · checked 2026-09-28
7. macr-r6-05 · RCT
   Eight healthy male volunteers ate four test meals on consecutive mornings and in random order; the meals were 50 g carbohydrate taken as a 20% glucose solution or as boiled macaroni with and without supplementation with 6 g salt. In contrast with other reports, no significant differences in peak plasma glucose concentrations or areas under the plasma glucose curves could be established.
   Br Med J (Clin Res Ed), 1987 · checked 2026-09-28
8. macr-r6-03 · Crossover RCT
   A total of 14 healthy male volunteers underwent two different mixed-meal tests in a randomized order. ... Glucose tolerance, insulin, and incretin response were unaffected by the two different pasta types.
   Nutrients, 2021 · checked 2026-09-28
9. macr-r6-12 · Meta-analysis of surveys
   Most studies (69.7%) evaluated acrylamide in bread, cookies, and pasta, while PAHs (26.2%) were determined mainly in wheat grains and pasta. ... The highest concentration was for acrylamide (136.29 µg·kg-1) followed by HMF (70.59 µg·kg-1) and PAHs (0.11 µg·kg-1).
   Crit Rev Food Sci Nutr, 2023 · checked 2026-09-28
10. macr-r6-16 · Reference dataset
    USDA-RETN-R6:381 PASTA,BOILED,DRAINED: thiamin_mg 65%, niacin_mg 65%, folate_total_ug 70%, iron_mg 75%, riboflavin_mg 75%, potassium_mg 30%
    USDA Table of Nutrient Retention Factors, Release 6 (2007), code 381 · checked 2026-09-28
11. macr-r6-01 · Meta-analysis of RCTs
    We identified no trial comparisons of the effect of pasta alone and 32 trial comparisons (n=2448 participants) of the effect of pasta in the context of low-GI dietary patterns. Pasta in the context of low-GI dietary patterns significantly reduced body weight (MD=-0.63 kg; 95% CI -0.84 to -0.42 kg) and BMI (MD=-0.26 kg/m2; 95% CI -0.36 to -0.16 kg/m2) compared with higher-GI dietary patterns.
    BMJ Open, 2018 · checked 2026-09-28
12. macr-r6-09 · Meta-analysis of cohorts
    Meta-analyses of hazard ratios (HR) and 95% confidence intervals (CI) obtained from 17 prospective cohort studies (>875,000 participants) indicated that refined grain intake was not associated with risk of CVD (HR = 1.08, 95% CI, 0.99-1.18, I2 = 70%; 9 cohorts)
    Trends Cardiovasc Med, 2024 · checked 2026-09-28
13. macr-r6-10 · Outbreak report
    Epidemiologic investigation incriminated macaroni and cheese as a cause of the illness and samples of this food contained large numbers of Bacillus cereus.
    Arch Intern Med, 1981 · checked 2026-09-28
14. macr-r6-11 · Outbreak cohort
    Multiple food items (potato salad, macaroni salad, egg salad, and watermelon) were associated with illness, all of which required extensive handling during preparation.
    Clin Infect Dis, 2006 · checked 2026-09-28
15. sf-bc-r3-6 · agency advice
    The vomiting-type outbreaks generally have been associated with rice products; however, other starchy foods, such as potato, pasta, and cheese products, also have been implicated. Food mixtures, such as sauces, puddings, soups, casseroles, pastries, and salads, frequently have been linked with food-poisoning outbreaks. ... One of the most important things you can do to protect yourself from infection with B. cereus is to keep your food refrigerated at 40°F or lower. ... Cooking may kill the bacteria, but it might not disable the toxin that causes the vomiting type of illness.
    US FDA, Bad Bug Book 2nd ed. (2012), Bacillus cereus and other Bacillus species · checked 2026-10-08
16. macr-r6-02 · Regulatory decision
    POL-HC-6873 Carbohydrates in pasta products Kolhydrater i pasta ger ett lågt och långsamt blodsockersvar/har ett lågt glykemiskt index (GI). Carbohydrates in pasta products provide a low and slow blood sugar response/have a low glycaemic index (GI). Non-authorised
    EU Register on nutrition and health claims, claim POL-HC-6873, snapshot 2026-09-21 · checked 2026-09-28
17. macr-r6-04 · Crossover RCT
    the plasma glucose concentration was 57% higher for the GF rice and corn pasta compared to traditional wheat pasta (p = 0.011).
    Food Funct, 2017 · checked 2026-09-28
18. macr-r6-15 · Systematic review
    Hispanic women consumed grains, cereals, bread, flour, pasta, and corn masa flour. Most Hispanic women obtained folic acid from ECGP only.
    BMC Public Health, 2025 · checked 2026-09-28