Pate: dense in vitamin A, and a repeat Campylobacter source

In every pate trial we have, the pate was a product made for the study. In a small crossover trial in 22 adults at high cardiovascular risk, four weeks of reduced-fat pates and frankfurters enriched with omega-3 fats left LDL cholesterol 12 percent lower than the normal-fat versions, which themselves raised LDL. The two meats were eaten together, so the share of the pate cannot be separated. Ordinary liver pate is a different food. UK composition data list 7300 micrograms of retinol, 5.9 mg of iron and 32.7 g of fat per 3.5 oz (100 g) as one composite value, and US records for liver pate run from 217 to 4505 micrograms of vitamin A, so the recipe matters. EFSA and UK advice tell women who are pregnant or planning a pregnancy not to eat liver or liver products such as pate, because of the vitamin A. The finding that repeats across countries is food poisoning. Of 9 foodborne Campylobacter outbreaks in England in 2024, national surveillance counted 5 as likely linked to liver or liver products such as pate or parfait.

The numbers, per 3.5 oz (100 g)

How much is actually in it

• UK composition data list liver pate at 7300 micrograms of retinol, 5.9 mg of iron and 32.7 g of fat per 3.5 oz (100 g). — Food composition, UK Evidence E source
  Retinol 7300 microg, iron 5.90 mg, fat 32.7 g, vitamin B12 8.0 microg, sodium 750 mg per 3.5 oz (100 g)

What a real portion looks like

• USDA survey coding sets an unspecified serving of liver paste or pate at 85 g and one cup at 210 g. — US dietary survey food coding Evidence E source
  Quantity not specified 85 g, 1 cup 210 g
• EFSA judges that liver or offal eaten once a month or less keeps preformed vitamin A under the upper limit, while more frequent offal can push intake above it. — European populations (EFSA Comprehensive Food Consumption Database) Evidence E source
  Liver, offal and products thereof no more than once per month: UL not expected to be exceeded; higher frequency may exceed it
• Among the few UK women aged 16-49 who ate liver in the national diet survey, liver alone supplied on average about 3,500 micrograms of vitamin A a day, and 7,500 at the 97.5th percentile. — women aged 16-49, UK NDNS, liver consumers (liver with recipes) (n = 25 consumers) Evidence E source
  Vitamin A from liver: mean 3500 ug/day (50 ug/kg bw), 97.5th percentile 7500 ug/day (97 ug/kg bw)

What your body absorbs

• In a crossover RCT in 17 iron-deficient women, 2.8 oz (80 g) of meat pate carrying 15 mg of added iron gave similar serum iron curves over 6 hours whether the iron was ferrous sulfate or liposomal ferric pyrophosphate. — 17 women with low iron stores (ferritin below 30 microg/L), single test meals (n = 17) Evidence B source
  No significant difference by fortificant type, serum iron peaked between hours 2 and 4
• In a 7-week RCT in 159 healthy adults, 34 g a day of n-3 enriched fish pate raised plasma long-chain n-3 fats as much as fish oil capsules at about 1 g EPA plus DHA a day, with no change in blood lipids. — 159 healthy men and women, 7 weeks, 44 in the fish pate arm (n = 159) Evidence B source
  Plasma n-3 LCPUFA rose equally in pate, juice and fish oil arms versus control, no significant change in blood lipids or inflammation markers

What cooking and storage change

• In a 2017 hotel outbreak in England, chicken liver pate carried a crude relative risk of 12.95 for campylobacteriosis with a dose-response, and the authors tie such outbreaks to incorrectly cooked liver. — Diners at one hotel Christmas meal, 19 cases (7 confirmed, 12 probable) (n = 19 cases) Evidence C source
  Crude RR 12.95, dose-response relationship reported
• In a UK catered-event outbreak with a 58% attack rate, duck liver pate prepared the same way at the venue later tested positive for Campylobacter, pointing to inadequate preparation. — 77 attendees of one catered event, 45 cases (n = 77) Evidence C source
  Univariate RR 2.53 (95% CI 1.05 to 6.10) for duck liver pate, not retained in the multivariable model

What it does to your health

• In a crossover trial in 22 adults at high cardiovascular risk, 4 weeks of n-3 enriched reduced-fat pates and frankfurters gave 12% lower LDL cholesterol than normal-fat versions, while normal-fat products raised LDL. — 22 volunteers at increased cardiovascular risk, three 4-week periods with 4-week washouts (n = 22) Evidence C source
  LDL cholesterol 12% and oxidized LDL 15% lower after n-3 reduced-fat versus normal-fat products
• In a 28 to 30 day RCT in 36 overweight adults aged 61 to 66 on a low-calorie diet, adding a pork heart and aorta pate kept total cholesterol lower than diet alone (p = 0.018), mainly through LDL. — 36 adults aged 61 to 66, BMI 26.4 to 60.7, 28 to 30 days (n = 36) Evidence B source
  Between-group difference in total cholesterol p = 0.018 and in LDL cholesterol p = 0.005, no absolute size given in abstract
• In a non-randomized crossover trial in 18 men at high cardiovascular risk, 4 weeks of normal-fat pates and frankfurters raised LDL cholesterol, fibrinogen and insulin resistance markers, while reduced-fat versions lowered some of them. — 18 male volunteers at high cardiovascular risk, three 4-week periods (n = 18) Evidence C source
  Direction only in abstract, changes at p < 0.05

Safety, limits and interactions

• In a 2013 university outbreak in Australia, eating chicken liver pate was linked to gastroenteritis with an adjusted relative risk of 2.80, and Campylobacter was isolated from the pate. — 235 respondents at a catered college function, 56 cases (n = 235) Evidence C source
  Adjusted RR 2.80 (95% CI 1.26 to 6.19)
• UKHSA reported that in 2024 the larger Campylobacter foodborne outbreaks in England were linked to liver or products containing chicken or lamb liver such as pate or parfait. — England, national outbreak surveillance 2024, 9 outbreaks (n = 9 outbreaks) Evidence E source
  5 of 9 outbreaks likely associated with liver or liver products

Who this works differently for

• In 83,524 pregnant women in Norway, high dietary dioxin and PCB exposure was mainly explained by eating seagull eggs or pate made with fish liver and roe, and 2.3% exceeded the tolerable weekly intake. — 83,524 pregnant women, gestational weeks 17 to 22, Norway 2002 to 2009 (n = 83524) Evidence C source
  2.3% above the tolerable weekly intake of 14 pg TEQ/kg bw/week
• A 1991 UK case report linked Listeria meningitis in an immunocompromised man to pate, and a local survey found Listeria monocytogenes in 16 of 73 pate samples. — One 63-year-old man in remission from leukemia, plus 73 retail pate samples in Cardiff (n = 1 case, 73 samples) Evidence D source
  16 of 73 samples positive for Listeria monocytogenes
• CDC lists refrigerated pate or meat spreads as a riskier choice in pregnancy and shelf-stable pate in sealed containers as the safer choice. — Pregnant women Evidence E source
  Riskier: refrigerated pate. Safer: sealed airtight containers not needing refrigeration before opening
• EFSA in 2024 kept the upper limit for preformed vitamin A at 3,000 micrograms RE a day for adults, set to prevent birth defects, and it applies to pregnant and breastfeeding women too. — EU population; adults including women of child-bearing age, pregnant and lactating women Evidence E source
  UL 3000 ug RE/day for adults, from all sources including food; based on a NOAEL for teratogenicity
• EFSA advises women who are planning a pregnancy or are pregnant not to eat liver, offal or products made from them, because retinol can harm the embryo. — women planning pregnancy and pregnant women, EU Evidence E source
  General recommendation: do not consume liver, offal or products thereof (SCF 1992, 2002, maintained 2024)
• UK Government advice, as restated by the Committee on Toxicity in 2022, is that pregnant women and women thinking about having a baby should not eat liver or liver products such as pate, unless advised by a GP. — pregnant women and women planning pregnancy, UK Evidence E source
  Avoid liver, liver products such as pate, and vitamin A supplements including fish liver oil
• According to NIH, total intakes of preformed vitamin A above the upper limit can cause congenital birth defects. — women who are or might be pregnant Evidence E source
  Teratogenic above the UL
• CDC advises pregnant women, adults 65 and older and people with a weakened immune system to avoid refrigerated pâté or meat spreads and to choose pâté in sealed, airtight containers that need no refrigeration before opening. — people at higher risk of listeriosis: pregnant women, adults 65 and older, people with a weakened immune system Evidence E source
  Avoid refrigerated pate or meat spreads, choose shelf-stable pate or spreads in sealed airtight containers

The bottom line

Three outbreak investigations point the same way, and each is a single outbreak. At a 2013 college dinner in Australia with 235 respondents, chicken liver pate carried an adjusted relative risk of 2.80 (95% CI 1.26 to 6.19), and Campylobacter was isolated from pate in the kitchen. At a 2017 hotel Christmas meal in England the crude relative risk was 12.95, with more illness in those who ate more. At a UK catered event with a 58 percent attack rate, duck liver pate made the same way at the venue later tested positive. The hotel authors tie such outbreaks to liver that was cooked incorrectly, though the cooking itself was inferred and never measured. They also write that simple cooking techniques can kill all the Campylobacter, but this page holds no source for a safe cooking temperature for liver or pate, so it gives none. That is a gap, not a reassurance about home-made pate. Pregnancy brings a separate risk. CDC lists refrigerated pate and meat spreads as the riskier choice and pate in sealed containers that need no fridge before opening as the safer one, because of Listeria. That advice is about Listeria only and says nothing about the vitamin A in liver pate. For vitamin A, EFSA advises women planning a pregnancy or pregnant not to eat liver, offal or products made from them, and UK advice names liver pate directly, unless a GP advises otherwise. EFSA keeps the upper limit for preformed vitamin A at 3,000 micrograms RE a day for adults, pregnancy included, and judges that liver or offal eaten once a month or less keeps intake under it. Among 25 UK women aged 16 to 49 who ate liver, liver alone supplied about 3,500 micrograms a day on average. Listeria is not only a pregnancy question. A 1991 UK report linked Listeria meningitis in a 63-year-old man in remission from leukemia, so with weakened immunity, to pate, and a local survey that year found Listeria monocytogenes in 16 of 73 samples. In 83,524 pregnant women in Norway, high modeled dioxin and PCB intake was mainly explained by seagull eggs or pate made with fish liver and roe, and 2.3 percent went above the tolerable weekly intake. The CDC advice we hold is written for pregnancy, and we have no source here on refrigerated pate for older people or people with weakened immunity, which is a gap and not a reassurance. The enriched trials describe products built for research. In 17 iron-deficient women, 2.8 oz (80 g) of pate carrying 15 mg of added iron gave similar serum iron curves over 6 hours whichever iron form was used, and a serum curve is only a proxy for absorption. In 159 healthy adults over 7 weeks, 34 g a day of omega-3 enriched fish pate raised blood omega-3 as much as fish oil capsules at about 1 g of EPA and DHA a day, with no change in blood lipids. In 36 adults aged 61 to 66 on a low-calorie diet, a purpose-made pork heart and aorta pate with 3.8 percent fat kept total cholesterol lower than diet alone (p = 0.018) in an unblinded trial whose abstract gives no size. A US survey serving of liver pate is 85 g.

Sources

1. pate-r2-13 · food composition data
   Pate, liver (19-317): Retinol 7300 µg; Iron 5.90 mg; Fat 32.7 g; Vitamin B12 8.0 µg; Sodium 750 mg per 100 g
   CoFID 2021 (Public Health England), code 19-317 Pate, liver · checked 2026-09-29
2. pate-r2-14 · food portion data
   Liver, paste or pate (2706155): 1 cup 210 g; Quantity not specified 85 g
   USDA FNDDS 2021-2023, food code 25112200 Liver, paste or pate (FDC 2706155) · checked 2026-09-29
3. pate-vita-03 · agency risk characterization
   The Panel considers that the UL for preformed vitamin A is not expected to be exceeded in European populations if consumption of ‘liver, offal and products thereof’ is limited to once per month or less. However, a higher frequency of offal consumption, and/or the consumption of high‐dose supplements, may lead to intakes above the UL (Section 3.5.1 and Sections thereof).
   EFSA NDA Panel, Scientific opinion on the tolerable upper intake level for preformed vitamin A and beta-carotene, EFSA Journal 2024;22(6):e8814 · checked 2026-09-29
4. pate-vita-05 · exposure assessment
   Liver and liver products in the diet constitute a major source of dietary pre-formed RE. || Table 3. Chronic exposure of Vitamin A from Liver (with recipes) in women aged 16 -49 — Consumers 25 · Mean 3500 µg/person/day · 97.5th percentile 7500 µg/person/day · Mean 50 µg/kg bw/day · 97.5th percentile 97 µg/kg bw/day
   Committee on Toxicity (COT), Statement on the effects of excess Vitamin A on maternal health, 2022, para 111 and Table 3 · checked 2026-09-29
5. pate-r2-01 · randomized crossover trial
   Seventeen women with low iron stores (ferritin <30 microg/L) took part in a three-way, randomized, crossover, double-blind postprandial intervention. Test meals consisted of 80 g of the three different enriched meat pate products ... Serum iron concentration evolution during the postprandial study was similar with the three meals, and maximum concentrations were obtained between hours 2 and 4. The effect of type of fortificant was not significant.
   Nutrition, 2009 · checked 2026-09-29
6. pate-r2-02 · randomized controlled trial
   A parallel 7-week intervention trial was performed where 159 healthy men and women were randomised to consume either 34 g fish pâté (n 44), 500 ml fruit juice (n 38) or three capsules of concentrated fish oil (n 40), all contributing to a daily intake of approximately 1 g EPA and DHA. ... Compared with the control group, plasma n-3 LCPUFA and EPA:arachidonic acid ratio increased equally in all intervention groups. However, no significant changes in blood lipids and markers of inflammation and oxidative stress were observed.
   Br J Nutr, 2012 · checked 2026-09-29
7. pate-r2-07 · retrospective cohort
   Chicken liver pâté was the food item most strongly associated with illness (P < 0.001) with a corresponding high crude relative risk (12.95). This relationship was supported by multivariable analysis, sensitivity analyses and a clear dose-response relationship. ... This outbreak highlights that despite evidence that simple cooking techniques can ensure that all campylobacter are killed during cooking, outbreaks continue to occur.
   Epidemiol Infect, 2020 · checked 2026-09-29
8. pate-r2-08 · retrospective cohort
   The attack rate was 45/77 (58·4%) by clinical case definition, with four individuals confirmed to have Campylobacter. ... Samples of cooked duck liver pâté subsequently prepared using identical methods at the venue were contaminated with Campylobacter jejuni and C. coli; water sampling was negative.
   Epidemiol Infect, 2014 · checked 2026-09-29
9. pate-r2-03 · controlled crossover trial
   Twenty-two volunteers were enrolled in a sequential study of 3 consecutive 4-week periods separated by 4-week washout periods. ... LDL-cholesterol (p = 0.040) and oxidized LDL (p = 0.016) increased significantly after NF product consumption ... However, LDL-cholesterol, oxidized LDL, and the LDL-cholesterol/HDL-cholesterol ratio were lower (12, 15 and 10 %, respectively) after n-3 RF versus NF product consumption.
   Eur J Nutr, 2014 · checked 2026-09-29
10. pate-r2-04 · randomized controlled trial
    Adults (61-66 years old) with a body mass index of 26.4-60.7 kg/m2 (n = 36) were randomly divided into two groups: one group consumed a low-calorie diet (LCD), while the other consumed an LCD with the developed meat product (MP) for 28-30 days. ... The difference in total cholesterol was significantly different (p = 0.018) from that of the control group, mainly due to the difference in low-density lipoprotein cholesterol (p = 0.005).
    Int J Environ Res Public Health, 2021 · checked 2026-09-29
11. pate-r2-05 · controlled clinical trial
    Eighteen male volunteers enrolled in a blind crossover-controlled study consumed improved products during three 4-week periods: reduced fat (RF), n-3-enriched-RF (n-3RF), and normal fat (NF), separated by 4-week washouts. ... while LDL-cholesterol, fibrinogen, TXB2, insulin, and Homostatic Model Assessment-insulin resistance (HOMA-IR) increased (at least p < 0.05) and QUICKI (Quantitative Insulin Sensitivity Check Index) decreased (p < 0.05) during the NF period.
    J Am Coll Nutr, 2019 · checked 2026-09-29
12. pate-r2-06 · retrospective cohort
    Univariate analysis showed a significant association with a chicken liver pâté entrée [relative risk (RR) 3·64, 95% confidence interval (CI) 2·03-6·52, P < 0·001], which retained significance after adjustment for confounding via multivariable analysis (adjusted RR 2·80, 95% CI 1·26-6·19, P = 0·01). C. jejuni and C. coli were also isolated in chicken liver pâté recovered from the college's kitchen.
    Epidemiol Infect, 2016 · checked 2026-09-29
13. pate-r2-12 · surveillance report
    The larger outbreaks were associated with consumption of liver or products containing chicken or lamb liver such as a pâté or parfait.
    UK Health Security Agency, Campylobacter data 2015 to 2024 · checked 2026-09-29
14. pate-r2-09 · cohort
    Moreover, 2.3% of the participants had intakes exceeding the tolerable weekly intake (TWI) of 14pg TEQ/kg bw/week. ... A high dietary exposure to PCB-153 or dl-compounds (TEQ) was mainly explained by the consumption of seagull eggs and/or pate with fish liver and roe.
    Environ Int, 2013 · checked 2026-09-29
15. pate-r2-10 · case report
    He had, however, recently eaten paté produced in Belgium. This was no longer available for examination but a coincidental survey of paté in the Cardiff area found Listeria monocytogenes in 16 out of 73 samples.
    J Clin Pathol, 1991 · checked 2026-09-29
16. pate-r2-11 · agency advice
    Pâté or meat spreads in sealed, airtight containers that don't need to be kept refrigerated before opening
    CDC, Safer Food Choices for Pregnant Women, 2026 · checked 2026-09-29
17. pate-vita-01 · agency risk assessment (UL)
    The Panel proposes to retain the UL of 3000 μg RE/day for adults, based on a NOAEL for teratogenicity (Section 3.7.1.1). This UL applies to men and women, including women of child‐bearing age, pregnant and lactating women, and post‐menopausal women.
    EFSA NDA Panel, Scientific opinion on the tolerable upper intake level for preformed vitamin A and beta-carotene, EFSA Journal 2024;22(6):e8814 · checked 2026-09-29
18. pate-vita-02 · agency recommendation
    Since both acute and chronic intakes of preformed vitamin A and the timing of consumption by pregnant women (i.e. during embryogenesis) may be critical for teratogenicity (Section 3.6.1), the Panel maintains the general recommendation for women who are planning to become pregnant or who are pregnant not to consume liver, offal or products thereof (SCF, 1992, 2002).
    EFSA NDA Panel, Scientific opinion on the tolerable upper intake level for preformed vitamin A and beta-carotene, EFSA Journal 2024;22(6):e8814 · checked 2026-09-29
19. pate-vita-04 · agency statement
    UK Government dietary advice, as given on the NHS website, recommends that pregnant women, or women thinking about having a baby, should not consume liver or liver products such as pate, or supplements that contain vitamin A, including fish liver oil, unless advised by a GP, to avoid potential harm to the unborn child.
    Committee on Toxicity (COT), Statement on the effects of excess Vitamin A on maternal health, 2022, para 6 · checked 2026-09-29
20. pate-vita-06 · agency fact sheet
    Total intakes of preformed vitamin A that exceed the UL as well as some retinoid medications used as topical therapies (such as isotretinoin, used to treat severe acne, and etretinate, a treatment for severe psoriasis) can cause congenital birth defects [1].
    NIH Office of Dietary Supplements, Vitamin A and Carotenoids Fact Sheet for Health Professionals · checked 2026-09-29
21. sf-lis-r1-2 · agency advice
    You may be at higher risk if you are in one of the following groups: Women who are pregnant ... People who are 65 years or older ... People who have a weakened immune system ... Refrigerated pâté or meat spreads ... Pâté or meat spreads in sealed, airtight containers that don't need to be kept refrigerated before opening
    US CDC, Preventing Listeria Infection · checked 2026-10-08