Is it true that artificial food colors can make kids hyper?

The answer is a big “maybe.” Read on:

Artificial food colors (AFCs) are used in various combinations to make food and beverages more appealing to consumers. Interest in the possible health effects of AFCs began in the 1970s with Dr. Benjamin Feingold. From observations made in his clinical practice, Dr. Feingold theorized that food additives such as AFCs caused learning disabilities and hyperactivity. He created a AFC-free diet called the Feingold Diet that quickly gained popular appeal. Although the theory was popular with parents, the National Institutes of Health in 1982 concluded that there was insufficient evidence to support it. In the years following, additional studies showed a negligible effect of artificial food colors on health.

However, in the 2000s, three British studies brought AFCs to widespread media attention again. The studies found that parents reported an increase in symptoms of Attention Deficit Hyperactivity Disorder (ADHD) associated with their children’s consumption of AFCs. These studies prompted the European Union to require food and beverage manufacturers to include warning labels stating that artificial dyes “may have an adverse effect on activity and attention in children.” As a result, many manufacturers in Britain and other parts of Europe chose to forgo use of AFCs. In the US, the Center for Science in the Public Interest petitioned the Food and Drug Administration (FDA) to review the effects of AFCs on ADHD. In response, in 2011 the FDA Food Advisory Committee held public hearings and determined that no warning labels or other methods of informing parents were needed.

But, animal studies have suggested possible mechanisms by which AFCs may cause behavioral changes. The most likely is a hypersensitivity reaction to AFCs causing the release of histamine. Also, AFCs have been shown to bind with zinc, decreasing its ability to metabolize neurotransmitters. Finally, rat studies have suggested that AFCs may be toxic, causing elevations in liver enzymes and abnormal red and white blood cells. Behaviorally, exposure to AFCs has been shown to increase motor activity, anxiety, depression, and cause memory/learning impairment (in lab animals).

There are currently nine food dyes approved for use. The FDA sets the acceptable daily intake (ADI) for each color based on toxicity studies in animals. Unfortunately, because listing the exact amount of AFCs in food and beverages is not required, and because measured levels of AFCs can very widely (one study found a range of 0.2 to 52mg AFCs per 8 oz of beverage), it is very difficult to determine exactly how much is being consumed by an average child. Studies have shown that amounts as low as 50mg result in behavior changes. Because of the abundance of processed food in the American diet, many children are likely consuming enough AFCs to cause problem behaviors.

In summary, recent studies suggest that temporary behavior changes in children may result from the consumption of large amounts of AFCs. As more research emerges, the FDA will hopefully reconsider its review of AFCs’ impact on behavior and change its stance on the labeling of manufactured food products. In the meantime, follow the advice you already know is best for your children for many reasons: avoid processed foods!

This post was written by Shan Shan Xie, 4th year Medical Student at the University of Illinois at Chicago in December, 2013. [edited by Susan Buchanan]

References
• Arnold EL. (2012) Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. Neurotherapeutics, 9:599-609.
• Kanarek RB. (2011) Artificial food dyes and attention deficit hyperactivity disorder. Nutr Rev, 69(7):385-91.
• McCann D. (2007) Food additives and hyperactive behavior in 3-year-old and 8/9-year-old children in the community: a randomized, double-blinded, placebo-controlled trial. Lancet, 370(9598):1560-7.
• Stevens LJ. (2013) Amounts of artificial food colors in commonly consumed beverages and potential behavioral implications for consumption in children. Clin Pediatr (Phila). 2014 Feb;53(2):133-40.
• Stevens LJ. (2013) Mechanisms of behavioral, atopic, and other reactions to artificial food colors in children. Nutr Rev, 71(5):268-81.

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