Food additives and hyperactivity behaviour

It has been claimed , originally by Ben Feingold more than 30 years ago that artificial food colours and other food additives affect behaviour in children.
The principle effect of artificial food colours and other food additives is said to cause overactive, impulsive, and inattentive behaviour, i.e. hyperactivity. A pattern of behaviour that has substantial individual differences in the general population. Children who show this behaviour pattern to a large degree can be diagnosed with attention-deficit hyperactivity disorder (ADHD). A recent meta-analysis of double-blinded, placebo-controlled trials has shown a significant effect of artificial food colours and other food additives on the behaviour of children with ADHD. The possible benefit in a reduction in the level of hyperactivity of the general population by the removal of AFCA from the diet is less well established.
A community-based, double-blinded, placebo-controlled food challenge described in a paper in the Lancet tested whether the intake of artificial food colour and additives affected childhood behaviour.
In this trial 3-year-old and 8/9-year-old children were included in the study. The challenge drink contained sodium benzoate and one of two mixes (A or B) or a placebo mix.
Mix A included artificial food colouring, sunset yellow [E110], carmoisine [E122], tartrazine [E102], and ponceau 4R [E124 ] and sodium benzoate [E211].
Active mix B included artificial food colourings (sunset yellow, carmoisine, quinoline yellow [E110], and allura red AC E129j) and sodium benzoate.
The dosage for 3 year olds was equivalent to eating two 56 g bags of sweets a day, and for 8/9 years old dosage of A equivalent to 2 Bags of sweets and B 4 bags of sweets.
The main outcome measure was a global hyperactivity aggregate, based on aggregated z-scores of observed behaviours and ratings by teachers and parents, plus, for 8/9-year-old children, a computerised test of attention.
Mix A had a significant adverse effect compared with placebo in global hyperactivity aggregate for all 3-year-old children but not mix B versus placebo. 8/9-year-old children showed a significantly adverse effect when given mix A or mix B
The authors concluded that artificial colours or a sodium benzoate preservative (or both) in the diet result in increased hyperactivity in 3-year-old and 8/9-year-old children in the general population. There were significant individual differences in response to these compounds
It is important to note that sodium benzoate is an important food preservative whereas the other substances are cosmetic.
Eigenmann and Haenggeli 2007 Food colourings, preservatives and hyperactivity The Lancet vol 370, 1524-5
McCann et al (2007) Food additives and hyper active behaviour in 3 year old and 8/9 year old children in the community: a randomised double-blinded, placebo-controlled trial Lancet vol 370, 1560-67

Martin Eastwood
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