Mechanisms of behavioral, atopic, and other reactions to artificial food colors in children

Stevens LJ, Kuczek T, Burgess JR, Stochelski MA, Arnold LE, Galland L (2013) Nutr Rev. 2013 71(5) 268-81 doi: 10.1111/nure.12023. Epub 2013 Mar 13.

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Abstract:

This review examines the research on mechanisms by which artificial food colors (AFCs) and common foods may cause behavioral changes in children with and without attention-deficit/hyperactivity disorder (ADHD). Children with ADHD show excess inattention, impulsivity, and hyperactivity.

Studies have shown that a subgroup of children (with or without ADHD) react adversely to challenges with AFCs. Many early studies found few children who reacted to challenges with 20-40 mg of AFCs. However, studies using at least 50 mg of AFCs showed a greater percentage of children who reacted to the challenge.

Three types of potential mechanisms are explored: toxicological, antinutritional, and hypersensitivity. Suggestions for future studies in animals and/or children include dose studies as well as studies to determine the effects of AFCs on the immune system, the intestinal mucosa, and nutrient absorption.

Given the potential negative behavioral effects of AFCs, it is important to determine why some children may be more sensitive to AFCs than others and to identify the tolerable upper limits of exposure for children in general and for children at high risk.

FAB RESEARCH COMMENT:

Substantial evidence - including numerous randomised controlled trials - shows that some artifical food colourings (AFC) produce negative effects on behaviour and attention, in both ADHD and non-ADHD children.

However, the precise mechanisms behind these adverse effects remain unclear.

In this review, leading researchers in this area provide detailed coverage of several ways in which AFCs may operate to impair brain function and behaviour - and the evidence to date to support these. They include immune-mediated or toxicological reactions, interactions with digestive health and gut barrier function, and effects on nutrient absorption. These potential mechanisms are not mutually exclusive.

It is well-established that ADHD itself is not a unitary diagnosis - and individual differences with respect to the effects of food and diet on physical health, let alone behaviour, are also well known.

As the authors emphasise, more research into the effects of AFCs in both general and clinical populations is warranted, in order to better identify vulnerable individuals and sub-groups, and to help improve the evidence-base for public health policy with respect to these synthetic and non-essential food additives.

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