Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for
Arnold LE, Lofthouse N, Hurt E (2012) Neurotherapeutics 9(3) 599-609. doi: 10.1007/s13311-012-0133-x.
Web URL: Read this and related articles via Pubmed here. Free full text of this article is available online
Abstract:
The effect of artificial food colors (AFCs) on child behavior has been studied for more than 35 years, with accumulating evidence from imperfect studies.This article summarizes the history of this controversial topic and testimony to the 2011 Food and Drug Administration Food Advisory Committee convened to evaluate the current status of evidence regarding attention-deficit/hyperactivity disorder (ADHD).
Features of ADHD relevant to understanding the AFC literature are explained: ADHD is a quantitative diagnosis, like hypertension, and some individuals near the threshold may be pushed over it by a small symptom increment.
The chronicity and pervasiveness make caregiver ratings the most valid measure, albeit subjective. Flaws in many studies include nonstandardized diagnosis, questionable sample selection, imperfect blinding, and nonstandardized outcome measures.
Recent data suggest a small but significant deleterious effect of AFCs on children's behavior that is not confined to those with diagnosable ADHD.
AFCs appear to be more of a public health problem than an ADHD problem. AFCs are not a major cause of ADHD per se, but seem to affect children regardless of whether or not they have ADHD, and they may have an aggregated effect on classroom climate if most children in the class suffer a small behavioral decrement with additive or synergistic effects.
Possible biological mechanisms with published evidence include the effects on nutrient levels, genetic vulnerability, and changes in electroencephalographic beta-band power.
A table clarifying the Food and Drug Administration and international naming systems for AFCs, with cross-referencing, is provided.
FAB RESEARCH COMMENT:
This article - which is open-access - is by US psychiatrist Professor Eugene Arnold, a world-leading expert on the diagnosis and management of ADHD and related conditions.His credentials in 'evidence-based medicine' are second to none - as his decades of experience in child psychiatry include a major role in the largest, longest and most comprehensive randomised controlled trial ever conducted to assess the effectiveness of treatments for ADHD (the multi-site NIMH Multimodal Treatment Study of Children with ADHD - or “the MTA” - for which he received the NIH Director’s Award).
Here, Professor Arnold provides an expert summary of:
- the now substantial and compelling evidence that artificial food colourings (AFC) have negative effects on the health and behaviour of children with or without a diagnosis of ADHD. This includes:
Rigorously conducted randomised controlled controlled trials involving children from the general population
- the reasons why this evidence has still NOT led to any meaningful changes in policy and practice to reduce the exposure of children to these non-essential additives, despite the likely public health benefits
See also:
And for more articles on this topic, see also the following lists, which are regularly updated:
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