Source:Bateman B, Warner JO, Hutchinson E, et al. The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children.
Arch Dis Child.
2004
;
89
:
506
–511.

Researchers in the United Kingdom’s University of Southampton and Isle of Wight’s St. Mary’s Hospital performed a population-based study to test the hypothesis that food additives have a pharmacological effect on behavior in 3-year-old children. Two hundred seventy-seven children, in their fourth year of life, were screened for hyperactivity (HA) and atopy (AT), forming the following groups: HA/AT (n=36); not-HA/AT (n=75); HA/not-AT (n=79); not-HA/not-AT (n=87). Hyperactivity was initially assessed using the EAS (Emotionality, Activity and Socialization) and the WWP (Weiss-Werry-Peters) activity scales and atopy was determined by skin prick testing. After baseline assessment, children were placed on a diet eliminating artificial colorings and benzoate preservatives for the 4 weeks of the study. During week 2 and week 4 of the study, participants received, in random order, daily challenge with a drink containing artificial colorings (20mg/day) and sodium benzoate (45mg/ day) (active period), or a placebo mixture, supplementary to their diet. There were significant reductions in hyperactive behavior during weeks in which children were on the additive- free diet alone, based on parental reports. On aggregated parental hyperactivity ratings, there were also significantly greater increases in hyperactive behavior during the active when compared to the placebo period. These effects were not influenced by the presence or absence of hyperactivity, nor by the presence or absence of atopy. However, there were no significant differences detected based on objective testing in the clinic. The authors conclude that there is a general adverse effect of artificial food coloring and benzoate preservatives on the behavior of 3-year-old children, which is detectable by parents but not by a simple clinic assessment.

The effect of food additives on hyperactive behavior in children has been controversial since it was first proposed in the 1970s.1 Although case control studies have documented hyperactivity in individual children with artificial coloring in their diets,2,3 this is the only population-based study to evaluate a potential link between hyperactivity and food additives. At least for parental ratings, the observed effect in this study is substantial. Certainly, self-selection is a concern, but it might be that the parental ratings indicate that parents are simply more sensitive to changes in the behavior of their children. The objective test is done under optimal conditions and in strict settings. Not so for the parent who observes the child when he/she is tired, stressed, hungry, etc. Furthermore, unlike the results of prior studies,4 the effect noted by the parents was not associated with the level of initial hyperactivity. In the above study, the child with more extreme hyperactivity showed changes no greater, but also no less, than other children. The same is true for degree of atopy. Perhaps the effect being observed is irritability and not hyperactivity or inattention, per se.3,...

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