CENTER ON BEHAVIORAL MEDICINE
INGESTED INTOLERANCES and TOXINS
Ingested Intolerances and Toxins-Behavior: Research Article
Bateman, B., Warner, J.O., et al. (2004). 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.
Aims: To determine whether artificial food colourings and a preservative in the diet of 3 year old children in the general population influence hyperactive behaviour.
Methods: A sample of 1873 children were screened in their fourth year for the presence of hyperactivity at baseline (HA), of whom 1246 had skin prick tests to identify atopy (AT). Children were selected to form the following groups: HA/AT, not-HA/AT, HA/not-AT, and not-HA/not-AT (n = 277). After baseline assessment, children were subjected to a diet eliminating artificial colourings and benzoate preservatives for one week; in the subsequent three week within subject double blind crossover study they received, in random order, periods of dietary challenge with a drink containing artificial colourings (20 mg daily) and sodium benzoate (45 mg daily) (active period), or a placebo mixture, supplementary to their diet. Behaviour was assessed by a tester blind to dietary status and by parents’ ratings.
Results: There were significant reductions in hyperactive behaviour during the withdrawal phase. Furthermore, there were significantly greater increases in hyperactive behaviour during the active than the placebo period based on parental reports. These effects were not influenced by the presence or absence of hyperactivity, nor by the presence or absence of atopy. There were no significant differences detected based on objective testing in the clinic.
Conclusions: There is a general adverse effect of artificial food colouring and benzoate preservatives on the behaviour of 3 year old children which is detectable by parents but not by a simple clinic assessment. Subgroups are not made more vulnerable to this effect by their prior levels of hyperactivity or by atopy.
1 Feingold BF. Hyperkinesis and learning disabilities linked to artificial food flavors and colors. Am J Nurs 1975;75:797–803.
2 Levy F, Dumbrell S, Hobbes G, et al. Hyperkinesis and diet: a double blind crossover trial with tartrazine challenge. Med J Aust 1978;1:61–8.
3 Goyette CH, Conners CK, Petti TA, et al. Effects of artificial colors on hyperkinetic children: a double-blind challenge study. Psychopharmacol Bull 1978;14:39–40.
4 Harley JP, Ray RS, Tomasi L, et al. Hyperkinesis and food additives: testing the Feingold hypothesis. Pediatrics 1978;61:818–28.
5 Mattes JM, Gittelman R. Effects of artificial food colorings in children with hyperactive symptoms. Arch Gen Psychiatry 1981;38:714–18.
6 David TJ. Reactions to dietary tartrazine. Arch Dis Child 1987;62:119–22.
7 Gross MD, Tofanelli PA, Butzirus MS, et al. The effects of diets rich in and free from additives on the behaviour of children with hyperkinetic and learning disorders. J Am Acad Child Adol Psychiatry 1987;26:53–5.
8 Weiss BW, Williams JH, Margen S, et al. Behavioural responses to artificial food colors. Science 1980;207:1487–9.
9 Conners CK, Goyette CH, Southwick DA, et al. Food additives and hyperkinesis: a controlled double-blind experiment. Pediatrics 1976;58:154–66.
10 Williams JI, Cram DM, Tausig FT, et al. Relative effects of drugs and diet on hyperactive behaviours: an experimental study. Pediatrics 1978;61:811–17.
11 Harley JP, Matthews CG, Eichman P. Synthetic food colors and hyperactivity in children: a double-blind experiment. Pediatrics 1978;62:975–83.
12 Swanson JM, Kinsbourne M. Food dyes impair performance of hyperactive children on a laboratory learning task. Science 1980;207:1485–6.
13 Carter CM, Urbanowicz M, Hemsley R, et al. Effects of a few food diet in attention deficit disorder. Arch Dis Child 1993;69:564–8.
14 Rowe KS. Synthetic food colorings and ‘‘hyperactivity’’: a double blind crossover study. Aust Paediatr J 1988;24:143–7.
15 Kaplan BJ, McHicol J, Conte RA, et al. Dietary replacement in preschool-aged hyperactive boys. Pediatrics 1989;83:7–17.
16 Pollock I, Warner JO. Effect of artificial food colours on childhood behaviour. Arch Dis Child 1990;65:74–7.
17 Rowe KS, Rowe KJ. Synthetic food colouring and behavior: a dose response effect in a double-blind, placebo-controlled, repeated measures study. J Pediatr 1994;125:691–8.
18 Boris M, Mandel FS. Foods and
additives are common causes of the attention
19 Supramaniam G, Warner JO. Artificial food additive intolerance in patients with angio-oedema and urticaria. Lancet 1986;2:907–9.
20 Murdoch RD, Lessof MH, Pollock I, et al. The effects of food additives on leukocyte histamine release in normal and urticarial subjects. J R Coll Physicians Lond 1987;4:251–6.
21 Murdock RD, Plooock I, Naeem S. Tartrazine induced histamine release in vivo in normal subjects. J R Coll Physicians Lond 1987;21:257–61.
22 Buss AR, Plomin R. Temperament: early developing personality traits. Hillsdale, NJ: Erlbaum, 1984.
23 Routh D. Hyperactivity. In: Magrab P, ed. Psychological management of pediatric problems. Baltimore: University Park Press, 1978:3–8.
24 Thompson MJJ, Stevenson J, Sonuga-Barke E, et al. The mental health of preschool children and their mothers in a mixed urban/rural population: I. Prevalence and ecological factors. Br J Psychiatry 1996;168:16–20.
25 Sonuga-Barke E, Stevenson J, Thompson MJJ. Mental health of preschool children and their mothers in a mixed urban/rural population: II. Family and maternal factors and child behaviour. Br J Psychiatry 1996;168:21–5.
26 Hogg C, Rutter M, Richman N. Emotional and behavioural problems in children. In: Sclare I, ed. Child psychology portfolio. Windsor: NFER-Nelson).
27 Dreborg S, Frew A. Position paper—allergen standardization and skin-tests. Allergy 1993;(suppl 48):49–82.
28 Taylor E. Preschool behaviour observation schedule (PS-BOS). London: Dept of Child and Adolescent Psychiatry, Institute of Psychiatry, 1997.
29 Reed MA, Pien DL, Rothbart MK. Inhibitory self-control in pre-school children. Merrill Palmer Quart 1984;30:131–47.
30 Maccoby EE, Dowley EM, Hagen JW, et al. Activity level and intellectual functioning in normal preschool children. Child Dev 1965;36:761–70.
31 Swanson JM, McBurnett K, Christian DL, et al. Stimulant medications and the treatment of children with ADHD. Adv Clin Child Psychol 1995;17:265–32.
32 Connor DF, Fletcher KE, Swanson JM. A meta-analysis of clonidine for symptoms of attention-deficit hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1999;38:1551–9.
33 Schulte-Korne G, Deimel W, Gutenbrunner C, et al. The influence of an oligoantigenic diet on the behavior of children with attention-deficit hyperactivity disorders. Z Kinder Jugendpsychiatr Psychother 1996;24:176–83.
34 Boyce WT, Tschann JM, Chesney MA, et al. Dimensions of psychobiologic reactivity: cardiovascular responses to laboratory stresses in preschool children. Ann Behav Med 1995;17:315–23.
35 Taras HL, Sallis JF. Blood-pressure reactivity in young children—comparing three stressors. J Dev Behav Pediatr 1992;13:41–5.
36 Sonuga-Barke EJS, Thomson M, Stevenson J, et al. Patterns of behaviour problems among pre-school children. Psychol Med 1997;27:909–18.
37 Taylor E. Developmental neuropsychopathology of attention deficit and impulsiveness. Dev Psychopathol 1999;11:607–28.