The Adverse Effects of Food Additives on

Health: A Review of the Literature with Special

Emphasis on Childhood Hyperactivity
Tuula E. Tuormaa1

Introduction differs considerably from one country to

A food additive is any substance not com- another.32-33 However, in general terms, the
monly regarded or used as food, which is added diagnosis of hyperactivity is usually applied to
to, or used in or on, food at any stage to affect its childhood behavioural disorders with quite a
keeping quality, texture, consistency, taste, diverse symptomatology, which include;
colour, alkalinity or acidity, or to serve any other distractibility, poor tolerance to frustration,
technological function in relation to food, and temper tantrums, excitability, aggression,
includes processing aids in so far as they are difficulties with co-ordination, lability of mood,
added to or used in or on food.1,2 Food additives anxiety, impulsiveness, inattentive-ness, and
in use today can be divided roughly into three disabilities with both cognitive and learning
main types: cosmetics, preservatives and functions.32-33 In short, the diagnostic criteria of
processing aids, totalling presently about 3,794 hyperactivity seem to cover a substantial
different additives, of which over 3,640 are used proportion of children usually seen in child
purely as cosmetics, 63 as preservatives and 91 as psychiatric practice.34
processing aids.3 The growth in the use of food
additives has increased enormously in the past 30 The Diagnosis of Hyperactivity
years, totalling now over 200,000 tonnes per The short form of the Conners' Scale is the
year.45 Therefore it has been estimated that as most generally accepted index of childhood
today about 75% of the Western diet is made up hyperactivity.35 The higher the score, the more
of various processed foods, each person is now severe is considered to be the problem. By
consuming an average 8-10 lbs of food additives following the Conners' Scale criteria, especially
per year, with some possibly eating considerably tranquil children may score as low as O, whereas
more.5"7 With the great increase in the use of food the most severely hyperactive children can attain
additives, there also has emerged considerable scores as high as 40. Different commentators
scientific data linking food additive intolerance seem to have set their criteria of hyperactivity at
with various physical and mental disorders, different levels; however 15 seems to be the most
particularly with childhood hyperactivity.8"31 frequent figure. Obviously therefore the higher
the cut-off point for the diagnosis is set, the more
Childhood Hyperactivity strict also would be the criteria.33
It is clear that the definition and the diagnosis Holborow and Berry examined and compared
of Childhood Hyperactivity, which have been some of the literature on childhood hyperactivity
varyingly also labelled as Attention Deficit published from the 1970's onwards in various
Disorder, Minimal- or Cerebral Brain parts of the world.36 For example, one Australian
Dysfunction Disorder, Hyperkinesis etc., has been study of 1759 children from seven schools and
rather imprecisely defined in the medical from various socio-economic areas used the
literature.25,29,32,33 One explanation why this Conners' Scale cut-off point of 19. The results
syndrome, which will be called here by its more showed that 9% of the boys and 2.4% of the girls
popular name, hyperactivity, seems to be so scored above 19, while 18% of the boys and 5%
poorly understood may stem from the fact that its of the girls had a scored above 15.36 One New
diagnostic criteria Zealand study used a more random sample of
children and a relatively high cutoff point of 21.
1.Fillebrook, 12,Pixham Lane, Dorking, Surrey RH4 The final evaluation indi-
1PT.

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Journal of Orthomolecular Medicine Vol. 9, No. 4, 1994

cated that 22% of the boys and 9% of the girls hyperactives.32,44 For example, a research database
reached scores 15 or higher, while 5% of the boys on 357 hyperactive children, based at Surrey
and 4% of the girls scored 21 or above.37 An University, showed that 82% of them were
American study, which used a cut-off point of 15, already extremely restless as an infant, 61 %
reported that 9% of their sample of boys and 2% suffered from poor and irregular sleep patterns,
of the girls exceeded this limit.38 A German study, 75% displayed excessive crying or screaming,
which drew one of the largest samples of 5,357 52% rejected any contact or affection, 50% were
children, used a cut-off point of 18. The final poor feeders, 74% seemed to have an exaggerated
evaluation showed that 12% of the boys and 5% thirst and 67% suffered from colic.45
of the girls scored 15 or more.39 Some British Hyperactive toddlers, on the other hand, are
statistics were obtained from 711 children, drawn described as children who never walk but run, are
from carefully balanced social groups. The final incapable of playing with any object for more
results indicated that 14.6% of the boys and 5.5% than few seconds, and who combine unnaturally
of the girls scored 15 or more, while 9.3% of the impulsive behaviour with a complete lack of any
boys and 2.6% of the girls had scored 18 or apprehension or fear.32 When at school, these
above.40 children are usually extremely restless,
Using different diagnostic criteria, the term of inattentive, distractable and frequently display
hyperactivity was applied only to 0.08% of aggressive and anti-social tendencies.32-45 Prima-
children on the Isle of Wight.41 Whereas, in sharp rily because of these behavioural problems, their
contrast, one American study representing over academic school performance is generally poor
5000 children from San Francisco district and failed school grades are not uncommon. In
concluded that "The maximum prevalence rate of fact follow-up studies of young adolescents
hyperactivity in an elementary school population, diagnosed as hyperactives when children have
when all possible methods of identifying shown, when compared to controls, a significantly
hyperactivity are considered, and each child is higher drop-out and expulsion rate from
represented only once in the estimate, is about 12- schools,4649 a greater involvement in both drug
14%".42 Another American study of 500 children and alcohol abuse,4851 a higher rate of motor
found 20% hyperactivity among 6-9 years olds.43 vehicle accidents,48 a greater risk of developing
After carefully examining the extent of criminal tendencies, as well as appearing before
diagnostic variations between studies on courts.48,49,52
childhood hyperactivity from the different parts of For example one follow up study on 64
the world, Holborow and Berry concluded that if adolescents diagnosed hyperactive when children,
the diagnostic criteria for this disorder could be showed that when they reached ages 17 to 25
standardized, the incidence of hyperactivity years, 25% of them were still engaged in
among boys in the U.K. would be approximately antisocial and delinquent behaviour.53,54 Similar
9.3%, in Australia and in the U.S.A. 9%, in findings have also been observed by other
Germany 6% and in New Zealand in the region of investigators.55-56 In short, the prognosis of
5%.36 Their findings seem to confirm earlier sug- hyperactive children, when they mature into
gestions that the apparent discrepancies in the adulthood, seems to be relatively poor. Despite an
prevalence of childhood hyperactivity in world- apparent decrease in the ratings of hyperactivity
wide medical literature seem to stem primarily over the years, as adolescents and adults they still
from the lack of uniform diagnostic criteria.33,42 seem to continue to use impulsive rather than
reflective approaches to cognitive tasks, are still
Hyperactivity from Infancy to Adulthood distractable, generally emotionally immature,
Retrospective studies have shown that children have a poor self-image and are frequently unable
diagnosed as hyperactive as an infant had suffered to maintain goals.52-57
considerably more from varied health/behavioural
problems than non- The Aetiology of Hyperactivity
Many causal hypotheses for childhood
hyperactivity have been entertained in both

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 The Adverse Effects of Food Additives on Health

medical and psychiatric literature including; Using clinical observations and parental
genetic factors,58-61 implications of central testimony Dr Feingold found that approxi-
nervous system dysfunction,6264 improper mately in 30-50% of hyperactive children, the
embryological development or subtle adverse behaviour pattern displayed could simply
65
chromosomal irregularities, birth com- be a direct manifestation of an elevated sensitivity
plications,66 interactions between child-rearing to certain low molecular weight compounds, such
factors and biological disposition.67 as synthetic food additives as well as to foods
During the years there also has accumulated containing natural salicylates. He observed further
increasing scientific data on various toxicological that the children, whose hyperactive behaviour
and environmental factors that can have a clear was a direct manifestation of this elevated sensi-
potential in either causing an infant to be born tivity, can be treated effectively by simply
hyperactive or, alternatively, having a serious removing from their diet all foods containing
adverse effect on children diagnosed as artificial food additives as well as foods
hyperactive. These include an excessive maternal containing natural salicylates.13
pre-natal alcohol and/or tobacco consumption,47- Using a similar dietary regimen, he also
6871
toxicological environmental factors, such as claimed success in helping children suffering
sub-clinical lead contamination,47,72-78 food from a variety of learning disabilities.10
allergies26'32-7985 and, as previously stated, the As previously mentioned, Feingold's claims
consumption of artificial food additives.8-13,83-85 originated primarily from anecdotal reports;
however, there have been since several
The Feingold Hypothesis subsequent scientific evaluations to test his
Dr Benjamin F. Feingold, M.D., Chief hypothesis, some supportive,1422 some
86-90
Emeritus, Allergy Department, Kaiser unsupportive and some finding only a very
Permanente Hospital, San Francisco, and his limited support i.e. that only the very youngest of
team, when working under a National Institute of the children responded.20,90-92
Health grant, discovered in 1964 that low It has been speculated, however, that this wide
molecular weight compounds, like artificial food discrepancy between different observations may
dyes, can produce behavioural disorders in have been due to the differentiation between the
susceptible individuals.8-13,83-85 levels of food colours used in the test
After collecting evidence based on over 1,200 conditions.19-25 This may have been indeed the
cases, they found that hyperactivity, including case.
other neurophysiological disturbances, can be For example, both Conners90 and Harley92
induced in some children when they consume employed in their challenge procedure 26mg
certain chemicals such as food additives, as well artificial food colours daily, Weiss used 35mg,20
as some naturally occurring salicylates. He and a study by Swanson, which incidentally found
arrived at this conclusion by observing that a clear supportive evidence to Feingold's
certain children, who seem to react hypothesis, used a daily challenge dose of 100-
neurophysiologically to aspirin, reacted also in a 150mg.19 In fact it has been found that this
similar manner to natural foods containing highest daily challenge dose of 100-150mg of
salicylates. food additives is the most realistic amount to be
This led him to study further the effect of other employed in any test procedure.
low molecular compounds, such as artificial food This became apparent when the Food and Drug
additives, on childrens' health and behaviour, Administration studied 5,000 randomly selected
finding similar results. He also observed that as children between ages 5-12, determined that the
the affected individuals seem to react negatively 90th percentile for daily consumption of artificial
to allergy skin tests, the reaction involved could food dyes within this age group was 150mg. For
not be based on an allergic/immunological the population as a whole the FDA found an
mechanism, but rather on some pharmacological/ average daily mean to be 57.5mg, while the 90th
toxic mechanism.13 percentile range was between 100-300mg per
day.28-93

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Journal of Orthomolecular Medicine Vol. 9, No. 4, 1994

Some Food Additives and Their individual drinking only a few bottles of soft
Side-Effects drinks per day.96
Another carefully conducted double-blind
Cosmetics; Dyes/Colourants placebo- controlled trial on 76 children diagnosed
Tartrazine (E102), which is primarily used by as hyperactive, showed that tartrazine and
the soft drink industry, is one of the colours most benzoates provoked abnormal behaviour patterns
frequently implicated in food intolerance in 79% of them.29 In addition, a double-blind
studies.2,5,16,31,33,48,94-102 Adverse reactions to placebo-controlled trial on 10 hyperactive
tartrazine seem to occur most commonly in children when compared to controls, found that
subjects who are also sensitive to acetylsalicylic tartrazine increases urinary zinc secretion, and
acid (ASA), a finding which was also observed by decreases serum and salivary zinc concentration
Feingold and his team. Depending on the test in the hyperactives, with a corresponding deterio-
protocol followed, it has been found that between ration in their behaviour. This phenomena was not
10-40% of aspirin-sensitive patients are indeed found among the controls.
usually also affected by tartrazine,101 the reactions It was suggested therefore that tartrazine seems
including asthma,2,95,101-104 urticaria,2,99,101-105 to act as a zinc chelating agent in susceptible
rhinitis102-104 and, as previously mentioned, individuals. Furthermore, that zinc depletion may
childhood hyperactivity.9-13 also be one of the potential causes of childhood
This may come about because the chemical hyperactivity.100
structure of the tartrazine molecule has similar Although tartrazine seems to be most fre-
features to those of benzoates, other azo quently associated with adverse reactions,115 there
compounds, pyrazole compounds and the are also other colouring agents which are known
hydroxy-aromatic acids, which also include to cause mental and/or physical ill-effects.33,116
salicylates.2 Furthermore, it has been established Curcumin (E100), used mainly in flour
that the azo compounds can be reduced in the confectionery and margarine, has been found to
intestine and in the liver,106,107 indicating that one cause mutations in bacteria and when fed to pigs,
of the several routes through which these it increased the weight of their thyroid glands
molecules, too small to be antigenic in causing, in high doses, severe thyroid damage.533
themselves, may act as a hapten, thus conjugating Sunset Yellow (E110), used in biscuits, has
a larger molecule to form an antigenic been found to damage kidneys and adrenals when
compound.2,108,109 fed to laboratory rats.33 It has also been found to
A major breakthrough in the understanding of be carcinogenic when fed to animals.5
the mechanisms involved in ASA intolerance Carmoisine (El22), used mainly in jams and
came also with discovery that aspirin, including preserves, was found by the US Certified Color
other non-steroidal antiinflammatory drugs, Manufacturers Association to be unavoidably
inhibit the synthesis of prostaglandins, by contaminated with low levels of beta-
selectively blocking the cyclo-oxinase pathway, napthylamine, which is a well known
resulting in an enhanced production of carcinogen;33 it has also been found to be
leucotrienes.110-112 An excessive leucotriene mutagenic in animal studies.5
production in turn leads to vascular permeability, Amaranth (El23) has been found, when fed to
causing oedema and inflammation, which is laboratory rats, to cause cancer, birth defects, still
directly associated with various airway births, sterility and early foetal deaths.
constriction disorders, including asthma.2,113,114 Subsequent work has also found that amaranth
One study found that an oral administration of can cause female rodents to reabsorb some of
50mg tartrazine to 122 patients suffering from their own foetuses.5-33
allergy-related disorders, evoked the following Ponceau 4R (El24), used mainly in dessert
reactions; feeling of suffocation, weakness, heat mixes, has been found to exhibit a weak
sensation, palpitations, blurred vision, carcinogenic action.533
rhinorrhoea, pruritus and urticaria. Even though Erythrosine (E127), used in candied cherries
50mg could be considered as a substantial dose, and childrens' sweets, has been found to
such a quantity of tartrazine could easily be
consumed by an

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 The Adverse Effects of Food Additives on Health

act as a potent neurocompetitive dopamine Sulphites (E220-E227), used mainly in dried

inhibitor of dopamine uptake by nerve endings fruits, fruit juices and syrups, fruit-based dairy
when exposed in vitro on a rat brain.117 Other deserts, biscuit doughs, cider, beer and wine, have
studies have shown that erythrosine can have an been linked with pruritus, urticaria, angioedema
inhibitory action also on other neurotransmitters, and asth-ma.2,31,33,124,125 When fed to animals,
resulting in an increased concentration of sulphites have also been found to have a
neurotransmitters near the receptors, thus mutagenic action.5
functionally augmenting the synaptic Nitrates and nitrites (E249-E252), used in
118120
neurotransmission. bacon, ham, cured meats, corned beef and some
There is now some evidence that a reduced cheeses, have been found to cause headaches in
dopamine turnover may lead to childhood susceptible individuals.125 In addition, these
hyperactivity.121 Similar findings have been chemicals have been linked with cancer both in
linked with a reduction of noradrenaline.122 animal533 and human studies.126 They have also
Erythrosine also has been found to have a been found to be mutagenic when fed to
possible carcinogenic action when tested on mammals.5
animals.5 Butylated hydroxyanisole - BHA (E320),
Caramels (E150), of which over 100 different used in soup mixes and cheese spread, has been
formulations are currently in use, are widely used found to be tumour-producing when fed to rats.127
by the cola drinks industry, as well as the beer In human studies it has been linked with urticaria,
and alcohol industry. It is also used as a colouring angioedema and asthma.233-128-129
agent in crisps, bread, sauces, gravy browning etc. Monosodium glutamate (MSG), a flavour
The main recurring problem about the safety of enhancer, used in savoury foods, snacks, soups,
caramels concerns the presence of an impurity sauces and meat products, has been associated
called 4-Methylimidazole, produced by processes with a conjunction of symptoms in susceptible
using ammonia, which leads to convulsions when individuals, such as severe chest and/or facial
fed to rats, mice and chicks. It has been also pressure and overall burning sensations, not
found that ammoniated caramels can affect unlike a feeling that the victim is experiencing a
adversely the levels of white blood cells and heart attack.48
lymphocites in laboratory animals. Furthermore, a MSG has been also found to precipitate a
study on rabbits provided evidence that even severe headache and/or asthma in susceptible
small doses of ammoniated caramels seem to individuals.130,131 In susceptible children MSG has
inhibit the absorption of vitamin B6.33 been linked with epilepsy-type "shudder"
Brown FK is mainly used as a colouring agent attacks.132 In animal studies it has been found to
in fish, such as kippers. Two of the primary damage the brains of young rodents.48
metabolites of this colouring have been found to
act as a cardiotoxin. It has been also observed, Sweeteners
when fed in the long term to mice, to cause Saccharin, used as sweetening tablets and
potentially hazardous nodules to form in the liver. widely used by the soft drink and sweet food
Furthermore it has been found to cause mutations industry, has been shown to produce cancer when
in some bacteria, implying that it may also act as tested on animals.68,133-135 Saccharin has also been
a mutagenic and/or carcinogenic agent in hu- found to be mutagenic68,136,137 and growth
mans.5,33 inhibiting,'38 as well causing congenital
malformations in animal studies.139
Preservatives/Antioxidants The fact that any substance which has been
Benzoates (E210-E219), used mainly in found to be carcinogenic also seems to have a
marinated fish, fruit- based fillings, jam, salad mutagenic action, was established by testing 300
cream, soft drinks and beer, have been found to different carcinogenic chemicals for
provoke urticaria, angioedema and asthma.2-33123 mutagenicity. The results showed that of the 300
Furthermore, they have also been directly linked carcinogenic chemicals tested,
with childhood hyperactivity.29

229
Journal of Orthomolecular Medicine Vol. 9, No. 4, 1994

90% were also found to have a mutagenic length of the pre- and post-intervention period
action.140 lasted for three months each.158
Aspartame, of which the key ingredient is the Similar findings were observed when the
amino acid phenylalanine, is also widely used by behaviour of 2005 incarcerated offenders was
the soft drink and sweet food industry. When fed analyzed for 24 months. In the second half of the
to rats, aspartame was found to double the level of experiment i.e. after 12 months of the initial
phenylalanine in their brains, which re-doubled observation period, the offenders were no longer
when other carbohydrates were consumed at the allowed foods/drinks containing sucrose or
same time. This combination was found to give a artificial additives; instead they were offered nuts,
great rise in brain tyrosine, followed by a fruit, and fruit juices. After implementing the
considerable reduction in brain tryptophan low-sugar diet policy the incidence of rule
levels.141,142 Low tryptophan levels have been violations fell 21%, assaults and fights 25% and
directly linked with both aggressive and violent general disruptions 42%.159
behaviour.143-149 The consumption of sucrose/additive-rich
Furthermore, as dietary tryptophan acts as a foods was not only seen to worsen the behaviour
precursor for serotonin (5-hydroxy-trytamine, of young offenders, but when given to children
5HT), reduced tryptophan levels will also result in diagnosed as hyperactive, these foods seemed
a reduction of brain serotonin levels, which has greatly to increase their restless and destructive
been directly linked with both hyperactive and behaviour.160161
aggressive behaviour.150155 Similar results were established among a group
Sucrose/table sugar, which is a simple of normal pre-school children, as sucrose was
molecular substance artificially refined from found significantly to correlate with their
complex carbohydrates, thus called a refined "inappropriate behaviour" pattern.162
carbohydrate, can be found in most of our foods. An excessive refined carbohydrate con-
An excessive refined carbohydrate consumption sumption can also lead in susceptible individuals
has been directly associated with a high incidence to a disordered carbohydrate metabolism,
of both criminal and antisocial behaviour.28-47 especially to reactive hypogly-caemia,163,164 which
Schoenthaler and his team conducted several in turn has been found to be particularly prevalent
double- blind, design-over studies among among violent offenders.28,164-176 Reactive
thousands of incarcerated juvenile offenders, hypoglycemia has also been associated with
finding a clear correlation between high diverse personality and psychiatric disorders, such
sucrose/junk food intake and the incidence of as neuroses, panic attacks, agoraphobia and
antisocial behaviour. In all studies the primary schizophrenic episodes.177
dietary revision to reduce sugar consumption was
organised by simply replacing sugary drinks and Allergy or Intolerance?
junk food snacks with fruit juices and nutritious Allergic intolerance in susceptible individuals
snacks, such as nuts and fresh fruits. can be caused by a variety of substances.
After implementing this simple dietary policy However, in the majority of cases, cross-
with 276 incarcerated offenders, informal sensitivity and the possibility that several
disciplinary actions were lowered 48%, when nutritionally related factors are working together,
contrasting the twelve months before, and after should not be overlooked.
nutritional revision. Assault and battery was The most convincing evidence that this is
lowered 82%, theft 77%, horseplay 65% and indeed so, comes from a well conducted double-
refusal-to-obey-an-order 55%.156,157 blind, placebo-controlled crossover trial by Dr
When similar diet policy was designed for 1382 Egger and his team when studying 76 hyperactive
offenders confined in three different juvenile children to find out whether diet can contribute to
institutions, there was a clear 25% reduction in behavioural disorders. The results showed that
rule violations. All 1382 juveniles served as their 79% of the children tested reacted adversely to
own controls and the artificial food colorants and preservatives, pri-
marily to tartrazine and benzoic acid. These

230
 The Adverse Effects of Food Additives on Health

producing a marked deterioration in their Who are Affected?

behaviour. Young children seem to serve always as the
However, no child reacted to them alone. In first sentinels of any environmental con-
fact, 48 different foods were found to produce tamination, because of their immaturity of
symptoms among the group of children tested. enzymatic detoxifying mechanism, incomplete
For example; 64% reacted to cow's milk, 59% to function of excretory organs, low levels of plasma
chocolate, 49% to wheat, 45% to oranges, 39% to protein capable of binding toxic chemicals and
hens' eggs, 32% to peanuts, and 16% to sugar. incomplete development of physiological barriers
Interestingly enough, it was not only that the such as the blood-brain barrier.180 The young,
childrens' behaviour improved after the individual developing nervous system seems to be
dietary modification. Most of the associated particularly vulnerable. For example, results of
symptoms also improved considerably, such as some research studies, which incidentally were
headaches, fits, abdominal discomfort, chronic rather critical of Feingold's claims, found that
rhinitis, aches in limbs, skin rashes and mouth only the very youngest of the children tested
ulcers.29 reacted adversely to artificial food additives.20-87-
90 92
Another similar double-blind controlled food "
trial by Dr Egger and his team was conducted on It should be stressed however that the period of
88 children suffering from frequent migraines. As organ formation and development stretches long
before, most children reacted to several beyond the moment of birth. The Fetal Alcohol
foods/chemicals. However, the following Syndrome is a useful example, which arises with
foods/chemicals were found to be most prevalent: fetal exposure to neurotoxic agents such as
cow's milk provoked symptoms in 27 children, alcohol.68-70
egg in 24, chocolate in 22, both orange and wheat Similar adverse effects have been attached to
in 21, benzoic acid in 14 and tartrazine in 12. maternal smoking,68,69,71 to lead contami-
Yet again, interestingly enough, after dietary nation68,69,75-78 and now, more recently, to food
modification, not only migraine improved but additives.48,68,,69,180 Using animal experiments, it
also associated symptoms such as abdominal has been found that the fetus may be more
pain, aches in limbs, fits, rhinitis, recurrent mouth susceptible to tumour development than an adult
ulcers, asthma, eczema, as well as various animal.
behavioural disorders.178 Evidence is also accumulating that non-
These two studies are a prime example of how carcinogenic substances may cause a variety of
problems created by adverse dietary factors are biochemical changes, including alterations in the
typically polysymptomatic and multisystem in fetal enzyme development at levels at which the
type. Furthermore, that in order to create reaction mother is asymptomatic.180
in susceptible individuals, probably a whole range One class of compounds dangerous to the fetus,
of mechanisms co-exist. often in very low concentration, are the mutagens,
It has been already established that a reaction which are able to react with and injure
to low molecular compounds, such as artificial chromosomes and genes carrying the genetic
food additives do not appear to be immunological code. Furthermore, it has been found that
but rather pharmacological or toxic in type. Also mutagens not only cause mutations but are also
it has been suggested that low molecular capable of damaging and killing living cells, thus
compounds, such as food additives, may simply inflicting the greatest damage very early in
act as haptens and, after attaching themselves to pregnancy or during the weeks before
macromol-ecules, can become antigenic, thus conception.68
producing an allergenic reaction in susceptible in- Mutagens are reported to differ from other
dividuals.109,179 Even Feingold was careful not to poisons in that the human or animal body does
talk about allergy in its true sense in connection not seem to have a metabolic space within which
with food additives, but rather preferred the term they could be metabolized and rendered harmless
"elevated sensitivity". i.e. there appears to be no satisfactory evidence of
'no effect' doses or 'threshold doses' at which they
would not inflict genetic chromosomal damage.68

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Journal of Orthomolecular Medicine Vol. 9, No. 4, 1994

The mutagenicity of mutagenic substances varies Nutritional and Toxic Chemical Influences on
widely, depending on the dose consumed. As Behaviour
previously mentioned, most substances which Dietary and toxicological factors in behavioural
have been found to be mutagenic, also seem to disorders have been sadly neglected by
have a carcinogenic action.140 Out of the food mainstream psychiatry, even though it is known
additives mentioned in this paper, the following that brain function itself involves subtle chemical
have been found in animal studies to have either and electrical processes, which can be easily
mutagenic or carcinogenic action: curcumin altered and modified with the use of various
(E100),carmoisine(E122), amaranth (E123), psychoactive drugs. Therefore it is difficult to
ponceau 4R (E124), erythrosine (E127), brown comprehend why the role of nutritional influences
FK, sulphites (E210-E219), nitrates and nitrites on behaviour has been completely ignored, even
(E249-E252), butylated hydroxy-anisole (E320) though the precursors of neurotransmitter
and saccharin. Furthermore, the following food molecules, essential for the brain function, are
additives have been found to be teratogenic when only found in foods. Furthermore, that they cannot
tested on animals: amaranth, butylated be synthesized nor stored by the brain, unless
hydroxyanisole, mono-sodium glutamate, introduced by appropriate dietary substances.
saccharin and aspartame.5 However, it has been When the availability of these dietary pre-
argued that these toxicological food additive tests cursors are reduced, the neurotransmitter
on animals for the assessment for human safety synthesis will become impaired, with the
levels are really a waste of time. First of all, consequent changes in both thinking process and
experiments on animals are conducted on healthy behaviour. When this happens, learning and
species fed on a nutritious diet, not on the memory tasks may become impaired or disturbed,
malnourished, elderly or sick. Secondly, only one intellectual development inhibited and overt
agent is tested at a time, whereas humans are behaviours disordered, depending upon which
known to consume an elaborate cocktail of 12 to dietary precursor is deficient or missing. In
60 different additives in the course of the single addition, various neurotoxins such as alcohol,
meal.5 This may also be a reason why we still heroin, LSD, nicotine, lead, organic solvents,
remain ignorant of the number of people really individual food intolerances and some food
affected by the consumption of food additives. additives can modify neurotransmitter release,
An EEC report, published in 1982, estimated resulting in subtle or exaggerated behavioural
that 0.03- 0.15 per cent of the population may changes.47'142-204-205
react adversely to food additives and 0.01-0.1 per
cent may be intolerant to tartrazine.181 A later Food Additives and Malnutrition
report by MAFF in 1991 suggested an estimated Another form of risk posed by additives is the
figure may be one person in 10,000.182 loss of the nutritional value of the food, which can
On the other hand, other surveys on food result in inappropriate diets and subclinical
intolerance per se have shown that as many as 2 in malnutrition. The wide use of food additives can
10 people believe that they react badly to certain contribute to malnutrition in the following ways;
foods or to their constituents, whereas less than 2 The common factor in most foods containing
in every 100 has been considered to be the official additives is high salt, sucrose and fat content.
figure. This finding is based on the fact that only Pure sucrose, by definition, contains literally no
the latter statistical results can be measured using nutrients, only calories; fat, on the other hand,
presently acceptable diagnostic techniques. 183 contains few nutrients and is very high in calories.
However, a recently published report indicates In addition, foods containing additives are mainly
that small children are much more likely to react processed foods, which have lost a substantial
to certain foods. Although the exact numbers are proportion of their nutritional value through the
not known, surveys suggest that one child in 10 processing procedure.
may be affected in some way.184 Even though some vitamins and/or minerals are
sometimes added to some foods after

232
 The Adverse Effects of Food Additives on Health

processing, the ratio of essential nutrients to antisocial and behavioural consequences.28,164-177

calories is usually still quite inadequate, resulting Also, the diets on which the schoolchildren
in a high calorie, but a low nutritional, intake. existed seem to be so low in essential nutrients,
This type of diet, because of the high calorie and vitamins and minerals that it may not be
low nutritional content, can result in less than inappropriate to suggest that most of these
optimum nutrition and therefore subclinical and/or children were also suffering from a sub-clinical
marginal malnutrition. malnutrition, which in turn has been directly
linked with behavioural disorders and scholastic
What Are Our Children Eating? failures, as well as with antisocial and criminal
A recent study examined the nutritional status behav-iour.47,194-201
of 65 inner city school children. The results Another dietary survey among 836 school-
showed that 63% of the children obtained more children found that, although the proportion of
than 35% of their calorie intake from foods as fat 11-16 year old children having breakfast had
and 88% of the children consumed more than marginally risen, 5% still leave home without
11% of their calories from added sucrose. A third having anything to eat or drink. Also the tendency
of the children had nothing to eat for breakfast to snack on crisps, sweets, chocolate and fizzy
before going to school and the remainder drinks was high and many children were found to
consumed only confectionery and/or crisps. 40% buy these food-snacks and drinks on the way to
of the girls and 34% of the boys ate no fresh fruit school, during the mid-morning break and on the
during the week they kept the diary. way home.202
For the majority of children the mean intake of
essential nutrients such as calcium, magnesium, Subclinical Malnutrition in
iron, zinc, vitamin A, riboflavin and folate wereReproduction
found to be considerably below the lower Inefficient diet not only affects the brain and
reference nutrient intake (LRNI). behaviour of an individual, it also has serious
Both for the boys and for the girls the top foods
long-term consequences on reproduction and on
in order of priority were chips and/or crisps, white
the future infant's health, as a good maternal diet
bread, confectionery, meat, biscuits, cakes, bunsis of paramount importance in relation to a
and soft drinks.185 Even though the amount of healthy fetal development and to a successful
pregnancy outcome.68,'69,203,204 For example folic
additives per food item may be insignificant, it is
frightening to speculate the amount of food acid deficiency has been directly linked with
additives a child on the above diet will consume spina bifida.205,206
during his/her school life. Zinc in turn is involved in the process of cell
In addition, iron deficiency is directly differentation and replication, therefore zinc
associated with attention deficit disorders, deficiency can lead to diverse teratogenic
irritability and with poor scholastic achieve- congenital malformations,207-208 and premature
ment;186,188 zinc deficiency with irritable, tearful,
delivery,209 as well as small for gestational age
sullen, and possibly also babies.210 The adverse effects of a reduced state of
hyperactive
100,189
behaviour; calcium deficiency with anxiety
other single essential nutrient compounds on
neurosis;47 and magnesium deficiency with reproduction have also been well documented.69-
2
fidgeting, anxious restlessness, as well as with "
learning disabilities.190 Furthermore, the lack of anSubclinical maternal malnutrition has also been
adequate high protein breakfast in schoolchildrenfrequently associated with low birth weight
has been linked with a poor academic infants,68,679,203,204 which in turn appears to have a
performance.191-193 clear negative effect on the infant's future health
.212 It has been found that infants born with low
Finally, an excessive sucrose-rich food birth weight are more prone in adult life to suffer
consumption, without the presence of an adequate from cardiovascular diseases,213 have a high
amount of protein, can lead to serum cholesterol concentration,214 as well as suf-
reactive hypoglycaemia, with its most disturbing

233
Journal of Orthomolecular Medicine Vol. 9, No. 4, 1994

fer from hypertension, hyperlipidaemia and aspartame and saccharin.

diabetes mellitus.215 Now one could argue about what harm a
Subclinical maternal malnutrition can also lead minute amount of any food additive mentioned
to reduction of fetal brain development and above could do, especially when their mutagenic
subsequently to various intellectual deficits. The and teratogenic action is practically insignificant.
brain develops much more rapidly than most The answer is that none of the food additives
other organs in the embryo. In fact by about the would certainly do any harm by themselves.
20th week of pregnancy it already contains most However, unfortunately they are never by
of the neurons present in the adult brain, themselves but in many combinations, and it is
excluding the cerebellum which is initially slower the total cumulative xenobiotic burden of which
to develop but quicker to mature. By mid- one should be wary.68
pregnancy, almost all the neurons found in the
adult brain have been produced. Discussion and Recommendations
If the maternal diet is not sufficient during this The use of food additives has increased
rapid fetal brain neuronal development, this can enormously in the last few decades. As the result,
permanently reduce the number of neurons it has been estimated that today about 75% of the
formed in the foetal cerebrum with its negative Western diet is made up of various processed
consequences to the future intellect.47,142,216-219 foods, each person consuming an average 8-10
Although it has been speculated that the brain lbs of food additives per year, with some possibly
might recover from early nutritional deprivation, eating even more.
it is not known however which aspects of the The following adverse effects have been
brain are relevant to higher mental functioning. attributed to the consumption of food additives:
Hence it is extremely difficult to interpret these eczema, urticaria, angioedema, exfoliative
findings in terms of subsequent brain formation dermatitis, irritable bowel syndrome, nausea,
and intellect.217,218 vomiting, diarrhoea, rhinitis, bronchospasm,
However there is now no doubt whatsoever, migraine, anaphylaxis, hyperactivity and other
that in order to make sure that a child is born behavioural disorders.31
undamaged, both mentally and physically, all There is also now clear evidence that the health
appropriate dietary changes of both the would-be of the nation in the U.K. has deteriorated
parents must start well before conception to considerably during the last few decades. This
ensure that both the ova and the sperm are was found by Dr Michael Wandworth, when he
undamaged. This entails both future parents compared the health records of over 5000 people
adopting a good nutritional diet and avoiding all born in 1946 to their first-born children a
toxicological and mutagenic agents well in generation later. The survey found among the
advance of the planned conception. new generation a substantial increase in hospital
Toxicological agents include; alcohol,70 admissions of children up to the age of four, a
nicotine,71 lead pollution78 and other heavy metal tripling of instances of asthma, a six-fold increase
pollution, all unnecessary medication whether self in both eczema and juvenile diabetes, as well a
or medically prescribed, as well as foods double increase in obesity.222
containing mutagenic and teratogenic food The number of children admitted to psychiatric
additives.68,69,221 hospitals has also risen sharply. The latest official
Even though this paper has not the capacity to figures have shown between 1985 and 1990 a
discuss all food additives currently in use, the 42% rise in the number of under 10 year olds seen
following food additives at least have been found by the psychiatric services and a 65% increase in
to have either mutagenic or teratogenic action: children aged between 10 to 14, whilst the
curcumin (E100), carmoisine (E122), amaranth admissions of 15 to 19 year old juveniles to
(E123), ponceau (E124), erythrosine (E127), psychiatric hospitals had increased 21%. Even
Brown FK, sulphites (E210-E219), nitrates and some children as young as 5 years of age are
nitrites (E249-E252), butylated hydroxyani- ending up in psychiatric wards.223,224
sole (E320), monosodium glutamate (MSG),

234
 The Adverse Effects of Food Additives on Health

Crime is also presently on top of the political two of the basic reasons for a myriad of physical
agenda. In fact the present rising trend of the and mental health problems of today. This could
criminal statistics and violence resembles today be easily rectified by reducing the wide use of
more of an epidemic disease, with symptoms non-essential food additives, which in turn would
including mental disarrangement combined with a simply restrict the amount of non-nutritious foods
complete lack of any behavioural or emotional presently on sale, resulting in a wider uptake of
control (201). Whilst the crime statistics more nutritionally dense foods.
relentlessly rise, the Government and the media The main excuse of the food manufacturers and
are trying to put the blame on varied sociopolitical the government officials for the importance of the
influences such as TV and film violence, poverty, use of preservatives is that without them foods
lack of parental guidance, alleged child abuse, would soon spoil. This argument is indeed quite
frustration, lack of motivation, lack of appropriate realistic. However, it is interesting to note that of
prisons or institutions, the police etc. the nearly 4000 different additives currently in
In fact, the blame has been pointed at most use, over 3640 are used purely for cosmetic rea-
things, but never on faulty nutrition. Yet, as this sons and as colouring agents, the preservatives
paper has shown, an inappropriate nutrition can accounting for less than 2% of all additives when
modify brain function resulting, in susceptible counted by number or by weight.225
individuals, in a severe mental dysfunction, The other continued reason for the approval of
including manifestations of criminal and violent the use of additives is based on the argument that
behaviour. they are present in foods on such a minute scale
When this happens, several nutritional factors that they must be therefore completely harmless.
might be working together; however the following This argument may be almost acceptable
fundamental dietary factors must be taken into regarding additives with a reversible toxicological
consideration when confronting anyone action. However, with additives which have been
displaying an inappropriate behaviour pattern: is found to be both mutagenic and carcinogenic,
the person concerned living on a high sucrose, neither the human nor animal body is able to
high food additive diet which lacks an appropriate detoxify. Therefore even very minute doses of
amount of good protein? Is the diet completely these additives, when consumed continuously,
lacking in foods high in vitamin and mineral will eventually result in an irreversible toxic
content such as fresh fruits and/or salads? Could burden, resulting finally in cancer formation
the person have an allergic intolerance to any and/or in chromosomal and fetal damage. This is
foods he or she is consuming regularly? Could the quite unacceptable, particularly as the majority of
person suffer from a toxicological burden of these dangerous agents belong to the food colour-
heavy metal contamination, such as lead, ing group.
cadmium and/or aluminium, or a deficiency of an In order to improve the present situation, the
essential trace element, which be easily diagnosed following recommendations are made;
by current hair mineral analysis testing 1) All non-essential food additives should be
methods.220 banned, particularly all cosmetic agents such as
It must be stressed that this paper is most food colourants.
definitely not trying to insinuate that all negative 2) All foods which include additives with
behaviour manifestations are nutritional in origin, carcinogenic, mutagenic and teratogenic
as sociopolitical influences certainly do play a properties should be clearly labelled with the
part. However, it must be always remembered that appropriate warning.
a healthy and non-toxic brain can usually receive 3) All food additives should be banned from
information and process it in an intelligent and foods which may be consumed by infants and
positive manner, as opposed to a malnourished young children.
and toxic brain which simply does not possess the 4) The amount of TV advertising which en-
same capability. courages children to buy and eat unhealthy
As seen from the above, inadequate nutrition junk food should be vigorously cut down
and subclinical malnutrition seem to be

235
Journal of Orthomolecular Medicine Vol. 9, No. 4, 1994

as children are presently surrounded by images sional disorders,232,233 seizures, headaches,

promoting extremely unhealthy eating habits. blurred vision, "zombie-like" behaviour and
5) All foods that have little or no nutritional hair loss.234 In addition, the withdrawal
value should be discouraged from all pro- symptoms of Ritalin include severe and
motions. prolonged depression and suicide.235
6) Recent moves towards snack school meals I think it would be appropriate to suggest that
should be completely abolished. Instead the we must now finally insist that the Government
Government should re-introduce free must pass a law refusing permission for the food
nutritious school meals, preferably using industries to add continuously into our everyday
organic foods, which will be available to all foods and beverages demonstrably toxic agents
school-children. for cosmetic purposes only. If not for any other
7) Local Education Authorities should include in reason, at least in order to protect the health of our
their health education curricula specific significant population of young children, youths,
lectures stressing the prime importance of adolescents and adults, as well as the health of our
good nutrition in both physical and mental future generation.
health.
8) All foods, drinks or medications currently Acknowledgements
exempt from declaring additives must in future This study was supported by a grant from
be required to do so. This is particularly FORESIGHT, The Association for the Promotion
important and timely in connection with of Preconceptual Care, 28 The Paddock,
medicines, as presently there is no legal Godalming, Surrey GU17 1XD. A special
requirement by current British labelling recognition is given to Dr Bejamin Feingold for
regulations to oblige the drug manufacturers to his outstanding work on the dangers of artificial
disclose the presence of any of their food additives to children's physical and mental
pharmacological adjuvants. Adverse reactions health. Furthermore, also to Belinda Barnes,
to drugs themselves have been recognized, but Vicky Colquhoun and Sally Bunday who all have
the ever-expanding range of synthetic fought tirelessly to have hyperactive children
exipients currently in use can no longer be treated using Dr Feingold's simple and effective
considered either inert or non-toxic. In fact it nutritional methods.
has been already suggested that adverse reac-
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 The Adverse Effects of Food Additives on Health

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