Seeing beyond the rainbow
Doug Cook, RD, MHSc, CDE
While most are quick to blame sugar for causing ADHD, what if it wasn't the sugar but rather the food dyes found in products specifically marketed to children?
The notion that food dyes are a potential health problem is not new. While most are quick to blame sugar for causing hyperactivity, what if it wasn’t the sugar that is responsible, but rather the food colouring found in a host of food products specifically marketed to kids?
Indeed, this is the position that the Centre for Science in the Public Interest (CSPI), an independent health advocacy organization with offices in Ottawa and Washington, DC, has taken.
CSPI has expressed concern over the prevalence of food dyes in processed foods (see sidebar, “Forewarned is forearmed” for a list of possible culprits). Its position echoes well-known pediatrician Benjamin Feingold’s (1899 to 1982) views on the subject. In the 1970s Feingold recommended a diet free of artificial food colourings or dyes and preservatives in treating the symptoms of hyperactivity.
There is sufficient evidence to have this lingering question revisited, according to the CSPI. On the other hand, food manufacturers—clearly with a vested interest—point to reviews their industry believes have confirmed the safety of food dyes.
The proof is in the pudding
CSPI cites studies such as a 2004 meta-analysis in the Journal of Developmental and Behavioral Pediatrics which supports the hypothesis that artificial food dyes promote hyperactivity in children with hyperactivity disorders as measured by standardized behavioural rating scales.
More recently, a randomized placebo-controlled trial that appeared in the Lancet (November 2007), added further concern. In this study researchers in Southampton, England, found an increase in hyperactive behaviour in two different groups of children (one group aged three and the other aged eight or nine) after they consumed a test beverage with artificial food colouring and a common preservative, sodium benzoate.
Following the study’s publication, Britain’s Food Standards Agency issued an advisory to parents to limit their children’s intake of the additives used in the Southampton study if they notice an effect on behaviour.
Regulations slow to follow
In the US the CSPI petitioned the Food and Drug Administration (FDA) in June 2008, calling for a ban of the following eight synthetic food dyes or at least, as an interim measure, that foods containing synthetic food dyes be required to bear a warning notice.
To date, the FDA has not acted on the CSPI’s petition. During public meetings on March 30 and 31 of this year, an FDA advisory panel voted against recommending warning labels, concluding there is no solid proof that artificial food dyes cause hyperactivity. Though it was accepted that artificial food dyes may worsen hyperactivity in a small subset of susceptible children, it was decided that this did not warrant warnings across the board.
The European Parliament, however, has banned artificial colouring from foods intended for small children and infants and requires a warning label on all other products containing them. As of last July most foods in the European Union that contain artificial dyes are required to have a warning label stating that the food “may have an adverse effect on activity and attention in children.”
In Canada the regulatory machinery, like its American counterpart, has also been slow to respond. Health Canada’s Bureau of Chemical Safety opened a consultation process in February 2010, inviting opinions to its proposed regulatory amendments targeted at manufacturers who use colourings in their processed foods.
The proposed amendments “would eliminate the option of simply using the word ‘colour’ and require that individual colours be identified on food ingredient labels.” Though consultations are now closed, no regulatory amendments have yet been passed.
Despite this slow regulatory movement in North America against the use of artificial food dyes, it is still entirely possible to avoid their use. A healthy diet that is based on minimally processed, whole and organic foods will naturally eliminate this concern.
Forewarned is forearmed
There are many types of foods that may contain food dyes, though if you stick to organic foods, you can be assured that no synthetic or chemical food dyes have been used. Here is a list of foods that, if not organic, may be culprits:
Supplements for children with hyperactivity
A mineral involved in over 100 enzymatic pathways including neurotransmitter activity, zinc sulphate has shown its importance as an important nutrient in the treatment of children with ADHD in a study using zinc as a supplement to methylphenidate (Ritalin). Participants in the study showed greater improvement with the combination than with Ritalin alone.
Fish oils (EPA and DHA)
Two marine-based omega-3 fatty acids include docosahexaenoic acid (DHA), the primary structural fat of the brain, and eicosapentaenoic acid (EPA), which increases blood flow and influences hormones and the immune system. Studies have shown that fish oil supplements containing both EPA and DHA may help to improve ADHD-related problems with inattention, hyperactivity, and impulsivity.
A mineral involved in over 300 metabolic pathways, like zinc, magnesium has a role in neurotransmitter activity. Several studies have shown a benefit from magnesium supplementation in children with ADHD who were determined to have low body stores of magnesium. These studies showed an increase in magnesium content and a significant decrease of hyperactivity of those examined, compared to their clinical state before supplementation and compared to the control group, which had not been treated with magnesium.
Brain chemicals, including serotonin, dopamine, and norepinephrine, the chemicals affected in children with ADHD, require adequate levels of B6. Also called pyridoxine, B6, in conjunction with magnesium, was found to improve symptoms of excitability including physical aggression, instability, learning attention, and hyperemotivity (excessive emotions).