Red Dye #40

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A recent facebook post asked about the link between red 40 dye and hyperactivity.

Nicole Rousset WilliamsPediatric Partners, PA. Overland Park, Kansas

Would love to see an article on red 40 dye and thoughts from a professional medical standpoint. As the mom of a very strong-willed child, I've gotten advice from other moms who swear this is the "poison" that creates so much difficulty in kids. Wondering how you feel..... So"What's up, doc?"

Tolerability and safety of food additives and their influence on behavior have been questioned since the 1970s after a pediatric allergist alleged that there was risk of hyperactivity due to food additives. This allergist, Dr Feingold, supported the Feingold Diet.  Scientists reviewing his studies found he had no control group, limiting the validity of his study. Several other well designed studies have not found a risk except to those allergic to the food dye (FD&C Yellow No.5 leads to hives in 1 out of 10,000).

Studies attempting to show a link between food additives (including Red dye #40) have been inconclusive, inconsistent, or inadequate.

In 1982, a Consensus Development Panel of the National Institutes of Health concluded that for some children with ADHD and confirmed food allergy, dietary modification provided some benefit to behavior. They did not recommend all children alter their diet since there was no proof that it helped anyone but the small group with ADHD and food allergy.

In 1997, a review of several studies on this topic showed minimal evidence of benefit and extreme difficulty getting children and adolescents to adhere to a restricted diet.

In 2007, color additives specifically were questioned in relation to hyperactivity in a study by the UK Food Standards Agency.  Both the FDA and the European Food Safety Authority independently reviewed the results and concluded that there is no substantial link between color additives and behavioral effects.

Parents could argue that simply omitting foods with additives wouldn't hurt their child, and on many levels they are correct.  But...

We should all attempt to eat a nutritious diet rich in fruits and vegetables and minimize processed foods.  Unfortunately, that becomes very difficult in our society.  Many foods, including dairy, breads and cereals, and more have food additives.  It is difficult to eliminate these entirely and continue to get a balanced diet.  

Kids with true food allergies who must avoid certain foods often feel singled out and "different" or "fragile".  While this is very important for kids who have direct health risks to foods, it is psychologically difficult and if not a real risk/benefit, do we really want our kids suffering psychologically?  

Avoiding these foods also might allow the child to place blame on an external factor, leaving less responsibility for their action.  "I ate jelly beans, that is why I am out of control today.  It's not my fault."  

Trying an elimination diet also might delay the initiation of seeking professional help to try things that have been shown to work, such as behavioral modification, improved sleep, routines, and sometimes medication.

I believe in recognizing real risks, looking at the risk benefit ratio, and then making a decision.  If you have not noticed a difference with your child's behavior when eating only real whole foods (not from a package) then food additives likely aren't the culprit.

Behavior is very complex and is related to the child's temperament, sleep effectiveness, environment, hunger, emotional support, and more.  If there was one easy solution (ie removing food dyes) parents would all be doing it!

Sources:  

FDA: food ingredients and colors

FDA: Import Alert

Food Insight

Red40