How food additives and chemicals affect children’s moods and behaviour
Children have changed over the last thirty years. Behaviour and learning problems, asthma, depression, youth suicide, teenage violent crime and obesity are all increasing. At the Royal Children’s Hospital outpatients clinic in Melbourne in 2003, one-quarter of the children who attended were there for behavioural or learning difficulties rather than the traditional medical reasons.
What our children eat has changed too. In the early 1900s it was rare for families to eat out; there were daily deliveries of fresh meat, bread and milk, and most Australian families grew vegetables and fruit in their own gardens. In the 1970s, when processed food became widely available and supermarkets began taking control of our food supply, consumers started to eat more food additives, and the types of foods eaten by children changed dramatically.
A mother I’ll call Karen is typical of the growing number of parents concerned about their children’s behaviour. ‘I’m at my wit’s end,’ she wrote. ‘Zoe’s defiance and tantrums are driving us all mad.’
Although reluctant to medicate her four-year-old, Karen couldn’t see how Zoe’s behaviour could be related to food because, as she said, ‘We eat an extremely healthy diet with very little junk food and heaps of fruit and vegetables.’
When we went through Zoe’s menu and started reading labels, Karen was amazed at how many additives her daughter was eating.
The school lunchbox was the main disaster area. In Zoe’s homemade sandwiches, the bread contained calcium propionate (preservative 282). The spread contained sorbic acid preservative (200) as well as synthetic antioxidant (320), and the ham contained two preservatives (nitrates 250 and sodium metabisulphite 223).
Although the family drank preservative-free apple juice or freshly made juice at home, the lunchbox juice contained two preservatives (sodium benzoate 211 and sodium metabisulphite 223) and muesli bars contained another dose of sulphite preservatives this time as sulphur dioxide (220). Every day Karen gave Zoe a tub of yoghurt containing annatto colour (160b), not realising annatto is the only natural colour that can affect children as badly as artificial colours.
When Zoe went to friends’ places she was generally offered packet snacks and cordial (more sulphites and benzoates as well as artificial colours and flavour enhancers), the family ate once a week at a fast food restaurant with multiple additives in food and drinks, and any social function generally involved a sausage sizzle, another significant source of preservatives.
Reactions to food additives are related to dose. Children can be affected in many different ways and — unlike true allergic reactions such as peanut allergy — reactions are often delayed, sometimes up to two or three days. That is why it is so difficult for parents to identify the effects of food additives.
Some children are more sensitive than others. The children most likely to be affected are those from a food-sensitive family, or those eating very high doses of a particular additive. If parents have ever, even once, seen their child react to foods, it is a sign that they probably have hidden sensitivities to many other food chemicals. Karen had seen Zoe ‘high’ on Fanta artificially coloured orange drink.
Many children will improve on an additive=free diet. In 2004, a study of 277 three-year-olds from the Isle of Wight found that ‘significant changes in children’s hyperactive behaviour could be produced by the removal of colourings and additives from their diet’. Researchers suggested that all children would benefit from such a change, not just those already showing hyperactive behaviour.
Following on from the Isle of Wight study, an entire class of six-year-olds at the Dingle school in Cheshire were asked to avoid 39 additives at home and at school for two weeks. At the end of that time, nearly 60 per cent of parents said their children had improved with regard to cooperation, behaviour and sleeping. For this trial, Professor Jim Stevenson from the Southampton University Department of Psychology conducted before and after measurements on a pair of identical twins, one in the additive-free class, the other on his normal diet. Although Professor Stevenson didn’t know which twin was on which diet, there were measurable improvements in the additive-free twin in a wide range of areas including IQ.
Additives are not the only food chemicals that can affect children’s behaviour. Like most parents, Karen preferred to think that artificial is bad and natural is good, but that’s no longer the way it is.
The foods we eat, including fruit and vegetables, are made up of hundreds of naturally occurring compounds that can have differing effects on us — positive or negative. All plants contain a hormone called salicylic acid that regulates growth, ripening and resistance to pests and diseases. Salicylates are present in varying amounts in most fruit, vegetables, herbs and spices and are synthesised in laboratories as the active ingredient in medications such as aspirin and other nonsteroidal anti-inflammatory drugs, skin creams and teething gels.
In the 1960s, rheumatologists noticed that children’s behaviour could be affected by salicylates in their arthritis medication. One even reported a patient who attacked him with a knife while ‘under the influence of salicylates’. Not long after this, American paediatrician Dr Ben Feingold noticed that children’s behaviour can also be affected by natural salicylates in foods. His observations were confirmed in a study showing that children’s behaviour and learning ability could be affected by both salicylates in foods and salicylates in aspirin.
In the mid-80s Australian researchers published a new analysis of salicylate contents in foods showing that there were salicylates in many more foods than previously thought. When they used an elimination diet much lower in salicylates than Feingold’s, nearly 90 per cent of 140 children with behaviour disturbance improved significantly, and nearly three-quarters of those reacted to salicylates. For people who had already been following low salicylate diets, the new salicylate information was a revelation. ‘When I found the Australian salicylate lists I was so excited,’ wrote a salicylate-sensitive asthmatic from New Mexico. ‘I could finally understand what was happening — I had inadvertently been eating salicylates every day.’
The Australian researchers also excluded biogenic amines that are a breakdown product of protein in foods such as processed or fermented foods especially meat, fish, cheese and chocolate and some ripe fruit such as bananas, as well as natural flavour enhancers called glutamates in tasty foods. This is the diet that many thousands of families including my own have found to be so effective.
Understandably, most parents are appalled by the suggestion that fruit could cause problems. Yet two thousand years ago the ancient Greek physician Galen, considered to be the co-founder of modern medicine, wrote that his father had lived to be a hundred by avoiding fruit. It’s important to understand that many more vegetables are low or moderate in salicylates than fruit, and that children have never eaten such high levels of concentrated fruit as they do today.
I have spent months in remote subsistence villages in the Himalayas, where children ate very little fruit. These children were happy, healthy, well-spoken and eager to learn, sometimes walking up to two hours each way to school. They were mostly vegetarians living on home-grown rice, lentils, dried beans, potatoes and other vegetables in season, with a few fruit trees around the house. ‘How often do you eat fruit?’ I would ask. After a lot of thought, they would generally estimate ‘about once a week’. Their intake of additives was zero and their intake of foods high in salicylates was much lower than ours.
During the transition from subsistence diets to supermarket diets, salicylate intake increases because salicylates are concentrated in products such as jam, juices, sauces, stock cubes, tomato paste, dried fruit, vegetables and anything with added flavours. As well, foods are usually picked unripe for long shelf life when salicylates are at their highest. A wide variety of very high salicylate fruit and vegetables is available all year round and plants are genetically engineered with increased salicylates for disease resistance. It is also possible that supermarket varieties of, for example, tomatoes chosen for long shelf life may be higher in salicylates than old-fashioned heirloom varieties that were picked when soft, sweet and ripe.
Food chemicals can be addictive. In Karen’s family, Zoe was choosing to eat the highest salicylate foods, especially tomato sauce, orange juice, broccoli, grapes, sultanas and kiwifruit. When Karen decided to try the additive-free, low-salicylate, low-amine elimination diet, Zoe’s behaviour improved dramatically within three weeks. A salicylate challenge supervised by a dietitian resulted in a full return of her exasperating pre-diet behaviour.
It is common to find that others in the family are affected by food chemicals in different ways. When the entire family goes on the elimination diet to support the child, parents or siblings often notice unexpected improvements in asthma, migraines, depression, stomach bloating, itchy rashes and other symptoms of food intolerance.
The great debate
Despite ample evidence, the connection between children’s behaviour and what they eat is considered to be controversial. On one side of the debate, the influential US Food and Drug Administration (FDA) denies that artificial colours affect children’s behaviour, in a booklet co-sponsored by the food industry. There has been heavy criticism in recent years that the FDA has failed in its mission to protect public health due to industry pressure.
On the other side of the debate, independent scientists from the [US] Centre for Science in the Public Interest carried out a review of 25 years worth of diet and behaviour studies. Their recommendations included ‘that parents should consider dietary changes (along with behaviour therapy) as the first course of treatment for children with behavioural problems before turning to stimulant drugs’, ’that the FDA should consider banning from foods consumed widely by children any dyes and other additives that affect behaviour’ and ‘that schools … should minimise the use of food additives that may contribute to behavioural disorders’.
What parents can do
Since it is unlikely that food regulators will act in the foreseeable future, avoiding additives is up to parents. How do children feel about this? A four-year-old whose eczema is food related chose to go to a new childcare centre where she didn’t have to eat ‘itchy food’. A twelve-year-old who has been failsafe (free of additives, low in salicylates, amines and flavour enhancers) for four years explained: ‘I was really naughty such as screaming all the time and hitting people and hitting my head on the wall. It felt so bad but now I am on the diet I feel so much better — I don’t get headaches or pains in my side and feel sick in the stomach all the time. When I first found out about the diet I was so happy that it wasn’t me that was naughty or bad inside — it was the food I was eating.’
A 21-year-old is pleased his parents started the diet when he was four. ‘I went from a kid who everyone said would grow up to be a juvenile delinquent, to a better behaved kid who is now 21, studying for an Information Technology Bachelors degree,’ he wrote. ‘I’m surprised that the link between food and behaviour has only recently become publicised.’
Altogether, out of the hundreds of permitted additives, more than 50 additives (see box) — and some natural chemicals — can trigger a bewildering range of symptoms from difficulty concentrating, irritability, oppositional defiance, restlessness, anxiety and tantrums to problems with sleeping, toilet training, bedwetting, fussy eating, speech delay, tiredness, tearfulness, silly noises and many other seemingly trivial child-rearing problems that can erode family quality of life. As well, physical symptoms can include asthma, headaches, itchy skin rashes, reflux, stomach aches and growing pains. Children can be affected differently and any food additive can be related to any symptom.
A ‘50s diet
What children typically ate in the 1950s was much lower in additives and salicylates: porridge or plain cereals with milk for breakfast; an apple for morning tea; a sandwich for lunch with preservative-free bread, pure butter and preservative-free filling (e.g. egg and lettuce); a plain sweet biscuit such as milk arrowroot and a glass of plain milk for afternoon tea; lamb chops with mashed potato, peas and carrots for dinner, home-made rice pudding for dessert and water to drink all day.
Many families see an improvement by cutting down: switching to preservative-free bread, drinking water, avoiding artificial colours and other nasty additives, switching to A2 milk, and perhaps reducing their intake of citrus, tomatoes, broccoli, grapes and other high salicylate foods (jam, juice, sauces, dried fruit, fruit flavoured yoghurt). One mother wrote: ‘After months of struggling with my four-year-old son’s behaviour, I have started to cut foods high in additives from his diet and have already noticed a change after only a couple of weeks.’
For best results with difficult children, many families like Karen’s choose to do a trial of the low-salicylate, low-amine elimination diet supervised by a dietitian. This avoids every food chemical known to cause problems for a few weeks, then systematically reintroduces one group at a time to test reactions. After six months, Karen wrote: ‘The change in Zoe has been remarkable. We had tried so many other methods to help her without success and food has turned out to be so important. Zoe is a pleasure to live with and our whole family is so happy.’
Additives to Avoid
104 quinoline yellow,
107 yellow 2G,
110 sunset yellow,
122 azorubine, carmoisine,
124 ponceau, brilliant scarlet,
128 red 2G,
129 allura red,
132 indigotine, indigo carmine,
133 brilliant blue,
142 green S, food green,
acid brilliant green,
151 brilliant black,
155 brown, chocolate brown
200-203 sorbates — in fruit juice, dips, fruit products, reduced fat products
210-219 benzoates — in cordials, soft drinks, juice, syrups, medication
220-228 sulphites — in a wide range especially dried fruit, sausages, drinks
249-252 *nitrites, nitrates — in processed meats such as ham
280-283 propionates — in bread, crumpets, English muffins, bakery products
Synthetic antioxidants in fats and oils
319-321 TBHQ, *BHA, *BHT
Sugar free sweeteners
420 *sorbitol and other sweeteners ending in -ol can cause gas pain, bloating, diarrhoea
Flavour enhancers in tasty foods
620-625 *MSG, glutamates
627 *disodium guanylate
631 *disodium inosinate
Yeast extract, HVP HPP hydrolysed vegetable or plant protein
Added flavours are trade secrets, so there are no names or numbers.
*Not permitted in foods intended specifically for infants and young children
Full scientific references are given at www.fedup.com.au
Jacobson MF, Schardt MS. Diet, ADHD and behaviour: a quarter-century review. Washington DC: Centre for Science in the Public Interest, 1999, www.cspinet.org.
Swain AR, Dutton SP, Truswell AS. Salicylates in foods. J Am Diet Assoc 1985; 85(8):950-60.
Swain A, Soutter V, Loblay R, Truswell AS. Salicylates, oligoantigenic diets, and behaviour. Lancet 1985; 2(8445):41-2.
Published in Kindred, Issue 20