Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Instagram
  • Listen to CMAJ podcasts
SynopsisI

Do food additives cause hyperactivity in preschool children?

Paul A. Kurdyak
CMAJ August 31, 2004 171 (5) 450; DOI: https://doi.org/10.1503/cmaj.1041187
Paul A. Kurdyak
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Bateman B, Warner JO, Hutchinson E, Dean T, Rowlandson P, Gant C, et al. 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;89:506-11.

Figure
  • Download figure
  • Open in new tab
  • Download powerpoint

Figure. Photo by: © Norbert Schaefer/CORBIS

Background: There have been claims that artificial food additives such as colouring and benzoate preservatives are potentially linked to hyperactivity in children1,2 and that children with atopy may be at particular risk.3 However, the generalizability of findings from these studies is limited because of the small, highly selected samples.

Design: Parents of all 3-year-old children living on the Isle of Wight, UK, were sent a letter inviting them to participate in the trial. Of the 2878 children whose parents were contacted, 277 completed the randomized, placebo-controlled, double-blind, crossover study. Children were entered into 1 of 4 groups based on the presence or absence of hyperactivity and atopy. The study took place over 4 weeks, during which the participants were instructed to follow an additive-free diet. The first and third weeks were unblinded washout periods. In the second and fourth weeks, the children received bottles of fruit juice (placebo challenge) or fruit juice containing known quantities of food additives (active challenge). Research psychologists assessed the children's behaviour weekly using validated tests. In addition, the parents rated behaviour daily and kept a diary detailing consumption of the provided drinks and compliance with the diet.

Results: The assessments by the research psychologists showed no change in hyperactive behaviour resulting from the addition of or washout from the food additives. By contrast, parental ratings showed decreases in hyperactive behaviour when the food additives were limited (i.e., during the washout periods from the baseline normal diet and between the placebo and active challenges) and increases in hyperactive behaviour during the placebo and active challenge periods. However, these increases in hyperactivity did not deviate significantly from baseline measures. The child's initial hyperactivity level did not have an effect on the parental ratings. There was no association observed between atopy or pre-existing hyperactivity and hyperactivity during the study period.

Commentary: Although the authors attempted to conduct a population-based randomized controlled trial, they were able to recruit only 397 of the 2878 children 3 years of age on the Isle of Wight. No comparison was made between the 277 participants who completed the trial and the 2581 eligible children who did not. Indeed, given the demands placed on both subjects and their parents to complete the study's protocol, parents whose children completed the study may have represented a biased sample who had pre-existing notions on the behavioural effects of food additives. Therefore, it is unlikely that the findings are generalizable to the population studied, let alone to other populations.

Still, the parents found that the removal of artificial food additives from a child's diet may have a beneficial effect on hyperactive behaviour. However, parents were not blinded to the removal of food additives, and the research psychologists detected no benefit from such removal. The challenge with the food additives did not appear to differ from the placebo challenge in its effects on hyperactive behaviour according to the parental ratings.

Practice implications: This trial is the most rigourous test of the effect of artificial food additives on hyperactive behaviour in preschool children to date. However, it remains unclear whether the removal or controlled addition of food additives has an effect on hyperactive behaviour. There are still insufficient grounds to advise parents to attempt to limit the exposure to food additives in the diets of their children.

Paul A. Kurdyak Research Fellow Centre for Addiction and Mental Health Department of Psychiatry University of Toronto Toronto, Ont.

References

  1. 1.↵
    Conners CK, Goyette CH, Southwick DA. Food additives and hyperkinesis: preliminary report of a double-blind crossover experiment. Psychopharmacol Bull 1976;12(2):10-1.
    OpenUrl
  2. 2.↵
    Weiss B, Williams JH, Margen S, Abrams B, Caan B, Citron LJ, et al. Behavioral responses to artificial food colors. Science 1980;207:1487-9.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ, et al. Effects of a few food diet in attention deficit disorder. Arch Dis Child 1993;69(5):564-8.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 171 (5)
CMAJ
Vol. 171, Issue 5
31 Aug 2004
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Do food additives cause hyperactivity in preschool children?
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Do food additives cause hyperactivity in preschool children?
Paul A. Kurdyak
CMAJ Aug 2004, 171 (5) 450; DOI: 10.1503/cmaj.1041187

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Do food additives cause hyperactivity in preschool children?
Paul A. Kurdyak
CMAJ Aug 2004, 171 (5) 450; DOI: 10.1503/cmaj.1041187
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • References
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • Google Scholar

Cited By...

  • A Research Model for Investigating the Effects of Artificial Food Colorings on Children With ADHD
  • Google Scholar

More in this TOC Section

  • The changing ecology of avian flu
  • Applying the 2005 Canadian Hypertension Education Program recommendations: 4. Managing uncomplicated hypertension
  • A newborn requiring selective bronchial intubation
Show more Synopsis

Similar Articles

Collections

  • Topics
    • Psychiatry & mental health: child & adolescent

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected]

CMA Civility, Accessibility, Privacy

 

Powered by HighWire