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Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for.

Abstract

The effect of artificial food colors (AFCs) on child behavior has been studied for more than 35 years, with accumulating evidence from imperfect studies. This article summarizes the history of this controversial topic and testimony to the 2011 Food and Drug Administration Food Advisory Committee convened to evaluate the current status of evidence regarding attention-deficit/hyperactivity disorder (ADHD). Features of ADHD relevant to understanding the AFC literature are explained: ADHD is a quantitative diagnosis, like hypertension, and some individuals near the threshold may be pushed over it by a small symptom increment. The chronicity and pervasiveness make caregiver ratings the most valid measure, albeit subjective. Flaws in many studies include nonstandardized diagnosis, questionable sample selection, imperfect blinding, and nonstandardized outcome measures. Recent data suggest a small but significant deleterious effect of AFCs on children's behavior that is not confined to those with diagnosable ADHD. AFCs appear to be more of a public health problem than an ADHD problem. AFCs are not a major cause of ADHD per se, but seem to affect children regardless of whether or not they have ADHD, and they may have an aggregated effect on classroom climate if most children in the class suffer a small behavioral decrement with additive or synergistic effects. Possible biological mechanisms with published evidence include the effects on nutrient levels, genetic vulnerability, and changes in electroencephalographic beta-band power. A table clarifying the Food and Drug Administration and international naming systems for AFCs, with cross-referencing, is provided.

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  • Authors+Show Affiliations

    ,

    Department of Psychiatry, The Ohio State University, Columbus, OH 43210, USA. L.Arnold@osumc.edu

    ,

    Source

    MeSH

    Attention Deficit Disorder with Hyperactivity
    Food Coloring Agents
    History, 20th Century
    Humans
    United States
    United States Food and Drug Administration

    Pub Type(s)

    Historical Article
    Journal Article

    Language

    eng

    PubMed ID

    22864801

    Citation

    Arnold, L Eugene, et al. "Artificial Food Colors and Attention-deficit/hyperactivity Symptoms: Conclusions to Dye For." Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics, vol. 9, no. 3, 2012, pp. 599-609.
    Arnold LE, Lofthouse N, Hurt E. Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. Neurotherapeutics. 2012;9(3):599-609.
    Arnold, L. E., Lofthouse, N., & Hurt, E. (2012). Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics, 9(3), pp. 599-609. doi:10.1007/s13311-012-0133-x.
    Arnold LE, Lofthouse N, Hurt E. Artificial Food Colors and Attention-deficit/hyperactivity Symptoms: Conclusions to Dye For. Neurotherapeutics. 2012;9(3):599-609. PubMed PMID: 22864801.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. AU - Arnold,L Eugene, AU - Lofthouse,Nicholas, AU - Hurt,Elizabeth, PY - 2012/8/7/entrez PY - 2012/8/7/pubmed PY - 2013/2/16/medline SP - 599 EP - 609 JF - Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics JO - Neurotherapeutics VL - 9 IS - 3 N2 - The effect of artificial food colors (AFCs) on child behavior has been studied for more than 35 years, with accumulating evidence from imperfect studies. This article summarizes the history of this controversial topic and testimony to the 2011 Food and Drug Administration Food Advisory Committee convened to evaluate the current status of evidence regarding attention-deficit/hyperactivity disorder (ADHD). Features of ADHD relevant to understanding the AFC literature are explained: ADHD is a quantitative diagnosis, like hypertension, and some individuals near the threshold may be pushed over it by a small symptom increment. The chronicity and pervasiveness make caregiver ratings the most valid measure, albeit subjective. Flaws in many studies include nonstandardized diagnosis, questionable sample selection, imperfect blinding, and nonstandardized outcome measures. Recent data suggest a small but significant deleterious effect of AFCs on children's behavior that is not confined to those with diagnosable ADHD. AFCs appear to be more of a public health problem than an ADHD problem. AFCs are not a major cause of ADHD per se, but seem to affect children regardless of whether or not they have ADHD, and they may have an aggregated effect on classroom climate if most children in the class suffer a small behavioral decrement with additive or synergistic effects. Possible biological mechanisms with published evidence include the effects on nutrient levels, genetic vulnerability, and changes in electroencephalographic beta-band power. A table clarifying the Food and Drug Administration and international naming systems for AFCs, with cross-referencing, is provided. SN - 1878-7479 UR - https://www.unboundmedicine.com/medline/citation/22864801/full_citation L2 - https://dx.doi.org/10.1007/s13311-012-0133-x DB - PRIME DP - Unbound Medicine ER -