Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial
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Published on: June 12, 2020
Donna McCann1, Angelina Barrett, Alison Cooper
1School of Psychology, Department of Child Health, University of Southampton, Southampton, UK.
Insights
Artificial food colours and additives (AFCA) and sodium benzoate increase hyperactivity in young children. This randomized trial found significant effects in 3-year-olds and 8/9-year-olds, impacting childhood behavior.
Area of Science:
- Pediatric Health
- Nutritional Science
- Behavioral Science
Background:
- Investigated the impact of artificial food colour and additives (AFCA) on childhood behavior.
- Utilized a randomized, double-blinded, placebo-controlled, crossover trial design.
Purpose of the Study:
- To determine if artificial food colours and additives affect childhood behavior.
- To assess the effects of specific AFCA mixes and sodium benzoate on hyperactivity.
Main Methods:
- Included 153 3-year-olds and 144 8/9-year-olds.
- Administered challenge drinks with AFCA mixes (A or B) or placebo.
- Measured hyperactivity using a global hyperactivity aggregate (GHA) and, for older children, a computerised attention test.
Main Results:
- Mix A significantly increased hyperactivity in 3-year-olds compared to placebo (effect size 0.20, p=0.044).
- Mix A (0.12, p=0.023) and Mix B (0.17, p=0.001) significantly increased hyperactivity in 8/9-year-olds.
- Results were consistent when analyzing children with high adherence to the study protocol.
Conclusions:
- Dietary intake of artificial colours or sodium benzoate increases hyperactivity in both 3-year-old and 8/9-year-old children.
- These findings suggest a general population effect of these additives on childhood behavior.
Background:
We undertook a randomised, double-blinded, placebo-controlled, crossover trial to test whether intake of artificial food colour and additives (AFCA) affected childhood behaviour.
Methods:
153 3-year-old and 144 8/9-year-old children were included in the study. The challenge drink contained sodium benzoate and one of two AFCA mixes (A or B) or a placebo mix. The main outcome measure was a global hyperactivity aggregate (GHA), based on aggregated z-scores of observed behaviours and ratings by teachers and parents, plus, for 8/9-year-old children, a computerised test of attention. This clinical trial is registered with Current Controlled Trials (registration number ISRCTN74481308). Analysis was per protocol.
Findings:
16 3-year-old children and 14 8/9-year-old children did not complete the study, for reasons unrelated to childhood behaviour. Mix A had a significantly adverse effect compared with placebo in GHA for all 3-year-old children (effect size 0.20 [95% CI 0.01-0.39], p=0.044) but not mix B versus placebo. This result persisted when analysis was restricted to 3-year-old children who consumed more than 85% of juice and had no missing data (0.32 [0.05-0.60], p=0.02). 8/9-year-old children showed a significantly adverse effect when given mix A (0.12 [0.02-0.23], p=0.023) or mix B (0.17 [0.07-0.28], p=0.001) when analysis was restricted to those children consuming at least 85% of drinks with no missing data.
Interpretation:
Artificial colours or a sodium benzoate preservative (or both) in the diet result in increased hyperactivity in 3-year-old and 8/9-year-old children in the general population.
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