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A double-blind assessment of additive intolerance in children using a 12 day challenge period at home
1Department of Paediatrics, Royal Postgraduate Medical School, Hammersmith Hospital, London.
Insights
Food additive intolerance was investigated in 19 children. Only 3 children showed confirmed intolerance to specific food additives (colorings or preservatives) through a double-blind, randomized trial.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Nutrition Science
Background:
- Food additives are commonly used in processed foods.
- Concerns exist regarding potential adverse effects of food additives on children's health.
- Previous studies on food additive intolerance have yielded mixed results.
Purpose of the Study:
- To assess alleged food additive intolerance in children.
- To identify specific additives causing adverse reactions.
- To evaluate the efficacy of a double-blind, individualized challenge protocol.
Main Methods:
- Nineteen children with suspected food additive intolerance participated.
- A 12-day double-blind, randomized, placebo-controlled challenge with specific food additives (colorings and preservatives) or placebo.
- Children were maintained on an additive-free diet, with symptoms and medication recorded daily.
Main Results:
- Additive intolerance was confirmed in only 3 out of 19 children (15.8%).
- One child reacted to colorings (urticaria), another to preservatives (behavioral changes), and a third improved on placebo (asthma, abdominal pain).
- The individualized challenge protocol confirmed intolerance in a small subset of children with suspected reactions.
Conclusions:
- The study highlights the importance of rigorous, individualized testing for food additive intolerance.
- Most children with suspected intolerance did not show a consistent reaction to the tested additives.
- Further research may be needed to understand the mechanisms and prevalence of true food additive intolerance.
Abstract:
Alleged food-additive intolerance (respiratory, dermatological, behavioural or abdominal) was assessed in 19 children using daily challenge drinks of either, base product alone, base product plus sunset yellow/tartrazine, or base product plus sodium metabisulphite/sodium benzoate. The same type of drink was given for 12 days, double-blind and in random order. During the trial the children were maintained on an additive-free diet under supervision. Diary cards were used to record symptoms and medication usage. If there was an apparent association between symptoms and drink ingredient the trial was repeated, again double-blind. Additive intolerance was confirmed by a consistent deterioration of symptoms in only three children. In one, urticaria was induced by the colourings, in another extremely abnormal behaviour was induced by the preservatives and a third child was only free of asthma and abdominal pain on placebo. This form of individual trial, using 12 daily drinks, overcomes some of the objections to a single challenge study. Despite this, intolerance to the additives was only confirmed in 3/19 children in whom it had been believed to occur.