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Prevalence of intolerance to food additives among Danish school children
G Fuglsang1, C Madsen, P Saval
1Department of Pediatrics, Viborg Hospital, Denmark.
Insights
Food additive intolerance affects an estimated 1-2% of school children. Reactions, including eczema and urticaria, were observed in children with atopic conditions during controlled challenges.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Nutrition
- Public Health
Background:
- Food additive intolerance is a growing concern in pediatric populations.
- Atopic diseases are common in school-aged children, and their relationship with food sensitivities requires further investigation.
Purpose of the Study:
- To determine the prevalence of food additive intolerance in unselected school children aged 5-16 years.
- To investigate the specific reactions and triggers associated with food additive intolerance in children with atopic conditions.
Main Methods:
- A study group of 271 children was selected from 4,274 school children based on atopic disease questionnaires.
- Children underwent a two-week elimination diet followed by an open challenge with a mixture of food additives.
- Positive open challenges were confirmed with double-blind, placebo-controlled challenges.
Main Results:
- The prevalence of food additive intolerance in school children was estimated at 1-2%.
- Among children with atopic disease, 17 out of 173 showed a positive open challenge, with reactions including aggravated atopic eczema and urticaria.
- Double-blind challenges confirmed intolerance in 6 children, with synthetic colorings and citric acid being common triggers.
Conclusions:
- Food additive intolerance is present in 1-2% of the school-aged population.
- Children with atopic conditions are more likely to experience adverse reactions to food additives.
- Synthetic colorings and citric acid are identified as frequent culprits in pediatric food additive intolerance.
Abstract:
The prevalence of intolerance to food additives was assessed in a group of unselected school children aged 5-16 years. A study group of 271 children was selected on the basis of the results of a questionnaire on atopic disease answered by 4,274 (86%) school children in the municipality of Viborg, Denmark. The children in the study group followed an elimination diet for two weeks before they were challenged with a mixture of food preservatives, colourings and flavours. The challenge was open and the additives were prepared as a fizzy lemonade. If the open challenge was positive, a double-blind placebo controlled challenge with gelatine capsules was performed. The study included 281 children, 10 were excluded, and the remaining 271 children were given the open challenge (98 healthy controls and 173 with atopic symptoms). The open challenge was negative in all 98 healthy control children who had not reported any atopic symptoms. Of the 173 children reporting present or previous atopic disease 17 had a positive open challenge. Of these 17 children 1 experienced gastrointestinal symptoms, 13 reacted with aggravation of atopic eczema, and 3 with urticaria. Twelve of these 17 children went through the double-blind challenge which was positive in 6 cases. Five of these 6 children had positive reactions to synthetic colourings and 1 to citric acid. No serious reactions were seen. Based upon calculations of the results from this study and an earlier multi-center study in children referred to hospital clinics, the prevalence of intolerance to food additives in school children is estimated to be 1-2%.