A double-blind assessment of additive intolerance in children using a 12 day challenge period at home.
Wilson, N., Scott, A. (1989) Clin Exp Allergy. 19(3) 267-72.
Web URL: View this abstract via Pubmed here
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.
FAB RESEARCH COMMENT:
This study used a rigorous double-blind procedure to assess sensitivity to two artificial food additives in children with behaviour problems, whose parents believed that they reacted badly to these additives.Results confirmed intolerance to these particular additives in only 3 of the 19 children studied - but it is noteworthy that in 2 of these children, the symptoms provoked involved physical rather than behavioural symptoms, while the behavioural reactions of the third child were described as 'extrenely abnormal'.
Previous double-blind trials have also failed to confirm adverse reactions to food additives in children with ADHD-type behaviour problems as a group - although this is not surprising given the variability within any such group.
- See Mattes & Gittelman 1981 and the accompanying FAB comment.
Meanwhile, as these additives themselves have no nutritional value (and are usually found only in highly processed foods and drinks) they also indicate that a trial of their exclusion from an individual child's diet may be well worthwhile if parents and professionals suspect that intolerance may be an issue.
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