Food and Behaviour Research

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Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials.

Schab, D.W., Trinh, N.H. (2004) Journal of Developmental & Behavioral Pediatrics. 25(6) 423-434 

Web URL: View this and related abstracts via PubMed here


Burgeoning estimates of the prevalence of childhood attention-deficit/hyperactivity disorder (ADHD) raise the possibility of a widespread risk factor. We seek to assess whether artificial food colorings (AFCs) contribute to the behavioral symptomatology of hyperactive syndromes. We searched ten electronic databases for double-blind placebo-controlled trials evaluating the effects of AFCs. Fifteen trials met the primary inclusion criteria. Meta-analytic modeling determined the overall effect size of AFCs on hyperactivity to be 0.283 (95% CI, 0.079 to 0.488), falling to 0.210 (95% CI, 0.007 to 0.414) when the smallest and lowest quality trials were excluded. Trials screening for responsiveness before enrollment demonstrated the greatest effects. Despite indications of publication bias and other limitations, this study is consistent with accumulating evidence that neurobehavioral toxicity may characterize a variety of widely distributed chemicals. Improvement in the identification of responders is required before strong clinical recommendations can be made.


This systematic review of the evidence from 15 previously published controlled trials shows that artificial food colourings (AFC) do worsen the behaviour of hyperactive children.

Similar findings were reported from the largest controlled trial to date, involving 277 3-year-old children from a geographically defined population sample (from the Isle of Wight) . These children were carefully screened and selected for ADHD, allergies, both, or neither of these conditions. The researchers tested similar AFCs along with one common preservative for their effects on the children's behaviour (see Bateman et al, 2004).

This large Isle of Wight study showed detrimental effects of the food additives versus placebo across the sample as a whole, i.e. these were not specific to any of the subgroups. This study was published too late to be included in the systematic review from the US reported here, but it did lead to calls for a UK ban on these kinds of artificial additives. BBC News online,25 May 2004

Given that these AFCs have no nutritional value (and are often used to make non-nutritious foods appealing to children), the evidence of potential risks now emerging from well-conducted studies would seem to support such calls. In the UK, however, the FSA has called for more research before considering any change in official regulations.

Meanwhile, parents and carers wishing to prevent their children from consuming artificial additives of this kind will not find it easy. However, a list of children's foods that contain these additives can be found on the website of the Food Commission