American Academy of Pediatrics
ADHD and Food Additives Revisited


The American Academy of Pediatrics (AAP) is the organization that recommends practice parameters for pediatricians to follow. A review published in the AAP Grand Rounds in February, 2008, has noted the adverse effects of artificial additives on the behavior of children in the general population as reported by a British study in the Lancet in September 2007. We encourage parents to print this page and share it with their pediatricians, in case they have not seen this article. [full report attached]

The reviewer, Alison Schonwald, MD, FAAP, is an expert in developmental and behavioral pediatrics at Children's Hospital in Boston. Dr. Schonwald writes:

Despite increasing data supporting the efficacy of stimulants in preschoolers with attention deficit hyperactivity disorder (ADHD) parents and providers understandably seek safe and effective interventions that require no prescription. A recent meta-analysis of 15 trials concludes that there is "accumulating evidence that neurobehavioral toxicity may characterize a variety of widely distributed chemicals." [Schab DW, et al. J Dev Behav Pediatr. 2004;25:423–434] Some children may be more sensitive to the effects of these chemicals, and the authors suggest there is a need to better identify responders. In real life, practitioners faced with hyperactive preschoolers have a reasonable option to offer parents. For the child without a medical, emotional, or environmental etiology of ADHD behaviors, a trial of a preservative-free, food coloring–free diet is a reasonable intervention. (emphasis added)
And the Editors' Note which follows states:
Although quite complicated, this was a carefully conducted study in which the investigators went to great lengths to eliminate bias and to rigorously measure outcomes. The results are hard to follow and somewhat inconsistent. For many of the assessments there were small but statistically significant differences of measured behaviors in children who consumed the food additives compared with those who did not. In each case increased hyperactive behaviors were associated with consuming the additives. For those comparisons in which no statistically significant differences were found, there was a trend for more hyperactive behaviors associated with the food additive drink in virtually every assessment. Thus, the overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong. (emphasis added)

6/24/08