Do food additives lead to medical problems?

Food additives have been used for centuries, but only recently have they come under heavy scrutiny. Food additives may be synthetically produced or derived from plants and animals. Examples of natural preservatives are salt used to cure and preserve meat and sugar in wine.

The categories that draw a lot of attention are flavor enhancers, dyes, color preserving agents and preservatives. Who really wants to eat Fruit Loops that are all the same color or Cheez-It crackers that aren’t orange like cheese? People want food that looks appealing, lasts a long time and tastes better than the real thing. The real question for me, as a physician, parent and consumer, is “What are the health risks associated with processed foods?”

As a general rule, food additives have not been proven to harm most people. However, some people have allergic or asthmatic reactions to one or more of them, just as they may have allergic reactions to natural foods such as nuts or seafood.

Symptoms of allergic reactions or food intolerance vary greatly. They may include hives, rash, swelling, difficulty breathing, skin irritation, wheezing, nausea, vomiting, anxiety, behavioral changes and headache.

Food additives should be considered a possible trigger of allergy, difficulty breathing or stomach symptoms when reactions occur in association with food or drink intake. Several clues may indicate a possible food additive reaction. First, does the onset of symptoms usually occur within minutes to a few hours of eating? Next, do you have a history of symptoms that occur when ingesting several apparently unrelated foods? Finally, do you have a reaction to commercially-prepared foods (store-bought frozen pizza) that are tolerated when prepared at home (home-made pizza).

Consultation with a physician should be considered if a pattern of symptoms and ingestion of the potential food/preservative is noted on a regular basis. If you or your child experiences difficulty breathing or the symptoms appear to be severe, seek medical help immediately.

Asthma exacerbations have been studied to identify potential links to food additives and dyes. Only one additive has been isolated. Sulfites have been linked to up to 5 percent of all exacerbations in patients with asthma. Follow-up studies indicate that people who do not have asthma do not experience any respiratory symptoms.

Over the past five years, the effects of food additives on Attention Deficit Hyperactivity Disorder (ADHD) have been studied. Dietary factors generally do not impact behavior to a clinically significant level and do not account for the majority of ADHD cases.

However, a small subset of children may demonstrate mild adverse behavioral effects in response to particular dietary components and improvements in behavior when these components are eliminated. Most successes with the elimination diet are usually noted by parents and difficult to measure with commonly used ADHD scoring guides. If a parent would like to try an elimination guide, it should be done in correlation with a physician to ensure adequate nutrition. Diets should show a change within five weeks. If symptoms improve, slowly add back one food per week to identify problematic foods and ultimately allow a less restrictive long-term diet.

While many studies have been performed to identify the relationship that food additives have on developing cancer, only one has been isolated. There appears to be a relationship between the curing additive salt and the risk of developing gastric cancer.

One particular study summarizes the attention that food additives are receiving with regard to their effects on medical conditions. The study consisted of 100 patients with chronic, unexplained skin irritation. Almost half believed they had a sensitivity or allergy to a food additive. These patients were exposed to the 11 most commonly recognized dyes and additives known to cause reactions. Only two of the 100 patients felt their skin irritation worsened. These two patients had additional testing which failed to show a link between the additives or dyes and any increase in their symptoms.

What does this study really mean? Can food additives and dyes cause health problems? Most definitely. Is it common? No.

It is important to be observant of your environment and diet. I encourage parents to keep a journal of the diet, activities, and symptoms their child is experiencing in an attempt to isolate possible triggers. This journaling is particularly important when medications are not resulting in the expected improvement.

This story was originally published September 23, 2014 at 7:44 AM with the headline "Do food additives lead to medical problems?."