Alex Bevans checks the ingredient list on a bag of mini candy bars to see if the product uses synthetic food dyes. (Rebecca Bevans)
Unlike most kids, Alex Bevans scrutinizes the ingredient list before he eats anything. In the candy aisle of a grocery store in Carson City, Nevada, the 14-year-old scowls as he reads the label on a bag of lollipops,
“Get this," Alex said. "It has Red 40, Red 3, Yellow 5, Blue 1, Blue 2, Yellow 5, and Yellow 6.”
His mom, Rebecca, reached for the bag then gave her assessment: "Yeah, that's completely toxic.”
Each pigment affects Alex differently, Rebecca said.
"So red ... he can't pay attention and he's impulsive. Green makes him manic. Blue makes him grumpy and tired. Yellow is the worst. He's explosive and it leads to suicidal ideation."
Alex is not alone in these types of reactions, says Lisa Lefferts, a senior scientist for the Center for Science in the Public Interest.
“We've been contacted by over 2,000 families reporting their experiences with food dyes," she said. “The parents say that when their child is off of dyes they're just lovely children. On dyes they’re like a completely different person.”
Lefferts is lobbying the Food and Drug Administration to follow Europe’s example on dyes: The E.U. requires manufacturers to add a warning label to foods with artificial coloring that says they “may have an adverse effect on activity and attention in children.”
Most European companies avoid the label by switching to natural dyes like beet juice and Spirulina extract. A few American companies have followed suit. Kraft Macaroni and Cheese now uses turmeric and paprika to turn its noodles bright yellow. But substitutions like these aren’t widespread in the U.S, because natural dyes are more expensive and less stable.
The FDA has approved nine colors for use in processed food and other products like sunscreen, cough syrup and pills. The synthetic additives are made from petroleum and are contained in at least 90% of candies, fruit-flavored snacks, and drink mixes marketed to kids. It's also in 40% of all food products designed for children. The agency has determined there's not enough evidence to support adding a warning label to these products, and in 2011, after reviewing 35 years of research, it declined to impose any new regulations on manufacturers.
The FDA website currently says, "The totality of scientific evidence indicates that most children have no adverse effects when consuming foods containing color additives, but some evidence suggests that certain children may be sensitive to them."
Shaky or Sound Science?
Joel Nigg, psychologist and researcherat Oregon Health and Science University, followed up on the FDA probe with a comprehensive review, published in 2015, of all the human clinical trials related to synthetic color additives. The article concluded that restricting the chemicals for some kids with attention deficit hyperactivity disorder does have a notable effect, but he agrees that the evidence is on the weak side because it relies on dated, often small studies.
“One can question whether [the underlying studies] are convincing," Nigg said. "But they do show a causal effect if taken at face value."
A 2007 human clinical trial known as the Southampton study is often highlighted in the debate. British researchers gave kids beverages with synthetic food coloring in opaque containers. Afterwards, observers noted an increase in child hyperactivity. This replicated a prior similar study. But skeptics have noted that not all the dyes were FDA approved. Plus the behavioral changes were not as noticeable for teachers and independent people as for parents.
Nigg and colleagues estimate that 5-10% of kids with ADHD may be sensitive to synthetic food coloring. That’s tens of thousands of children who could be exposed to a preventable influence on their ADHD.
But for Rebecca, all the evidence she needed was right there in her son. She remembered the moment she began connecting Alex’s diet to strange behavior. He was in second grade and complained he couldn’t focus because his brain was buzzing.
“It's like if you played a decibel machine and you just kept turning the tone and the sound up," Alex said. "It just got really ear-piercing.”
Then there were the meltdowns. Several times or more a day, small frustrations resulted in crying fits. "It was like I was trapped by myself and I couldn't escape the feelings," Alex said.
Rebecca shuddered as she recounted an episode when Alex was seven. He was shredding his clothes and scratching himself on his bed. “He looked at me and said, ‘Please get me a knife. I want to kill myself. I don’t want to live like this anymore.’”
The family doctor had no clear answers for her, so Rebecca turned to the internet. She began cutting things out of Alex's diet like dairy, gluten, eggs, sugar, corn syrup and preservatives. The family tried behavioral then cognitive behavioral therapy. Nothing worked. Finally, one night Rebecca stumbled across a teenager’s blog post about an extreme reaction to red food coloring. Rebecca wondered if that was why Alex struggled with erratic mood swings. She decided to cut dyes out of Alex's diet.
At first, Alex crashed like a detoxing addict. He could hardly get out of bed, and his body was sore to the touch. But within days, both the suicidal thoughts and the tantrums disappeared.
“It completely changed who I was," he said. "I could finally focus.”
The dramatic change inspired Rebecca to share her family's story in a TEDX talk.
The Bevans hoped Alex would grow out of his sensitivity, but seven years later he continues to experience negative reactions every time he accidentally eats something with chemical food coloring.
Back on the Table
The American Academy of Pediatrics said in a 2018 policy statement that "artificial food colors may be associated with exacerbation of attention-deficit/hyperactivity disorder symptoms."
"The AAP has concerns about the limited safety testing available on chemicals intentionally and unintentionally added to foods, including food dyes," said Dr. Leonardo Trasande, who co-wrote the statement. "There are safe and simple steps families can take to limit children’s exposure to these chemicals."
Nigg says even though more robust research is needed, it's clear that synthetic food coloring is not benign. The good news, he says, is that the behavioral shifts triggered by the chemicals appear to usually last less than a week.
“I think we'll be surprised in the future that we were so laissez-faire about adding so many synthetic chemicals and thinking they wouldn't do anything to children's brains,” said Nigg.
The issue is back on the table at the federal and state levels, too. Scientists at the California Office of Environmental Health Hazard Assessment are conducting a risk assessment to determine if artificial colors impact neurobehavioral or neurological processes. The agencyexpects a conclusive report next summer. And, theFDA recently asked its science board to assess whether new studies warrant another literature review.
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