Health Implications of Artificial Food Dyes: do they cause hyperactivity, cancer, and IBD?

health implications of artificial food dyes and dye free foods
Written by Olivia Farrow, RD, MHSc

Written by Olivia Farrow, RD, MHSc

Reviewed by Krista Kolodziejzyk, RD, MPH, MBA

Artificial food dyes (like Red 40, Blue 1, Yellow 5 and Yellow 6) are commonly used in processed foods and beverages to enhance their appearance and appeal to consumers. As health professionals, clients may come to us with concerns about potential links to hyperactivity in children, allergic reactions, cancer, and, most recently, gut inflammation.

This blog post will explore what practitioners should know about artificial food dyes and the current research on their health implications.

 

What Are Food Dyes?

Food dyes are commonly added to food during processing to impart color. They are used to enhance the appearance of food and make it more appealing. Food color can significantly impact consumer behavior, with more colorful foods typically being more readily purchased (1).

Food dyes are commonly added to candies, snacks, and beverages, especially those marketed to children (2). 

 

Artificial food dyes are made from petroleum compounds. They are commonly used in food processing because of their affordability and intense color that is not heat or light-sensitive (3). 

Some of the most common food dyes found in food (2) include:

  • Red 40, Allura Red
  • Blue 1, Brilliant Blue
  • Yellow 5, Tartrazine
  • Yellow 6, Sunset Yellow

 

Natural dyes come from plant or animal sources and are typically more expensive, and may add unintended flavoring during food processing (3). Examples include beet juice, turmeric, and paprika. 

 

What are the health concerns with artificial food dyes?

Hyperactivity in Children

Hyperactivity in children is one of the most prominent ties with artificial food dyes. The controversy started in the 1970s when a pediatric allergist, Dr. Ben Feingold, proposed a link between the two. He suggested eliminating food additives from children’s diets could improve hyperactive behaviors. The “Feingold diet” gained popularity among health professionals and parents.

Since then, numerous studies have looked at the potential link between artificial food dyes and hyperactivity in children.

      • In 1994, a short-term, elimination diet and double-blind placebo-controlled study with a small sample size found a 73% improvement in ADHD symptoms by removing dietary food additives, including dyes (4).

      • Studies in 2004 and 2007, commissioned by the British Food Standards Agency (FSA) found a possible link between the consumption of six types of food colorings and hyperactivity in children (5, 6).
            • The 2004 clinical trial found parent-reported changes in hyperactive behavior but not by clinical assessment (5). 

            • The 2007 randomized controlled trial found a significant adverse effect of juice with added artificial food dye on hyperactive behavior compared to placebo (6).  

      A 2010 Irish study found that childrens’ and teens’ average intake of food additives was far below the levels seen in studies on hyperactivity (7). Some groups argue that very young children may be more likely to consume larger quantities of food additives and may be more susceptible to potential impacts due to their smaller body size, rapid growth rates, and selective eating patterns (8). 

      Overall, there needs to be more high-quality research to infer a direct link between hyperactivity and food dyes. Artificial food dyes are unlikely to cause generalized adverse effects in all children but may affect some sensitive children (9,10,11).

       

      Check out DSC’s Adult ADHD evidence summary and client handout. Not a member? Join now to get access to our entire library of evidence summaries, video courses, and client/patient resources. 

       

      Allergic Reactions

      Artificial food dyes can trigger allergic reactions in some individuals. 

      High-quality evidence in this area is needed; most studies are from the 1970s. Tartrazine (yellow food coloring) was the most commonly cited food dye causing allergic reactions (12,13,14). 

      Food color additives must be listed on a food label ingredient list in most countries (including USA, Canada, Australia and New Zealand). Individuals who are sensitive or allergic to food colors can read labels to avoid them and dietitians can support clients in finding alternative options. 

       

      Cancer

      The research on whether artificial food dyes cause cancer is mixed and inconclusive. Some studies have suggested that certain food dyes may be carcinogenic in rats and mice (15). Some dyes may also contain small quantities of additives that would be potentially carcinogenic in higher amounts (15).

      However, the evidence in humans needs to be more extensive and consistent to make conclusions.

      As animal studies are not direct predictors of human reactions to exposure, more research is needed in this area.

       

      Inflammatory Bowel Disease 

      Inflammatory bowel disease includes Crohn’s Disease and Ulcerative Colitis.

      You can learn more about inflammatory bowel diseases in our IBD toolkit which includes a 3-part video course, evidence summary, and client/patient resources.

      Not a member? Join now to get access to our entire library of evidence summaries, video courses, and client/patient resources. 

      The cause of IBD is unknown. Environmental, immune, microbiota, and genetic factor interactions are thought to play a role in triggering the immune system to malfunction and attack the healthy tissue of the GI system (16,17). 

      A recent (December 2022) Canadian study found a link between exposure to red food dye 40 (Allura Red) and colitis in rats (18). In their investigation, intermittent exposure, similar to how food colorings would occur in the human diet, found no link. Chronic exposure, especially in very young rats, was associated with gut barrier disruption through gut alterations of serotonin and thus, increased risk of colitis. 

      Because of this finding, individuals diagnosed with, or at risk for, IBD or other gastrointestinal diseases may choose to avoid food dyes. However, more research is needed in this area, as animal studies do not predict human reactions. 

       

      Dye Free Foods

      Despite the lack of high-quality human research on the adverse effects of artificial food dyes, some individuals may choose to avoid them. Dietitians can support clients in label reading for food colorings listed on the ingredients list. 

      It is possible to have a nutritionally complete diet without artificial food dyes. For families avoiding food dyes, dietitians can help with finding nutritious substitutes for familiar foods preferred by children. 

       

      Nutritious Dye Free Foods:

          • Fruits and vegetables (fresh or frozen)

          • Legumes (beans, lentils, chickpeas, split peas)

          • Grains (wheat, oats, rice) and pseudo-grains (quinoa, buckwheat) 

          • Meat (chicken, beef, pork)

          • Fish (salmon, tuna, trout, etc.)

          • Eggs

          • Milk (white), cheese, plain yogurt, plain cottage cheese

          • Nuts and seeds

         

        Key Messages for Dietitians & Health Professionals

            • Food dyes are added to many food products, especially those marketed to children, to enhance their color and appeal.

            • There has been concern about the adverse health effects of artificial food dyes, including hyperactivity in children, allergic reactions, cancer, and gut inflammation. 

            • Most of the research available on health implications of artificial food dyes are  animal studies or studies completed in the 1970s-1990s. Many of these studies looked at higher consumption levels than most individuals would normally consume. There is an opportunity for more human studies on health concerns regarding artificial food dyes. 

            • Government food safety organizations regulate food additive safety. Food colors currently used in food are approved by these groups.

            • Food dyes do not contribute any nutritional value to food, and consumers can choose from many nutritious food options that do not contain dyes. 

            • Dietitians can support clients concerned about artificial food dyes by reading labels, choosing minimally processed foods, and considering natural alternatives for coloring food.

           

          References

          1. Spence, C. On the psychological impact of food colour. Flavour 4, 21 (2015). https://doi.org/10.1186/s13411-015-0031-3
          2. Batada, Ameena, and Michael F Jacobson. “Prevalence of Artificial Food Colors in Grocery Store Products Marketed to Children.” Clinical pediatrics vol. 55,12 (2016): 1113-9. doi:10.1177/0009922816651621
          3. International Food Information Council (IFIC) and U.S. Food and Drug Administration (FDA). “Overview of Food Ingredients, Additives & Colors”. (2010). Available from https://www.fda.gov/food/food-ingredients-packaging/overview-food-ingredients-additives-colors
          4. Boris, M, and F S Mandel. “Foods and additives are common causes of the attention deficit hyperactive disorder in children.” Annals of allergy vol. 72,5 (1994): 462-8.
          5. Bateman, B et al. “The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children.” Archives of disease in childhood vol. 89,6 (2004): 506-11. doi:10.1136/adc.2003.031435
          6. McCann, Donna et al. “Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial.” Lancet (London, England) vol. 370,9598 (2007): 1560-7. doi:10.1016/S0140-6736(07)61306-3
          7. Connolly, A et al. “Pattern of intake of food additives associated with hyperactivity in Irish children and teenagers.” Food additives & contaminants. Part A, Chemistry, analysis, control, exposure & risk assessment vol. 27,4 (2010): 447-56. doi:10.1080/19440040903470718
          8. Martyn, Danika M et al. “Food additives and preschool children.” The Proceedings of the Nutrition Society vol. 72,1 (2013): 109-16. doi:10.1017/S0029665112002935. 
          9. Nigg, Joel T et al. “Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives.” Journal of the American Academy of Child and Adolescent Psychiatry vol. 51,1 (2012): 86-97.e8. doi:10.1016/j.jaac.2011.10.015
          10. Schab, David W, and Nhi-Ha T Trinh. “Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials.” Journal of developmental and behavioral pediatrics : JDBP vol. 25,6 (2004): 423-34. doi:10.1097/00004703-200412000-00007
          11. Miller, Mark D et al. “Potential impacts of synthetic food dyes on activity and attention in children: a review of the human and animal evidence.” Environmental health : a global access science source vol. 21,1 45. 29 Apr. 2022, doi:10.1186/s12940-022-00849-9
          12. Stenius, B S, and M Lemola. “Hypersensitivity to acetylsalicylic acid (ASA) and tartrazine in patients with asthma.” Clinical allergy vol. 6,2 (1976): 119-29. doi:10.1111/j.1365-2222.1976.tb01889.x
          13. Dipalma, J R. “Tartrazine sensitivity.” American family physician vol. 42,5 (1990): 1347-50.
          14. Neuman, I et al. “The danger of “yellow dyes” (tartrazine) to allergic subjects.” Clinical allergy vol. 8,1 (1978): 65-8. doi:10.1111/j.1365-2222.1978.tb00449.x
          15. Center for Science In the Public Interest. “Food Dyes: A Rainbow of Risks”. (2010). Available from https://www.cspinet.org/sites/default/files/attachment/food-dyes-rainbow-of-risks.pdf
          16. Raymond, J., Morrow, K. 2021. “Medical Nutrition Therapy for Lower Gastrointestinal Tract Disorders”. In Krause and Mahan’s Food & The Nutrition Care Process: 15th Edition. Pages 561-565. Elsevier, Inc.
          17. Owczarek, Danuta et al. “Diet and nutritional factors in inflammatory bowel diseases.” World journal of gastroenterology vol. 22,3 (2016): 895-905. doi:10.3748/wjg.v22.i3.895
          18. Kwon, Yun Han et al. “Chronic exposure to synthetic food colorant Allura Red AC promotes susceptibility to experimental colitis via intestinal serotonin in mice.” Nature communications vol. 13,1 7617. 20 Dec. 2022, doi:10.1038/s41467-022-35309-y

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