Adverse reactions to food additives in children: A retrospective study and a prospective survey

Food Safety and Health Concerns of Synthetic Food Colors: An Update

The toxicity of food additives is widely studied and concerns many consumers worldwide. Synthetic food colors are often considered an unnecessary risk to consumer health. Since the European Food Safety Authority's (EFSA) re-evaluation between 2009 and 2014, the body of scientific literature on food colors has grown, and new evaluations are being published by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). Therefore, this narrative review aims to review the toxicological data that have become available since 2014. The reviewed colors are Quinoline Yellow, Sunset Yellow, Azorubine, Amaranth, Ponceau 4R, Erythrosine, Allura Red, Patent Blue, Indigo Carmine, Brilliant Blue FCF, Green S, Brilliant Black, Brown HT, and Lithol Rubine BK. Tartrazine was not included in this paper; the overwhelming amount of recent data on Tartrazine toxicity requires more space than this review can provide. The issues regarding the toxicity of synthetic food colors and real population exposures are being regularly examined and reviewed by relevant authorities, such as the EFSA and JECFA. The current ADI limits set by the authorities are mostly in agreement, and they seem safe. However, the EFSA and JECFA assessments of some of the colors are more than a decade old, and new evidence will soon be required.

Synthetic Colors in Food: A Warning for Children's Health

This study addressed the harmful effects of artificial colors in pediatric populations, including children diagnosed with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), as well as those without behavioral disorders. There is a consensus that synthetic food colorings have several impacts on consumers, especially pediatrics, due to their influence on sensory appeal, which can encourage preference for certain foods. The results revealed that these color additives are directly linked to a series of health problems, with a greater impact on children, including a predisposition to pathological conditions such as carcinogenic, allergenic, mutagenic, cytotoxic, and clastogenic activities, as well as gastrointestinal and respiratory problems, in addition to behavioral changes in children with and without diagnosed disorders. The harms of synthetic dyes in children with or without comorbidities are worrying and require a careful and proactive approach from parents, caregivers and public authorities.

[Differential diagnosis in food allergy]

It is important to establish the differential diagnosis of food allergy with other disorders, for example: toxic reactions that occur in any person exposed to a sufficient amount of some allergen, and non-toxic reactions that depend on individual susceptibility (food allergy or intolerance). The differential diagnosis is decisive to establish the appropriate treatment. Food intolerance involves adverse reactions to foods without any immunological response involved, and commonly manifests with gastrointestinal symptoms (malaise, abdominal pain or diarrhea). Food allergy is an exaggerated reaction of the immune system, often mediated by IgE, that can trigger serious symptoms (hives, inflammation, respiratory distress, even anaphylaxis). The complex thing is because the symptoms sometimes overlap. To establish an accurate diagnosis, exhaustive clinical evaluation, laboratory tests and, in some cases, controlled provocation tests are required. It is important to understand these distinctions, because treatment and management vary significantly. Food intolerance involves the elimination or reduction of the food that triggers the allergic reaction and requires rigorous measures (complete avoidance of the allergen and availability of epinephrine in cases of severe reactions).

Dyes Used in Processed Meat Products in the Polish Market, and Their Possible Risks and Benefits for Consumer Health

Manufacturers are obliged to label processed meat products with information concerning the additives used and nutritional values. The aim of the study was to identify the dyes most frequently used in processed meat, evaluate their influence on specific food qualities, assess whether their use was correct and review their effect on health. The analysis was based on information on the labels and images of processed meat, and used a generalised linear model with a binary dependent variable. The risks and benefits for human health were defined based on the available literature. Twelve dyes were found to be used in the manufacture of processed meat. Carmine was found in 183 of 273 (67.03%) evaluated assortments containing dyes. The occurrence of water, flavourings and high fat and carbohydrate contents increased the chances that a dye would be present in a particular product. Unauthorised use of food additives was found in 20 products, with smoked meat products demonstrating the highest number of non-compliances. In general, the dyes used with food are considered safe; however, reservations are associated with the use of E150C and E150D caramels due to their potential carcinogenic effect, and carmine and annatto due to their allergic effects.

Risk assessment of azo dyes as food additives: Revision and discussion of data gaps toward their improvement

The food industry uses dyes mainly to overcome color loss during the processing and storage of products, with the azo dyes currently being the most employed. Studies on the safety of using these dyes in foods started in the 1950s and have indicated the potential for concern. This review discusses the risk assessment of food intake containing artificial azo dyes. There are case reports and, subsequently, double-blind placebo-controlled trials in some individuals who may experience adverse effects from the intake of azo dyes, but it is unclear whether these adverse effects are restricted to specific populations or more generalized. In view of this, different toxicological endpoints are evaluated to verify toxic effects in in vitro and in vivo models and to establish the no observed adverse effect level. Exposure estimation studies have shown that human exposure to azo dyes via oral intake is mainly below the acceptable daily intake established by advisory bodies. However, most countries do not have studies that estimate the oral intake of azo dyes. In this case, local food diversity and racial-ethnic specificities are not considered when stating the exposure estimate is below the acceptable daily intake for the human population and thus may not represent actual intake. Concerning the scenario established above, this review discusses the most critical gaps to be overcome to contribute to the direction of future studies and the development of more effective public policies concerning the safety of the intake of artificial azo dyes.

Safety and efficacy of a feed additive consisting of carmine for cats and dogs (Mars Petcare GMbH)

Following a request from the European Commission, EFSA was asked to deliver a scientific opinion on the re-evaluation of the safety and efficacy of carmine (sensory additive, functional group: colourants - substances that add or restore colour in feeds) for cats and dogs. The additive consists of aluminium lakes of carminic acid (carmines), which are complexes of aluminium and carminic acid. Carminic acid, produced from the female insect Dactylopius coccus Costa, is the colouring principle and is present in the final additive at 50%. The additive does not pose a risk concerning genotoxicity and is considered safe for dogs and cats at 264 and 220 mg Carmine/kg feed, respectively (which correspond to 132 and 110 mg carminic acid/kg feed, respectively). Due to the nature of the additive, the FEEDAP Panel concluded that allergic reactions may occur in the target species following the ingestion of feeds containing the additive. The FEEDAP Panel concluded that the exposure of users by inhalation is very likely, and that carmine is a respiratory and skin sensitiser; however, due to the lack of data, a conclusion cannot be reached on the potential skin and eye irritation of the additive. The additive is considered to be efficacious in feeds for dogs and cats under the proposed conditions of use.

THE FEATURES OF THE NORMAL ULTRASTRUCTURE OF THE RAT DUODENUM AND UNDER THE COMBINED EFFECT OF THE FOOD ADDITIVES COMPLEX

OBJECTIVE

The aim: Investigation of ultrastructural changes in the elements of rats' duodenal mucosa in norm and exposed to a complex of food additives (monosodium glutamate, sodium nitrite and Ponceau 4R).

PATIENTS AND METHODS

Materials and methods: 70 rats of the experimental groups was administered 0.6 mg/kg of sodium nitrite, monosodium glutamate at a dose of 20 mg/kg, Ponceau 4R at a dose of 5 mg/kg in 0.5 ml of distilled water once daily per os. The doses of food additives were twice lower the allowable normal rate in food products. Animals were removed from the experiment at 1, 4, 8, 12 and 16 weeks.

RESULTS

Results: The effect of the complex of food additives on the mucous membrane of the duodenum was manifested by the development of edema and increased local immune response. In the later stages of observation, dystrophic changes in epithelial cells were determined. Vacuoles were found in the cytoplasm.

CONCLUSION

Conclusions: The use of a complex of food additives led to general ultramicroscopic changes in the mucous membrane of rats' duodenum, triggering the morphological mechanisms of nonspecific inflammation in the form of dystrophic changes and the development of apoptosis.