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

Effects of preservatives on the activities of salivary enzymes

OBJECTIVES

To investigate the effects of common preservatives used in oral health care products on the enzymatic activities of lysozyme, peroxidase, and α-amylase in-solution and on-hydroxyapatite surface phases.

DESIGN

The preservatives used in this study were sodium benzoate, methylparaben, propylparaben, and benzalkonium chloride. Hen egg-white lysozyme, bovine lactoperoxidase, and α-amylase from Bacillus sp. served as sources of purified enzymes. Human unstimulated whole saliva was used as a source of salivary enzymes. Hydroxyapatite beads were used as the surface phase. The preservatives were incubated with purified enzymes or saliva samples in-solution or on-hydroxyapatite surface phases, respectively. Enzymatic activities of lysozyme, peroxidase, and α-amylase were measured by hydrolysis of fluorescein-labelled Micrococcus lysodeikticus, oxidation of fluorogenic 2',7'-dichlorofluorescin, and hydrolysis of fluorogenic starch, respectively.

RESULTS

The effects of the preservatives on the enzymatic activities of lysozyme and peroxidase were more distinct in the saliva samples than purified substances, and in the in-solution phase than on-hydroxyapatite surface phase, and the opposite was true for α-amylase. The most significant result was apparent decrease in peroxidase activities caused by the parabens in the in-solution phase (P<0.05). Sodium benzoate and parabens inhibited lysozyme activity in the in-solution phase, but differently for the purified and salivary lysozymes. Parabens and benzalkonium chloride inhibited the enzymatic activity of α-amylase from Bacillus sp., not saliva samples, only on-hydroxyapatite surface (P<0.05).

CONCLUSIONS

Each preservative affected the enzymatic activities of lysozyme, peroxidase, and α-amylase differently. Based on the effects on salivary enzymes, sodium benzoate or benzalkonium chloride was recommended as preservatives rather than parabens.

Biochemical Alterations and Motor Dysfunctions in Corpus Striatum of Rats Brain Exposed to Azo Dyes

Azo food dyes are prohibited in most countries, but their injudicious use is still reported particularly in the developing Nations. Continuous use of contaminated food raises health concerns and given this the present study designed to investigate the effects of 3 non-permitted azo dyes (metanil yellow - MY, malachite green - MG, and sudan III - SIII) on neurobehavioral, neurochemicals, mitochondrial dysfunction, oxidative stress, and histopathological changes in the corpus striatum of rats. Rats were grouped and treated with MY (430 mg/kg), MG (13.75 mg/kg), SIII (250 mg/kg) & mixture (YGR) (MY 143.33 + MG 4.52 + SIII 83.33 mg/kg) p.o. for 60 days showed a significant decrease in grip strength and motor activity, the activity of acetylcholinesterase (AChE), monoamine oxidase - B (MAO-B), and mitochondrial complex I and II compared to the control. The treated groups showed a significant increase in lipid peroxidation and a decrease in the level of reduced glutathione, superoxide dismutase, and catalase as compared to the control. Histopathology of the corpus striatum revealed immense damage. Data from the present study correlate between azo dyes and changes in the behavior of rats which have been associated with the altered biochemicals and neurochemicals activities. In conclusion, exposure to azo dyes caused neurotoxicity involving motor impairments associated with enhanced oxidative stress, mitochondrial dysfunctions, AChE and MAO-B inhibition, and neuronal damage in the corpus striatum of rats.

Simultaneous determination of 11 water-soluble synthetic colorants in foods consumed in Chile by high-performance liquid chromatography with diode Array detection

In Chile, limited information is available on colorants in commonly consumed foods among vulnerable age groups. We developed and validated a rapid HPLC-DAD method to simultaneously evaluate 11 synthetic colorants in candies, beverages, ice cream, and cereals. The method exhibited excellent analytical performance for all 11 colorants with LOD (0.44 - 1.55 mgL-1), LOQ v(1.32 - 4.70 mgL-1), precision (4.0 and 7.3% RSD), and recovery (80 - 105%) in fortified matrices (10-50-100 mgL-1). The highest detection frequencies were as follows: cereals > candies > beverages > ice cream. Sunset Yellow was the most prevalent colorant in all food matrices, followed by Allura Red and Azorubine. Positive samples contained between 1 and 5 synthetic colorants. With the exception of cereals, the colorant concentrations in the remaining matrices exceeded the Codex Alimentarius regulations and the values reported in other studies worldwide, indicating the Chilean population is at risk.

Artificial food additives: hazardous to long-term health?

Many additives, some of which have no nutritional value, can be legally used in processed foods. They intensify colour, thicken, increase shelf life and enhance flavour. Regulatory authorities issue approvals as safe within acceptable quantitative limits. Ultra-processed foods (UPFs) contain combinations of all these additives and are particularly attractive to children.Many publications suggest that artificial colourants, benzoate preservatives, non-caloric sweeteners, emulsifiers and their degradation derivatives have adverse effects by increasing risks of mental health disorders, attention deficit hyperactivity disorder, cardiovascular disease, metabolic syndrome and potential carcinogenic effects.A systematic review has established that artificial azo dye food colourants (AFCs) and sodium benzoate preservative cause disturbed behaviour in children. AFCs and benzoates in animal models have neurotoxic properties through gut microbial generation of toxic metabolites. Observational studies show associations between high emulsifier intake and cardiovascular disease. Animal models and in vitro studies have highlighted neurotoxic, cytotoxic, genotoxic and carcinogenic effects. High intake of non-caloric sweeteners has been linked to cardiovascular disease and depression in adults and is linked to childhood obesity.Little research has focused on children who are the largest consumers of UPFs. Potentially, they are a ticking time bomb for adult obesity, metabolic syndrome, cardiovascular diseases, mental health disorders and cancers. Based on risk/benefit analysis, azo dye AFCs should be banned. Benzoates, emulsifiers and sweeteners require assessment of quantitative limits and cumulative effects of combinations. Consumers purchasing UPFs require information through ingredient health warnings and recommendations to use natural unprocessed foods which have well-described health-promoting properties.

Removal of food dyes using biological materials via adsorption: A review

It is alarming that synthetic food dyes (FD) are widely used in various industries and that these facilities discharge their wastewater into the environment without treating it. FDs mixed into industrial wastewater pose a threat to the environment and human health. Therefore, removing FDs from wastewater is very important. This review explores the burgeoning field of FD removal from wastewater through adsorption using biological materials (BMs). By synthesizing a wealth of research findings, this comprehensive review elucidates the diverse array of BMs employed, ranging from algae and fungi to agricultural residues and microbial biomass. Furthermore, this review investigates challenges in practical applications, such as process optimization and scalability, offering insights into bridging the gap between laboratory successes and real-world implementations. Harnessing the remarkable adsorptive potential of BMs, this review presents a roadmap toward transformative solutions for FD removal, promising cleaner and safer production practices in the food and beverage industry.

Microencapsulation of highly concentrated polyphenolic compounds from purple corn pericarp by spray-drying with various biomacromolecules

Colored corn pericarp contains unusually high amounts of industrially valuable phytochemicals, such as anthocyanins, flavanols, flavonoids, and phenolic acids. Polyphenols were extracted in an aqueous solution and spray-dried to produce microencapsulates using four carrier materials, namely, maltodextrin (MD), gum arabic (GA), methylcellulose (MC), and skim milk powder (SMP) at three concentrations (1, 2, and 3 %, respectively). The encapsulates were evaluated for their polyphenolic contents using spectrophotometric techniques and HPLC analyses, and their antioxidant properties were evaluated using four different assays. The physicochemical properties of encapsulates were analyzed by measuring the zeta potential (ZP), particle size distribution, water solubility index (WSI), water absorption index (WAI), and color parameters. Structural and thermal properties were evaluated using Fourier transform infrared spectroscopy (FTIR), optical profilometry, and differential scanning calorimetry (DSC) analyses. Comparative analysis of structural characteristics, particle size distribution, zeta potential, WSI, WAI, and aw of the samples confirmed the successful formulation of encapsulates. The microencapsulates embedded with 1 % concentrations of MD, MC, GA, or SMP retained polyphenolic compounds and exhibited noteworthy antioxidant properties. The samples encapsulated with GA or MD (1 %) demonstrated superior physicochemical, color, and thermal properties. Comprehensive metabolomic analysis confirmed the presence of 38 phytochemicals in extracts validating the spray-drying process.

Azo food dye neurotoxicity in rats: A neurobehavioral, biochemical, and histopathological study

Azo Food dyes (AFDs), which are widely used in the food industry, may be associated with adverse health effects. We have investigated the effects of the AFDs metanil yellow (MY), malachite green (MG), and sudan III (SIII) on cognitive impairment, oxidative stress, mitochondrial dysfunction, neuro-enzyme activities, and histopathology in rats. Rats treated with MY (430 mg/kg), MG (13.75 mg/kg), SIII (250 mg/kg), and a mixture (MY 143.33 + MG 4.52 + SIII 83.33 mg/kg) p.o. for 60 d showed significant learning and memory impairments. Significant biochemical changes were observed in the rat frontal cortex and hippocampus: increases in lipid peroxidation and the activity of acetylcholinesterase (AChE); decreases in the level of reduced glutathione and the activities of catalase, superoxide dismutase, and mitochondrial complexes I and II. Histological damage to brain neurons accompanied the learning and memory impairments and was linked with other biochemical and neurochemical alterations.

Metabolism of azo food dyes by bacterial members of the human gut microbiome

OBJECTIVES

We set out to survey the capacities of bacterial isolates from the human gut microbiome to reduce common azo food dyes in vitro.

METHODS

A total of 206 strains representative of 124 bacterial species and 6 phyla were screened in vitro using a simple azo dye decolorization assay. Strains which showed azoreductive activity were characterized by studies of azoreduction kinetics and bacterial growth.

RESULTS

Several groups of gut bacteria, including ones not previously associated with azoreduction, reduced one or more of the four azo food dyes commonly used in Canada: Allura Red, Amaranth, Sunset Yellow, and Tartrazine. Strains within some species differed in their azoreductive capabilities. Some strains displayed evidence of effects on growth related to the presence of azo dyes and/or the products of their azoreduction.

CONCLUSION

The continued widespread use of food azo dyes requires re-evaluation in light of the potential for disturbance of the gut microbial ecosystem resulting from azoreduction and the possibility of consequences for human health.

Systematic Review and Meta-Analyses: Safety and Efficacy of Complementary and Alternative Treatments for Pediatric Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

Complementary and alternative treatments (CATs) for ADHD have proliferated over the past decade; however, their safety and efficacy remain uncertain. We completed a systematic review and meta-analyses across CAT domains.

METHODS

Systematic search and data extraction identified randomized controlled trials for pediatric ADHD (ages 3-19 years) that included probably blind ADHD symptom outcome measures. We evaluated basic (RCT of a CAT compared with sham/placebo, attention/active control, treatment as usual, and waitlist control), complementary (RCTs comparing an evidence-based treatment with a CAT and the same evidence-based treatment), and alternative (evidence-based treatment to CAT) efficacy. Random-effect meta-analyses were conducted when at least 3 blinded studies were identified for a specific CAT domain.

RESULTS

Eighty-seven of 2253 nonduplicate screened manuscripts met inclusion criteria. No study reported significantly greater adverse effects for CATs than controls; naturopathy reported fewer adverse effects than evidence-based treatments but did not demonstrate basic efficacy. In the systematic review of basic efficacy, evidence of effectiveness was mixed but replicated previous evidence for the possible efficacy of cognitive training, neurofeedback, and essential fatty acid supplementation for certain patients. With respect to alternative and complementary efficacy, no CAT outperformed or enhanced evidence-based treatments (stimulant medications and behavioral therapy) when replication was required. Individual meta-analyses indicated that cognitive training was the only CAT that demonstrated overall basic efficacy ( SMD = 0.216; p = 0.032).

CONCLUSION

Clinicians may cautiously recommend (but monitor) cognitive training when evidence-based treatments are not feasible or effective for a patient. Additional studies are needed to further understand the potential of CAT domains.

Dietary exposure to food azo-colours in a sample of pre-school children from Southern Brazil

The dietary exposure of six food azo-colours was assessed in a sample of pre-schoolers from Guaratuba-Paraná, Brazil. Consumption data of 323 children aged 2 to 5 years was collected through 3-day food records. Dietary exposure, is expressed by milligrams of food colour by kilogram of body weight per day, as compared to the Acceptable Daily Intake (ADI). Three exposure scenarios were developed to account for uncertainties around consumption estimates. Intakes of Amaranth (INS 123) described in means, 50th and 95th percentiles exceeded ADI levels in the two most conservative scenarios, with the highest percentiles exceeding about four times the ADI. High intakes of Sunset Yellow FCF (INS 110) were also observed, of up to 85% of the ADI in the worst-case scenario. Findings suggest high exposure levels to azo-dyes in the survey population, with children likely exceeding the ADI for Amaranth (INS 123) and concerns for Sunset Yellow FCF (INS 110). Major food contributors were beverages (juice powders and soft drinks), dairy and sweets. Further studies on dietary exposure assessment are needed at the national level. The authors highlight the need of controlling the use of such additives through national policies that are aligned with the consumption patterns observed in the country.

Characterizing the metabolomic signature of attention-deficit hyperactivity disorder in twins

Emerging evidence implicate the gut microbiota as a potential susceptibility factor in attention-deficit hyperactivity disorder (ADHD), a common multifactorial neurodevelopmental condition. However, little is known about the biochemical signature of ADHD, including the metabolic contribution of the microbiota via the gut-brain axis, and the relative contribution of genetics and environmental factors. Here, we perform unbiased metabolomic profiling of urine and fecal samples collected from a well-characterized Swedish twin cohort enriched for ADHD (33 ADHD, 79 non-ADHD), using ¹H nuclear magnetic resonance spectroscopy and liquid chromatography-mass spectrometry. Our results highlight sex-specific patterns in the metabolic phenotype of individuals with ADHD. Specifically, the urine profile of males, but not females, with ADHD was characterized by greater excretion of hippurate, a product of microbial-host co-metabolism that can cross the blood-brain-barrier with bioactivity of potential relevance to ADHD. This trans-genomic metabolite was also negatively correlated with IQ in males and was significantly correlated with fecal metabolites associated with gut microbial metabolism. The fecal profile of ADHD individuals was characterized by increased excretion of stearoyl-linoleoyl-glycerol, 3,7-dimethylurate, and FAD and lower amounts of glycerol 3-phosphate, thymine, 2(¹H)-quinolinone, aspartate, xanthine, hypoxanthine, and orotate. These changes were independent of ADHD medication, age, and BMI. Furthermore, our specific twins' models revealed that many of these gut metabolites had a stronger genetic influence than environmental. These findings suggest that metabolic disturbances in ADHD, involving combined gut microbial and host metabolic processes, may largely derive from gene variants previously linked to behavioral symptoms in this disorder.

Progress and Prospective of the Industrial Development and Applications of Eco-Friendly Colorants: An Insight into Environmental Impact and Sustainability Issues

Color is the prime feature directly associated with the consumer's attraction and choice of their food. The flavor, safety, and nutritional value of any food product are directly associated with the food color. Natural and synthetic colorants (dyes and pigments) have diversified applications in various sectors such as food, feed, pharmaceutical, textiles, cosmetics, and others. Concerning the food industry, different types of natural and synthetic colorants are available in the market. Synthetic food colorants have gained popularity as they are highly stable and cheaply available. Consumers worldwide prefer delightful foodstuffs but are more concerned about the safety of the food. After its disposal, the colloidal particles present in the synthetic colorants do not allow sunlight to penetrate aquatic bodies. This causes a foul smell and turbidity formation and gives a bad appearance. Furthermore, different studies carried out previously have presented the toxicological, carcinogenic effects, hypersensitivity reactions, and behavioral changes linked to the usage of synthetic colorants. Natural food colorings, however, have nutraceutical qualities that are valuable to human health such as curcumin extracted from turmeric and beta-carotene extracted from carrots. In addition, natural colorants have beneficial properties such as excellent antioxidant properties, antimutagenic, anti-inflammatory, antineoplastic, and antiarthritic effects. This review summarizes the sources of natural and synthetic colorants, their production rate, demand, extraction, and characterization of food colorants, their industrial applications, environmental impact, challenges in the sustainable utilization of natural colorants, and their prospects.

Complementary and Integrative Treatments for Attention-Deficit/Hyperactivity Disorder in Youth

First-line psychopharmacologic and psychosocial treatments for attention-deficit/hyperactivity disorder in children are effective but limited by tolerability and accessibility problems. Many complementary and integrative strategies have been investigated as alternative or adjunctive treatments for the disorder, and the literature has progressed to meta-analyses for several. Although heterogeneity of study methods and risk of bias pervades the literature, we conclude that Omega-3 supplementation, dietary restriction of artificial food colorings, and physical activity can be considered evidence-based. Additionally, meditation, yoga, and sleep hygiene are safe, partially effective, cost effective and sensible adjunctive treatment strategies.

Association between food additives and prevalence of allergic reactions in children: a systematic review

Food additives contain synthetic and natural chemical compounds and are one of the causes of food allergies. In this regard, it is necessary to recognize the food additives that are of special interest for children. In this survey, the relation between food additives and allergic reactions and attention-deficit hyperactivity disorders in children was studied. The research studies with keywords "allergic reactions", "hypersensitivity", "food additives" and "children" were searched in PubMed, Scopus, Science Direct, Web of Science, and SID databases, from 1984 to 2020. Three hundred twenty-seven studies were obtained and only seven articles were finally selected according to exclusion and inclusion criteria. In the final review, seven articles were selected to investigate the relationship between food additives and hypersensitivity reactions. Some clinical factors such as urticaria, eczema, rhinitis and gastrointestinal symptoms and the prevalence of laboratory evidence in atopic children are due to increased exposure to food additives including artificial colors and sweeteners, preservatives, and monosodium glutamate. Clinical signs and laboratory evidence prove a significant association between some food additives and allergenic adverse reactions. It was also found that food additives such as artificial colors and sweeteners, preservatives, and monosodium glutamate are responsible for most cases of hypersensitivity in children, and the prevalence of hypersensitivity to food additives was estimated to be about 1.2% based on data extracted from studies.

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.

A Case Study for the Extraction, Purification, and Co-Pigmentation of Anthocyanins from Aronia melanocarpa Juice Pomace

Chokeberry (Aronia melanocarpa) pomace is a by-product from the juice industry very rich in anthocyanins and other bioactive components. Recovery and purification of anthocyanins from the pomace is a viable valorization strategy that can be implemented to produce high-value natural food colorants with antioxidant properties. In this study, chokeberry pomace was subjected to enzyme-assisted extraction using commercial pectinases. The extracts were further purified by adsorption-desorption using an acrylic resin and stabilized by co-pigmentation with ferulic acid. The anthocyanin concentration and antioxidant activity of the extracts were unaffected by the enzymatic treatment at the conditions tested. The total phenolic content of the extracts suffered minor variations depending on the enzyme formulation used, whereas the dissolved solid content increased in all cases. The adsorption-desorption strategy allowed a 96% recovery of the anthocyanins initially present in the extract, whereas the co-pigmentation treatment magnified the intensity of the color in terms of absorbance, and improved the stability during storage up to one month.

Food allergy in children—the current status and the way forward

Food allergy in children is a major health concern, and its prevalence is rising. It is often over-diagnosed by parents, resulting occasionally in unnecessary exclusion of some important food. It also causes stress, anxiety, and even depression in parents and affects the family’s quality of life. Current diagnostic tests are useful when interpreted in the context of the clinical history, although cross-sensitivity and inability to predict the severity of the allergic reactions remain major limitations. Although the oral food challenge is the current gold standard for making the diagnosis, it is only available to a small number of patients because of its requirement in time and medical personnel. New diagnostic methods have recently emerged, such as the Component Resolved Diagnostics and the Basophil Activation Test, but their use is still limited, and the latter lacks standardisation. Currently, there is no definite treatment available to induce life-long natural tolerance and cure for food allergy. Presently available treatments only aim to decrease the occurrence of anaphylaxis by enabling the child to tolerate small amounts of the offending food, usually taken by accident. New evidence supports the early introduction of the allergenic food to infants to decrease the incidence of food allergy. If standardised and widely implemented, this may result in decreasing the prevalence of food allergy.

Potential impacts of synthetic food dyes on activity and attention in children: a review of the human and animal evidence

Concern that synthetic food dyes may impact behavior in children prompted a review by the California Office of Environmental Health Hazard Assessment (OEHHA). OEHHA conducted a systematic review of the epidemiologic research on synthetic food dyes and neurobehavioral outcomes in children with or without identified behavioral disorders (particularly attention and activity). We also conducted a search of the animal toxicology literature to identify studies of neurobehavioral effects in laboratory animals exposed to synthetic food dyes. Finally, we conducted a hazard characterization of the potential neurobehavioral impacts of food dye consumption. We identified 27 clinical trials of children exposed to synthetic food dyes in this review, of which 25 were challenge studies. All studies used a cross-over design and most were double blinded and the cross-over design was randomized. Sixteen (64%) out of 25 challenge studies identified some evidence of a positive association, and in 13 (52%) the association was statistically significant. These studies support a relationship between food dye exposure and adverse behavioral outcomes in children. Animal toxicology literature provides additional support for effects on behavior. Together, the human clinical trials and animal toxicology literature support an association between synthetic food dyes and behavioral impacts in children. The current Food and Drug Administration (FDA) acceptable daily intakes are based on older studies that were not designed to assess the types of behavioral effects observed in children. For four dyes where adequate dose-response data from animal and human studies were available, comparisons of the effective doses in studies that measured behavioral or brain effects following exposure to synthetic food dyes indicate that the basis of the ADIs may not be adequate to protect neurobehavior in susceptible children. There is a need to re-evaluate exposure in children and for additional research to provide a more complete database for establishing ADIs protective of neurobehavioral effects.

Sodium Benzoate—Harmfulness and Potential Use in Therapies for Disorders Related to the Nervous System: A Review

Currently, due to the large number of reports regarding the harmfulness of food additives, more and more consumers follow the so-called “clean label” trend, i.e., prefer and choose the least-processed food products. One of the compounds known as a preservative with a high safety profile is sodium benzoate. While some studies show that it can be used to treat conditions such as depression, pain, schizophrenia, autism spectrum disorders, and neurodegenerative diseases, others report its harmfulness. For example, it was found to cause mutagenic effects, generate oxidative stress, disrupt hormones, and reduce fertility. Due to such disparate results, the purpose of this study is to comprehensively discuss the safety profile of sodium benzoate and its potential use in neurodegenerative diseases, especially in autism spectrum disorder (ASD), schizophrenia, major depressive disorder (MDD), and pain relief.

Formulation Optimization of Extemporaneous Oral Liquids Containing Naloxone and Propranolol for Pediatric Use

There is a need to develop dosage forms suitable for children to improve drug treatment. Extemporaneous compounding of drugs for children is one way to meet these needs. However, excipients generally considered as safe in adults may not be appropriate in dosage forms intended for children. The aim was to optimize the composition of two pediatric liquid preparations by substituting paraben as a microbiological preservative and ethanol as a solubilizer, with excipients more suitable for pediatric use. The oral liquids were Naloxone 1 mg/mL and Propranolol 10 mg/mL. Twelve different formulations were tested with propranolol and naloxone, respectively, during the screening process to select appropriate formulations. Sodium benzoate and glycerol were used as a preservative and solubilizer, respectively, and different pH of the formulations were evaluated. The formulations were characterized according to dispensed dose (dosing accuracy), viscosity and osmolality. The optimized formulations from the screening process were tested with two amounts of sodium benzoate and microbiological assays were performed. These formulations were shown to have satisfactory preservative properties and dosing accuracy. The results showed that the oral liquids could be prepared without the addition of solubilizer and with lower osmolality (naloxone), thus reducing the risk of gastrointestinal side effects.

Preparation of fluorescent organic nanoparticles via self-polymerization for tartrazine detection in food samples

Fluorescent polydopamine nanoparticles (PDA NPs) have been effectively synthesized by means of self-polymerization of dopamine under the strong alkaline condition of ethylenediamine at room temperature for 2.5 h.

Diet modification impact on ADHD outcome

Background

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, affects 5% of children worldwide and characterized by impaired inattention, hyperactivity and impulsivity. One of the risk factors that precipitate ADHD is food. Food affects behavior of children by different ways such as food allergy, food intolerance and gut–microbiota–brain axis. The study aimed to assess effect of diet modification on ADHD outcome and the role of food as a precipitating factor for ADHD symptomatology. The study included 47 children newly diagnosed with ADHD, not receiving medical or behavioral therapy, their ages ranged from 6 to 9 years and their intelligence quotient not below 70 with no associated comorbidities. All participants were subjected to Full history taking, clinical examination, anthropometric measurements, 24 h dietary recall. Dietary analysis and Conner’s parent rating scale-revised short form (CPR-RS) were done before and after diet modification program for 5 weeks.

Results

There was improvement in ADHD symptoms as measured by CPR-RS after 5-weeks of diet modification program. Carbohydrate and protein intake decreased significantly after diet modification program. Energy intake did not show statistical difference while fat intake increased significantly after the diet program. Vitamin A, C, riboflavin, thiamin and iron intakes decreased significantly after diet program but were within the recommended dietary allowance.

Conclusion

Following the Diet modification program, ADHD symptoms were improved as documented by decrease in CPR scores. Diminished carbohydrate and protein intake in diet were positively associated with improvement of ADHD symptoms. Diet modification program succeeded in reducing obesity and then ADHD symptoms.

Using High-Throughput Screening to Evaluate Perturbations Potentially Linked to Neurobehavioral Outcomes: A Case Study Using Publicly Available Tools on FDA Batch-Certified Synthetic Food Dyes

There is growing evidence from human and animal studies indicating an association between exposure to synthetic food dyes and adverse neurobehavioral outcomes in children. However, data gaps persist for potential mechanisms by which the synthetic food dyes could elicit neurobehavioral impacts. We developed an approach to evaluate seven US FDA-batch-certified food dyes using publicly available high-throughput screening (HTS) data from the US EPA's Toxicity Forecaster to assess potential underlying molecular mechanisms that may be linked to neurological pathway perturbations. The dyes were screened through 270 assays identified based on whether they had a neurological-related gene target and/or were mapped to neurodevelopmental processes or neurobehavioral outcomes, and were conducted in brain tissue, targeted specific hormone receptors, or targeted oxidative stress and inflammation. Some results provided support for neurological impacts found in human and animal studies, while other results showed a lack of correlation with in vivo findings. The azo dyes had a range of activity in assays mapped to G-protein-coupled receptors and were active in assays targeting dopaminergic, serotonergic, and opioid receptors. Assays mapped to nuclear receptors (androgen, estrogen, and thyroid hormone) also exhibited activity with the food dyes. Other molecular targets included the aryl hydrocarbon receptor, acetylcholinesterase, and monoamine oxidase. The Toxicological Prioritization Index tool was used to visualize the results of the Novascreen assays. Our results highlight certain limitations of HTS assays but provide insight into potential underlying mechanisms of neurobehavioral effects observed in in vivo animal toxicology studies and human clinical studies.

Attention Deficit and Hyperactivity Disorder

The treatment of attention-deficit/hyperactivity disorder can be a very rewarding and challenging task. The management of this condition has impact on a child's performance in school in both academics and extracurriculars, and therefore, can be a determinant of what they are able to achieve and become. Treatment can also impact the child's self-image and ability to successfully interact with their peers. Adequate control of the disorder can break down barriers to successful development of a child's potential and ability to play a role in the work force someday.

Production of Rainbow Colorants by Metabolically Engineered Escherichia coli

There has been much interest in producing natural colorants to replace synthetic colorants of health concerns. Escherichia coli has been employed to produce natural colorants including carotenoids, indigo, anthocyanins, and violacein. However, production of natural green and navy colorants has not been reported. Many natural products are hydrophobic, which are accumulated inside or on the cell membrane. This causes cell growth limitation and consequently reduces production of target chemicals. Here, integrated membrane engineering strategies are reported for the enhanced production of rainbow colorants-three carotenoids and four violacein derivatives-as representative hydrophobic natural products in E. coli. By integration of systems metabolic engineering, cell morphology engineering, inner- and outer-membrane vesicle formation, and fermentation optimization, production of rainbow colorants are significantly enhanced to 322 mg L-1 of astaxanthin (red), 343 mg L-1 of β-carotene (orange), 218 mg L-1 of zeaxanthin (yellow), 1.42 g L-1 of proviolacein (green), 0.844 g L-1 of prodeoxyviolacein (blue), 6.19 g L-1 of violacein (navy), and 11.26 g L-1 of deoxyviolacein (purple). The membrane engineering strategies reported here are generally applicable to microbial production of a broader range of hydrophobic natural products, contributing to food, cosmetic, chemical, and pharmaceutical industries.

Influence of the Anthocyanin and Cofactor Structure on the Formation Efficiency of Naturally Derived Pyranoanthocyanins

Pyranoanthocyanins are anthocyanin-derived pigments with higher stability to pH and storage. However, their slow formation and scarcity in nature hinder their industrial application. Pyranoanthocyanin formation can be accelerated by selecting anthocyanin substitutions, cofactor concentrations, and temperature. Limited information is available on the impacts of the chemical structure of the cofactor and anthocyanin; therefore, we evaluated their impacts on pyranoanthocyanin formation efficiency under conditions reported as favorable for the reaction. Different cofactors were evaluated including pyruvic acid, acetone, and hydroxycinnamic acids (p-coumaric, caffeic, ferulic, and sinapic acid) by incubating them with anthocyanins in a molar ratio of 1:30 (anthocyanin:cofactor), pH 3.1, and 45 °C. The impact of the anthocyanin aglycone was evaluated by incubating delphinidin, cyanidin, petunidin, or malvidin derivatives with the most efficient cofactor (caffeic acid) under identical conditions. Pigments were identified using UHPLC-PDA and tandem mass spectrometry, and pyranoanthocyanin formation was monitored for up to 72 h. Pyranoanthocyanin yields were the highest with caffeic acid (~17% at 72 h, p < 0.05). When comparing anthocyanins, malvidin-3-O-glycosides yielded twice as many pyranoanthocyanins after 24 h (~20%, p < 0.01) as cyanidin-3-O-glycosides. Petunidin- and delphinidin-3-O-glycosides yielded <2% pyranoanthocyanins. This study demonstrated the importance of anthocyanin and cofactor selection in pyranoanthocyanin production.

Whey protein addition and its increased light absorption and tinctorial strength of model solutions colored with anthocyanins

Anthocyanins (ACN) are pigments with vivid colors, but their application as food colorants is restricted by their limited stability and color expression. Anthocyanins exhibit higher stability in dairy systems than in buffers at similar pH, suggesting that pigments may be able to interact with dairy components such as proteins, resulting in improved performance as colorants. Our objective was to determine the type of interaction between whey proteins (WP) and ACN leading to color enhancements and to determine the role of the ACN chemical structure in this interaction. Model solutions colored with semipurified pigments from sources with different ACN profiles (Berberis boliviana, grape skin, purple corn, black carrot, and red cabbage) were mixed with different concentrations of whey protein isolate (WPI) in pH 3 buffer. Absorption spectra of these solutions were acquired using an absorbance microplate reader, and color parameters were calculated from spectral data. Isolated ACN 3-glucosides were used to determine the role of the aglycone structure in the WP-ACN interaction using visible and fluorescence spectroscopy. In silico modeling was used to visualize potential differences in the interaction between β-lactoglobulin and ACN. Addition of WPI resulted in hyperchromic shifts at the wavelength of maximum absorption in the visible range (λ_vis-max) of up to 19%, and a significant increase in tinctorial strength for all ACN sources (ΔE > 5). Moreover, ACN acylation did not seem to play a significant role in the WP-ACN interaction. When using isolated ACN, WPI addition resulted in hyperchromic shifts at the λ_vis-max only for methoxylated ACN such as petunidin-3-glucoside (up to 24%), and malvidin-3-glucoside (up to 97%). The bimolecular quenching constant values (K_q > 10¹⁰M^-1s^-1) strongly suggested that the predominant type of quenching interaction was static. Analysis of enthalpy, entropy, and Gibbs free energy showed that this binding was spontaneous; depending on the chemical structure of the ACN, the predominant binding forces could be hydrophobic interactions or hydrogen bonding. Modeling suggested that methoxylations in the B ring of the aglycon structure promoted interactions with electron acceptor amino acids. Overall, WP could be used to enhance the tinctorial strength of select ACN depending on their structural characteristics. Therefore, ACN source selection may play a key role for specific applications in dairy products.

Dietary intake of artificial food color additives containing food products by school-going children

Nutritional risk in children is associated with food safety. This is the first study to identify the food type consumed by 6–17-year-old school-going children in Saudi Arabia. Eight permitted artificial food color additives, including Tartrazine (E102), Sunset Yellow (E110), Carmoisine (E122), Allura Red (E129), Indigo Carmine (E132), Brilliant Blue (E133), Fast Green (E143), and Black PN (E151), and two non-permitted ones, Erythrosine (E127) and Red 2G (E128), were determined using 24-h dietary recall questionnaires. Artificial color additives in 839 food products were divided into nine categories, including biscuits, cakes, chocolates, chips, ice cream, juices and drinks, candy, jelly, and chewing gum, are determined using high performance liquid chromatography and diode array detector. The results indicated a high intake of juices and drinks, ice cream, and cakes, but low consumption of chewing gum among school-going children. Among the permitted artificial food color additives, Brilliant Blue (E133) (54.1%) and Tartrazine (E102) (42.3%) were the most commonly used. Sunset Yellow (E110) in one chocolate sample, Tartrazine (E102) and Sunset Yellow (E110) in one and two juice and drink samples, respectively, and Brilliant Blue (E133) in two candy samples exceeded the permitted level. Therefore, further investigations are needed to provide insights into the possible adverse health effects of high intake of these additives in artificial food coloring on the test population are warranted.

The use of diet interventions to treat symptoms of ADHD in children and adolescents - a systematic review of randomized controlled trials

Background: For over forty years diet interventions have been investigated as a treatment of ADHD in children and adolescents and, with the new discoveries of the microbiota-gut-brain axis, this research becomes more relevant than ever. The aim of this systematic review was therefore to investigate the current knowledge of diet interventions as a treatment of ADHD in children and adolescentsMethods: A systematic literature search in PubMed was conducted, identifying randomized controlled trials investigating diet interventions to treat ADHD in children and adolescents.Results: The study populations were generally small and the studies varied in duration and nature of the exposure. Overall 10 out of 12 studies spoke in favour of an elimination diet, 2 out of 6 of eliminating artificial food colourings from the diet and none in favour of eliminating sucrose or aspartame from the diet to treat ADHD.Conclusion: The current evidence is not enough to recommend treating ADHD with diet interventions, but a subgroup of children and adolescents might warrant from elimination of certain food-items. Further investigations of the mechanism and effect of diet interventions to treat ADHD is needed.

Copigmentation with Chlorogenic and Ferulic Acid Affected Color and Anthocyanin Stability in Model Beverages Colored with Sambucus peruviana, Sambucus nigra, and Daucus carota during Storage

The food industry is looking for alternatives to synthetic colorants. Anthocyanins (ACNs) are suitable replacements due to their color characteristics and potential health benefits. The application of sauco (Sambucus peruviana, SP) as a potential source of ACN-based colorants was evaluated and compared to elderberry (Sambucus nigra, SN) and an extract from purple carrots (PC). Color and pigment stability were evaluated using a model beverage system during eight weeks of storage. Copigmentation with chlorogenic acid (CGA) and ferulic acid (FA) were also evaluated. SP ACNs provided darker and more intense colors than those obtained with SN but less intense than those obtained with PC. Addition of CGA and FA resulted in significantly darker colors with higher chroma in beverages colored with SP and SN but not in beverages colored with PC. Copigmentation with FA reduced monomeric pigment half-lives for all ACN sources but increased the chroma half-lives of beverages colored with SP and SN, from 23 to 49 weeks, and from 23 to 55 weeks, respectively. Analyses using liquid chromatography coupled to photodiode array detection and mass spectrometry showed that interaction between non-acylated ACNs and FA resulted in the formation of pyranoanthocyanins. Overall, ACNs from non-acylated sources such as SP, in combination with FA, showed potential for commercial food applications.

Determination and Evaluation of Natural and Synthetic Dyes in Traditional Rock Candies (Nabat) Distributed in Tehran

Background:

The color of food products is one of the most important factors proposed by the consumer. Therefore, incorporation of coloring agents into food dates back to ancient times. Nowadays, various types of synthetic dyes are produced and widely used as part of formulations of food products to increase customer’s interest As the safety of this material is questionable, many of them are banned, or the level of their use is limited by the authorities. Among them, saffron is the only food color permitted for use in Nabat as a traditional rock candy which is mostly consumed in Iran. Therefore, the current investigation was aimed to determine the levels of artificial colors in traditional hard candy (Nabat) manufactured by organized and unorganized sectors distributed in Tehran.

Methods:

In this regard, 137 samples, (68 samples from unorganized sector and 69 samples from the organized sector), were collected in summer 2016. Analysis of samples was done according to the Iranian national standard through thin layer chromatography method. Also, the High-performance thin layer chromatography was used for reanalyzing five samples.

Results:

Findings showed that 64.7% of unorganized rock candy contained artificial food colors that 26.53% of these dyes are banned. About 5.8% of samples from the organized sector contained synthetic dyes that 25% of them are forbidden. The most commonly used color in both groups was defined as quinoline yellow.

Conclusion:

The high percentage of synthetic food color usage in unorganized sectors urges the necessity to control them, especially the incorporation of synthetic food dyes in Nabat. Therefore, the training providers and consumers and the monitoring of the production, have encouraged the manufacturers to develop and deploy health professionals and health license.

Prenatal exposure to artificial food colorings alters NMDA receptor subunit concentrations in rat hippocampus

Exposure to artificial food color additives (AFCAs) has been implicated in the etiology of certain childhood hyperactivity and learning disabilities. N-methyl-D-aspartate receptors and alpha-7 nicotinic acetylcholine receptor (α7 nAChR) are involved in learning and memory. We administered a mixture of AFCAs (erythrosine, ponceau 4R, allura red AC, sunset yellow FCF, tartrazine, amaranth, brilliant blue, azorubine, and indigotine) to female rats during gestation to investigate the effects of prenatal exposure to AFCAs on neurobehavior, spatial learning, and memory in their offspring. We also investigated whether AFCAs modulate NR2A, NR2B, and α7 nAChR protein levels in their offsprings' hippocampi. Although spatial learning and memory were not altered, the offspring of rats exposed to AFCAs exhibited decreased motivation and increased despair-related behavior. NR2A and NR2B protein levels were significantly reduced in female offspring in the experimental group (p < 0.05), whereas α7 nAChR level was not significantly altered. Our results suggest that prenatal exposure to AFCAs may lead to sex-dependent alterations in glutamatergic signaling which may continue into adolescence.

Evaluation of dietary intake in children and college students with and without attention-deficit/hyperactivity disorder

Objectives: To evaluate dietary intake among individuals with and without attention-deficit hyperactivity disorder (ADHD), to evaluate the likelihood that those with ADHD have inadequate intakes. Methods: Children, 7-12 years old, with (n = 23) and without (n = 22) ADHD, and college students, 18-25 years old, with (n = 21) and without (n = 30) ADHD comprised the samples. Children's dietary intake was assessed by a registered dietitian using 24-hour recalls over 3 days. College students kept a detailed food record over three days. Dietary information for both groups was entered into the Nutrition Data Systems for Research database, and output was analyzed using SAS 9.4. Nutrient analyses included the Healthy Eating Index-2010, Micronutrient Index (as a measure of overall micronutrient intake), and individual amino acids necessary for neurotransmission. Logistic regression was used to model the association of nutrient intake with ADHD. Models were adjusted for age, sex, IQ (or GPA), and energy intake (or total protein intake) as appropriate. Significance was evaluated at P = 0.05, and using the Benjamini-Hochberg corrected P-value for multiple comparisons. Results: No evidence existed for reduced nutrient intake among those with ADHD compared to controls in either age group. Across both groups, inadequate intakes of vitamin D and potassium were reported in 95% of participants. Children largely met nutrient intake guidelines, while college students failed to meet these guidelines for nine nutrients. In regards to amino acid intake in children, an increased likelihood of having ADHD was associated with higher consumption of aspartate, OR = 12.61 (P = 0.01) and glycine OR = 11.60 (P = 0.05); and a reduced likelihood of ADHD with higher intakes of glutamate, OR = 0.34 (P = 0.03). Among young adults, none of the amino acids were significantly associated with ADHD, though glycine and tryptophan approached significance. Discussion: Results fail to support the hypothesis that ADHD is driven solely by dietary micronutrient inadequacy. However, amino acids associated with neurotransmission, specifically those affecting glutamatergic neurotransmission, differed by ADHD status in children. Amino acids did not reliably vary among college students. Future larger scale studies are needed to further examine whether or not dietary intake of amino acids may be a modulating factor in ADHD.

Dietary patterns and attention deficit/hyperactivity disorder (ADHD): A systematic review and meta-analysis

BACKGROUND

The Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder characterized by persistent symptoms of inattention, impulsivity and hyperactivity. The diet during childhood has been investigated as a factor potentially involved in the ADHD etiology.

OBJECTIVE

To review systematically the evidence of the association between dietary patterns and ADHD.

METHODS

Two independent literature searches were carried out in PubMed, LILACS and PsycINFO databases. The studies included were only those that assessed dietary patterns and ADHD in children and adolescents. Due to heterogeneity between the studies random-effects models were used to pool the estimates.

RESULTS

We included fourteen observational studies (four cohorts, five case-control and five cross-sectional studies). In the pooled analysis, healthy dietary patterns were protective against ADHD (OR: 0.65; 95% CI: 044 - 0.97), while unhealthy dietary patterns were found as risk to ADHD (OR: 1.41; 95% CI: 1.15-1.74). After stratifying the studies by design (cohort/case control or cross-sectional), continent (Europe or Asia/Oceania) and sample size (≥1000 or <1000) the effects remained.

LIMITATIONS

Absence of randomized controlled trials at the literature on this subject and scarce evidence from more robust designs, such as cohort and case-control studies.

CONCLUSION

This study suggests that a diet high in refined sugar and saturated fat can increase the risk, whereas a healthy diet, characterized by high consumption of fruits and vegetables, would protect against ADHD or hyperactivity. Nevertheless, giving the number and the design of most of the studies available in the literature, the current evidence is weak. More studies using longitudinal design need to be performed to reinforce this evidence.

Food Preservative Capabilities of Grape (Vitis vinifera) and Clementine Mandarin (Citrus reticulata) By-products Extracts in South Africa

The drive towards sustainable food systems coupled with increased consumer sophistication have prompted innovation in waste valorization. Grape and citrus processing by-products, abundant in the Mediterranean and tropical regions, respectively, are expanding and are sustainable sources of bioactive phytochemicals that can be used as natural preservatives for foods. Phytochemical composition, antioxidant, and antimicrobial properties of extracts from grape pomace (GPE), seeds (GSE), and clementine mandarin peel and pulp (MPE) grown in South Africa were analyzed. Total phenols and carotenoids were highest in GPE followed by GSE and MPE (p ≤ 0.05). Flavonoids and anthocyanins were higher (p ≤ 0.05) in GPE and GSE compared to MPE. The GSE had the highest proanthocyanidins content followed by GPE and MPE (p ≤ 0.05). Ascorbic acid was only detected in MPE, which also had the highest titratable acidity and lowest pH values (p ≤ 0.05). The GSE had the highest antioxidant potency composite index followed by GPE and MPE (p ≤ 0.05). The order of antimicrobial activity of the extracts was MPE > GSE > GPE (p ≤ 0.05). Current findings show that GSE is a potential antioxidant while MPE holds promise as an antimicrobial for the food industry.

Human gut microbes are susceptible to antimicrobial food additives in vitro

The aim of this work was to test the hypothesis that antimicrobial food additives may alter the composition of human gut microbiota by selectively suppressing the growth of susceptible gut microbes. To explore the influence of antimicrobial food additives on the composition of the human gut microbiota, we examined the susceptibility of both aerobic and anaerobic gut bacteria to sodium benzoate, sodium nitrite, and potassium sorbate, and their combinations, using a broth microdilution method. The tested bacteria exhibited a wide range of susceptibilities to food additives. For example, the most susceptible strain, Bacteroides coprocola, was almost 580 times more susceptible to sodium nitrite than the most resistant strain, Enterococcus faecalis. However, most importantly, we found that gut microbes with known anti-inflammatory properties, such as Clostridium tyrobutyricum or Lactobacillus paracasei, were significantly more susceptible to additives than microbes with known proinflammatory or colitogenic properties, such as Bacteroides thetaiotaomicron or Enterococcus faecalis. Our data show that some human gut microbes are highly susceptible to antimicrobial food additives. We speculate that permanent exposure of human gut microbiota to even low levels of additives may modify the composition and function of gut microbiota and thus influence the host's immune system. Whether the effect of additive-modified gut microbiota on the human immune system could explain, at least in part, the increasing incidence of allergies and autoimmune diseases remains to be shown.

Sugar consumption and attention-deficit/hyperactivity disorder (ADHD): A birth cohort study

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent symptoms of lack of attention, impulsivity and hyperactivity. The association between nutritional exposures and ADHD has been investigated and some studies have identified adverse effects from higher intake of sugar. The objective of the present study was to evaluate the association between change in sugar consumption between 6 and 11 years of age and incidence of attention-deficit/hyperactivity disorder (ADHD).

METHODS

Pelotas 2004 Birth Cohort Study in Brazil. A food frequency questionnaire (FFQ) was used to estimate sugar consumption and the Development and Well-Being Assessment (DAWBA) was applied to mothers to assess the presence of ADHD.

RESULTS

Only children without ADHD at 6 years and with complete information from FFQ and DAWBA at 6 and 11 years were included in the analyses (n = 2924). Odds ratios with 95% confidence intervals were calculated. Incidence of ADHD between 6 and 11 years was 4.6% (3.6-5.6%) among boys and 1.8% (1.2-2.5%) among girls. Adjusted analyses showed no association between always high sucrose consumption between 6 and 11 years and incidence of ADHD, compared with individuals who always presented low consumption, both among boys (OR = 0.66; 0.21-2.04) and girls (OR = 2.71; 0.24-30.35).

LIMITATIONS

Reflect those that are inherent to use of FFQs, such as memory bias and lack of precision in quantifying the diet.

CONCLUSIONS

The results suggest that there is no association between sucrose consumption between 6 and 11 years of age and incidence of ADHD.

Food allergen labelling: "May contain" evidence from Malaysia

Food allergen labelling is mandatory and regulated whilst precautionary allergen labelling (PAL) remains voluntary in most countries. It is the aim of this study to identify the food allergens declared in food products sold in a developing country and to what extent food allergens and PAL are emphasised in the products. A total of 505 food and beverages (snacks, baked goods, confectionary, baby food, condiments & jams, beverages, powder & paste, instant food, chilled & frozen food and canned food) were evaluated in Malaysia. Soybean represents the largest group of food allergen declared in labels, followed by wheat and milk products. Thirteen variations of contains statement were found with "Contains [allergen(s)]" being the most common (55.02%). There were 22 different types of "may contain" statements with 'May contain traces of [allergen(s)]' being the most common advice labelling used (55.41%). Different font type or emphasis such as brackets (51.57%) and bold font (33.86%) were used to inform consumers about presence of allergens. The national regulations on food allergen labelling are then critically contrasted with other Asian countries and the EU Regulation No. 1169/2011, which represents one of the most stringent food regulations in the world. Improving current allergen labelling limitations and practices would be of great benefit to consumers to prevent risk of food hypersensitivity.

Rationale for Dietary Antioxidant Treatment of ADHD

Increasing understanding arises regarding disadvantages of stimulant medication in children with ADHD (Attention-Deficit Hyperactivity Disorder). This review presents scientific findings supporting dietary antioxidant treatment of ADHD and describes substantial alterations in the immune system, epigenetic regulation of gene expression, and oxidative stress regulation in ADHD. As a result, chronic inflammation and oxidative stress could develop, which can lead to ADHD symptoms, for example by chronic T-cell-mediated neuroinflammation, as well as by neuronal oxidative damage and loss of normal cerebral functions. Therefore, modulation of immune system activity and oxidant-antioxidant balance using nutritional approaches might have potential in ADHD treatment. The use of natural antioxidants against oxidative conditions is an emerging field in the management of neurodegenerative diseases. Dietary polyphenols, for example, have antioxidant capacities as well as immunoregulatory effects and, therefore, appear appropriate in ADHD therapy. This review can stimulate the development and investigation of dietary antioxidant treatment in ADHD, which is highly desired.

Understanding the impact of diet and nutrition on symptoms of Tourette syndrome: A scoping review

Anecdotal reports frequently suggest some dietary involvement in the maintenance of tics in children with Tourette syndrome (TS). This scoping review aimed to (1) understand the possible influence of diet as a trigger of tics and (2) map out the existing studies documenting dietary interventions in children with TS. Current evidence suggests no single diet to benefit individuals with TS. However, reports from parents of children with TS suggest that certain allergens in food may exacerbate tic-related symptoms. For example, an increase in tics has been related to the consumption of caffeine and refined sugar. Moreover, oligoantigenic diets and sugar-free diets have been identified as significantly reducing tics. More research is urgently needed to develop more accurate guidance for parents and children with TS, as many have reported using dietary and nutritional supplements, despite the lack of evidence detailing any benefits, side effects and recommended doses.