Mention the issue of children's food, and discussion usually focuses on childhood obesity and Jamie Oliver's crusade for healthy eating in schools. But the research from academics at South- ampton University published this month highlighted another alarming risk to children's health, when it established a clear link between artificial colourings and certain food additives and hyperactivity.
For Sally Bunday, founder and director of the Hyperactive Children's Support Group, the findings that these additives cause behavioural problems came as no surprise. Her organisation has insisted this has been the case since it was founded 30 years ago - and a series of reports have subsequently confirmed fears about E-numbers.
The Southampton study, which was funded by the Government's Food Standards Agency (FSA) and included children from the university's own day nursery, lasted six weeks and recorded the reactions of 153 three-year-olds and 144 eight- and nine-year-olds to mixtures of additives in different drinks (see box). The tests were designed to reflect a child's normal daily consumption of additives.
The additives used in the research are found in soft drinks, confectionery and ice cream. They included artificial colourings and the preservative sodium benzoate. The colours studied included Sunset yellow (E110), Quinoline yellow (E104), carmoisine (E122), Allura red (E129), tartrazine (E102), Ponceau 4R (E124) and sodium benzoate (E211).
The researchers found that some children showed signs of hyperactivity while others did not. But significantly, the 'deleterious effects' of the additives were found in children in the general population rather than just those already prone to hyperactivity.
As a result of the Southampton research and following an evaluation of it by the independent Committee on Toxicity, the FSA has updated its advice to parents, telling them that if their children display signs of hyperactivity or Attention Deficit Hyperactivity Disorder, they should ensure that some artificial colours are removed from their diet.
FSA chief scientist Dr Andrew Wadge says, 'If parents are concerned about any additives, they should remember that, by law, food additives must be listed on the label so they can make the choice to avoid the product if they want to.
'However, we need to remember that there are many factors associated with hyperactive behaviour in children. These are thought to include genetic factors, being born prematurely, or environment and upbringing.'
Weak response
The FSA has held an initial meeting with the UK food industry to discuss the research findings and implications. The agency says representatives from manufacturing and retail organisations revealed that there was 'already a trend within industry towards finding alternatives to the colours used in the study'. But it appears to hint at resistance to change within the industry when it adds: 'Some technical challenges in developing these alternatives were highlighted.'
It is clear that campaigners believe the FSA response to the findings is too weak, side-stepping a call for an immediate ban on these additives and instead heaping the burden on parents to scrutinise what their children can and cannot eat.
Sally Bunday welcomes the report by Professor Jim Stevenson and his team as 'a major step forward', but cautions that 'only a relatively small number of additives and artificial colourings that really need to be avoided by children were included in the study. There were quite a number that they didn't include.'
Richards Watts, co-ordinator of the Children's Food Campaign, says the research findings are 'indisputable evidence' of what parents have long suspected - that certain additives have an effect on children's behaviour. He says, 'The big lesson for parents is to reduce the amount of additives children are consuming, especially if they are already prone to hyperactivity. But parents need help in doing this, so we are calling on the FSA to give them more help in figuring out what food and drinks have additives in them. There should be a clearer message, with maybe labelling saying some things may cause hyperactivity.'
But he sees no reason why, with the possible exception of the preservative sodium benzoate, that 'these additives can't be phased out quickly, because they are all unnecessary and entirely cosmetic'.
Andrea Bilbow, director of the national Attention Deficit Disorder Information and Support Service (ADDISS), insists that 'food manufacturers need to consider this research more carefully when preparing and marketing foods for children'.
She adds, 'Modern life has brought with it a host of differing environmental influences which impact negatively on behaviour and the more we can eradicate, the better it must be for our children.'
Healthy eating
While parents are being left to negotiate their way around often complex scientific terminology to decide what foods and drinks may contain potentially harmful additives, childcare practitioners have the additional pressure of promoting healthy eating and simultaneously respecting parents' wishes - and the two may not always coincide.
Maureen Pratt, a childminder for more than 20 years, has had the benefit of Sally Bunday's expertise, as they are close neighbours in Chichester. She says, 'When you mind a child each day you can really see the difference in their behaviour. You have to abide by the parents' wishes, and mostly they listen if I have mentioned that artificial colours may be affecting their children. I had one child who used to come with bottles of pop each day and I could see the difference, so I pointed out the number of E-numbers involved to the parents and they took it on board.'
Heather Lowe, head of Homerton nursery school and children's centre in Cambridge, says, 'We have had children with behaviour problems and we work with parents to make sure we cut out highly coloured foods containing E-numbers. I don't know for sure whether it's entirely through that, or through our behaviour management approach - perhaps a combination of both - but certainly those children have calmed down a lot.'
The nursery school was part of a healthy eating pilot project in the Cambridge area involving many schools, and she was on a working party charged with adapting it for the private and voluntary daycare sector. She believes that it is vital to give children the chance to do 'healthy cooking', with an emphasis on them chopping their own fruit and vegetables and making fruit kebabs and smoothies. 'Some children start out not liking fruit and veg but often get hooked on them this way. They take that influence home with them, so it filters back to the family,' she adds.
Heather Lowe says the process of educating children about healthy food should start as early as possible. 'Part of it is through modelling, staff eating healthily, or me having a fruit bowl in my office so people are offered fruit rather than biscuits.
Given that the Southampton research, which was published in the medical journal The Lancet, is the biggest UK study into links between behavioural problems and chemical food additives, there is bound to be disappointment among campaigners that the FSA has chosen not to issue formal advice based on the findings to headteachers about the content of school meals.
But they are heartened that the FSA is sharing the findings with the European Safety Authority, which is currently reviewing the safety of all food colours approved for use in the European Union. Sally Bunday undoubtedly speaks for the growing lobby against these additives when she says the UK government should take a lead now and ensure that they are removed from children's food and drink.
CASE STUDY
The Southampton research project involved pre-school children at the university's day nursery, which reviewed its provision of meals and snacks in the wake of Jamie Oliver's campaign for healthier school meals.
The review in June 2005 by Hilary Blake, of the University of Southampton Catering Services, identified some concerns about the nutritional value of the food provided at the nursery and one of the university's nutritionists was brought in to advise.
The advice stressed that children need to learn to recognise food items by colour, texture and taste and that they should have sufficient iron and calcium in their diet through the consumption of red meat and full-fat dairy products.
A three-week menu cycle was devised to include all fresh vegetables, fruit, fish and meat. Parents can order food for their children for the following week so that any dietary needs can be met.
Nursery managers Corinne Finlay and Sarah Cooper say the nursery has also introduced vegan and 'weaning' menus. 'The weaning menu follows the ethos of nutritionist and author Annabel Karmel and is based on a combination of fruit, vegetables, fish and chicken,' they add.
There is now a clear focus on raising children's understanding of healthy eating and an emphasis on 'ensuring that meals and snacks are nutritious, avoiding large quantities of fat, sugars, salt, additives, preservatives and colourings'.
