Adverse reactions to food additives

Consumers have a paradoxical view of food additives. The term itself often has a negative connotation among consumers, who frequently state a preference for foods that are natural and made without chemical additives and preservatives. However, these same individuals also claim to prefer foods that are nutritious, convenient and maintain freshness, precisely the foods which are likely to contain nutritional additives and preservatives such as antioxidants (Sloan, 1998). 

Misconceptions about food additives are perpetuated in the media and popular press, and recently have been disseminated via the Internet. There is confusion about the sources and functions of these compounds. Consumers are confused, for example, about the relative safety of natural as opposed to artificial food ingredients. A number of studies have shown consumers suspicion of synthetic chemicals in foods which are seen as posing a higher health risk than natural ingredients (Sloan et al., 1986 McNutt et al., 1986 Crowe et al., 1992). Unrealistic fears about food additives may be attributed in part to the public s fundamental lack of understanding of toxicology, including the failure to appreciate the concept of dose or the body s capacity to metabolize and detoxify the myriad of food constituents people are exposed to daily (Jones, 1992). 

Although food additives have been blamed for a variety of ills, including epileptic seizures, brain tumors, and even criminal behavior, only a few of the approximately 2,800 food additives used in the United States have ever been directly linked to adverse events. New food additives undergo extensive safety testing prior to approval, and existing additives suspected of causing health 

This chapter begins by discussing how consumer perceptions of risks associated with food additives compare to other food-related health risks. It then addresses the US government s system for monitoring adverse reactions from food additives. The bulk of the chapter focuses on additives that have been blamed for causing health problems and which have generated controversy in the US and other countries. Finally, there is a brief discussion of future trends and additional sources of information are provided. 

Two of the best known surveys that monitor consumer attitudes, concerns, and behaviors on various nutrition and food safety issues are the Trends survey developed by the Food Marketing Institute (FMI) and the Prevention Index published by Rodale Press (1996). 

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KANTOR M A (2002) Adverse reactions to food additives , in Watson, D H (ed). Food chemical safety Volume 2 additives, Cambridge, Woodhead Publishing Ltd. 145-170. 

The United States is one of the only countries that has established a formal surveillance system for post-approval monitoring of adverse reactions to food additives. Despite the obvious limitations of a passive surveillance system, ARMS provides an important venue for the public and others to report health problems perceived to be related to food additives. It provides a means of spotting potential longer-term problems with additives which can then be investigated further. 

Another future area of research for monitoring adverse reactions to food additives might involve the development of clinical tests to screen for genetic biomarkers indicating food sensitivities. Perhaps vaccines will be developed and administered to sensitive individuals, preventing the occurrence of adverse reactions from food additives. 

US government agencies providing information on adverse reactions to food additives ... 

Wiithrich, B. 1993. Adverse reactions to food additives. Ann Allergy 71(4) 379-384. 

Pastorello, E.A. and Qrtolani, C., Oral allergy syndrome. In Food Allergy. Adverse Reactions to Foods and Food Additives. DD Metcalfe, HA Sampson and RA Simon Eds., Blackwell Science, Oxford, p 221, 1997. 

Although the US is one of the few countries to have a formal system for monitoring adverse reactions from food additives as part of its regulatory structure, other countries also periodically review additives. In addition, the Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO) also monitors food additives. Since 1956, the Joint FAO/WHO Expert Committee on Food Additives has developed specifications for the purity of additives, evaluated toxicological data, and recommended safe levels of use. 

Strobel, S. (1997). Oral tolerance Immune responses to food antigens. In "Food Allergy Adverse Reactions to Foods and Food Additives" (D. D. Metcalfe, H. A. Sampson, and R. A. Simon, eds.), 2nd ed., pp. 107-135. Blackwell Science, Boston. 

Jacobson, D.W. 1991. Adverse reaction to benzoates and parabens. In Food Allergy. Adverse Reactions to Food and Food Additives. D.D. Metcalfe and H.A. Sampson, Eds., pp. 276-287. Blackwell Scientific, Boston, MA. 

Metcalfe, D.D., Sampson, H.A., and Simon, R. A., Eds. 2008. Food Allergy. Adverse Reactions to Foods and Food Additives, 4th ed. Blackwell Publishing Ltd., New York. 

However, a range of foreign proteins, which are potential antigens, are present in the diet and are absorbed from the gastrointestinal tract. The immune systems of most individuals become tolerant via a regulatory system which prevents adverse reactions to food constituents and additives. However some individuals seem predisposed to allergic diseases and do not become tolerant and so may develop adverse reactions to dietary constituents. It is possible that the interaction of a breakdown product of tartrazine with a protein in the body could be sufficient to cause an allergic reaction in some sensitive individuals. 

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