I never really thought twice about food coloring – and if I did, I thought how wonderful it was. Isn't it great that you can make a green cake, decorate Easter eggs, customize treats for children, make play dough, etc.? It seemed as if every label I checked had some type of food coloring in it, so that meant it was safe right? Unfortunately, the answer turned out to be a resounding NO!
Why was it that some members of my family reacted after eating foods that contained coloring? Was it my imagination? Was it something else in the food? What about other children whose parents shared the same concern? Why did one child become hyperactive while another broke out in a rash? These questions haunted me, and I needed to find answers.
When we approached our pediatrician, she mentioned that some parents believe there is a connection between colors and behavior and illness, but there was absolutely no evidence to support that food coloring was in any way responsible for either outcome. However, she also was not able to provide data supporting that it was not detrimental, so I decided to keep looking. Eventually I heard of Dr. Ben Feingold, purchased his books, and read about the link he had made between hyperactivity and food coloring. A number of his patients improved or recovered by changing their diets, specifically eliminating salicylates and colorings. Dr. Feingold had quite a bit of data on salicylates, but what really intrigued me was the link between colors and hyperactivity – what exactly was in these colors?
Background
Artificial food colorings were first introduced after World War II when the chemical industry met with the food industry regarding using chemical-based colors since they were lower in cost than natural colors and had a longer shelf life. The safety of the colors was determined primarily from using LD-50 tests, and the amount was then extrapolated to humans. At the time of approval, behavioral toxicology testing was not required by the Food and Drug Administration (FDA) and therefore was not done on the artificial food colors.1
The Food and Drug Administration and Food Colorings
The FDA's website proved to be a valuable database for food coloring information. The site provides precise lists of color ingredients and is quite disturbing. I was personally horrified to learn that all artificial food colorings contain heavy metals such as lead and mercury as well as a myriad of chemicals.
One reason this was so disturbing was that one portion of the FDA had complete literature on the dangers of lead and the sources; however, food coloring was not listed as a potential source of exposure. Another reason this was disturbing was the consideration of all the possibilities for exposure to artificial food colorings in any given day. For example, is your child drinking a sports drink or a fruit juice with coloring? Does their antibiotic contain coloring? What about the macaroni and cheese you made for dinner last night? What are the cumulative effects of this exposure?
What Levels Are Safe?
Most artificial food coloring contains lead, mercury, and arsenic. What amounts of these substances are considered safe? The Department of Health and Human Services reports minimal risk levels (Table 1).
Table 1: Minimal Risk Levels for Mercury, Lead, and Arsenic
Mercury
| Mercuric Chloride (oral) | Acute: .007 mg/kg/day Intermediate: .002 mg/kg/day |
| Mercury (Inhalation) | Chronic: 0.0002 mg/m3 (mg per cubic meter of air) |
Lead
| Air | EPA:1.5 mcg/ m3 WHO: .5 mcg/ m3 |
| Blood | Children 10 mcg/dL OSHA – written notification & medical exam: 40 mcg/dL OSHA – medical removal from exposure 50 mcg/DL |
| Food | FDA: Bottled drinking water: .005 mg/L |
Arsenic
| Arsenic (Oral) | Acute: .005 mg/day Chronic: .0003 mg/day |
Endpoint: Gastrointestinal Endpoint: Dermal |
Artificial Colors
Artificial colors become even more of a concern because, not only are they in our food products, but they are also in other daily use items such as lotion, shampoo, soaps, etc. Furthermore, the metal allotments in these cosmetic products are even higher than those allowed in food products. Table 2 provides metal and chemical information for each color used in food products. Table 3 provides the same information for each color used in cosmetic products.
Table 2: Artificial Food Coloring (81KB .pdf)
All the colorings listed in the Tables are approved for general use in food with the exception of two colors. The first color, Orange B, is authorized for use only in casings or surfaces of frankfurters or sausages. Were you aware that these foods had colors in them? I certainly was not, and that is very concerning. Even if you are consciously trying to avoid colors, you have to be extremely vigilant and check every label, because colors show up in seemingly innocent places.
The second color, Citrus Red No. 2, is approved only for orange skins that are not intended for or used in processing – this means the oranges that we are going to sit down and eat. Again, here we are as parents, providing what we believe is a nutritious alternative for our children, only to learn that they can be laced with heavy metals.
Cosmetic Coloring
What do baby shampoos, lotions, and washes have in common? They are considered cosmetics and therefore can use FDA approved cosmetic coloring in their products. What is interesting is the FDA has allowed for higher levels of metals in the cosmetics category. Table 3 presents the data for cosmetic coloring.
Table 3: Artificial Cosmetic Coloring (127KB .pdf)
Dermal Absorption
According to the Children's Environmental Health Project, dermal absorption is proportional to the concentration of the substance and the surface area to which the substance is applied. Dermal absorption rates vary from person to person and are affected by variables such as skin thickness, occlusions, and the composition of the substance. Composition refers to if the substance is lipid-soluble. If it is, it will be more easily absorbed into the skin.4
This is such an important point because this means we have to be as vigilant about what we put on our skin as we are about what we are eating. In addition, most of the cosmetic colorings actually allow for higher concentrations of heavy metals and, if the dermal absorption rate varies from person to person, the amount of toxic substances could affect some individuals more so than others. Something as innocent as washing your hands with soap could be exposing you to more than you bargained, and identifying alternatives needs to be a priority.
There are several studies on PubMed that considered percutaneous absorption of lead. One study looked at inorganic lead compounds, and the conclusion of the study was that significant amounts of inorganic lead compounds can be absorbed through the skin and protection should be used.5 Another study looked at inorganic lead compounds and the effectiveness of skin cleansers at removing lead from the skin. Their results showed it is necessary to prevent skin contamination from occurring, because a short contact can increase skin content and penetration, even if quickly followed by washing.6 Furthermore, E-medicine reports that transdermal absorption for alkyl lead can be substantial.
Mercurial ointments were used as a treatment for syphilis before the discovery of penicillin. The ointments were applied directly to the thinnest areas of the skin such as the groin and the bends of the elbows and knees. Some scientists believed that the dermal absorption of the ointment was quite low and that patients were actually receiving benefit from inhaling the mercury vapor. A study was performed where the ointment was rubbed in and any excess was washed off the skin, eliminating any source of mercury vapor. Seventy-five percent of the study participants experienced salivation – one of the known effects of mercury – proving dermal absorption played a key role.7
According to the Department of Health and Human Services, dermal absorption of arsenic is low; however, it is readily absorbed if inhaled or ingested. Many wood-based playground structures have been removed out of fears that children would touch the arsenic-treated wood and then put their hands in their mouths.
Colors and Mental Health
As mentioned previously, Dr. Feingold identified a link between food coloring and hyperactivity. He also noticed a marked increase in the ADD/ADHD classification after the mass introduction of food colorings into our society. A brochure, available in my pediatrician's office, by McNeil Consumer & Specialty Pharmaceuticals indicates that lead exposure can lead to ADHD, yet the brochure writers discredit the idea that food/cosmetic colors have any role in affecting children's behavior.8 If lead has been implicated in ADHD, and colorings have lead in them, then removing coloring additives from the diet and environment are crucial. The Journal of Developmental & Behavioral Pediatrics published information regarding 15 trials with 219 participants; all were double-blind cross-over trials. Just by eliminating artificial food colorings from their diet, children's behavior improved significantly. Furthermore, just eliminating food colorings from the diet produced one-third to one-half the improvement typically seen with ADHD medication therapy.9
Even if one elects to use medication, heavy metal toxicity screenings need to be prescribed prior to psychoactive drugs, because most of these drugs contain colors that can lead to further toxicity. Table 4 provides an account of the coloring present in commonly prescribed ADHD medications.
Table 4: Color Content in ADHD Medications
| Ritalin 5mg and 20 mg | D&C Yellow No. 10 |
| Ritalin 10 mg | FD&C Green No.3 |
| Strattera | FD&C Blue No. 2, synthetic yellow iron oxide, and edible black ink. |
| Dexedrine | FD&C Yellow No. 5 and FD&C Yellow No. 6 |
This means that children taking these drugs are being exposed to lead, arsenic, and mercury. This also indicates that these children in particular need to be extremely careful with whatever medications they may take – acetaminophen, ibuprofen, antibiotics, etc., to ensure that alternative products that do not contain food dyes are selected. Amoxicillin11 and Cefzil,12 for example, contain Federal Food, Drug, and Cosmetic-approved red dyes as well as aspartame. As parents, we can check food labels, but we must rely on our physicians to select our medicines, since the bottles provided by the pharmacist do not list the ingredients. Colloidal silver, homeopathy, and supplements may provide a safer alternative.
Several studies also point to the link between lead and ADHD. One of the most recent was published in the Journal of Environmental Health Perspectives.13 According to the Journal, children with blood lead levels of more than two micrograms per deciliter were four times more likely to be diagnosed with ADHD than children with levels below .8 microgram per deciliter. The government's acceptable blood lead level is ten micrograms per deciliter. The study estimates that more than five million four-to-15 year olds in the US have levels higher than two micrograms per deciliter.
Another study done by the National Academy of Sciences in 2000 stated that roughly three percent of all developmental and neurological disorders in the US are caused by toxic chemicals and other environmental factors. The same study showed that environmental triggers, along with a genetic predisposition, may cause approximately 25% of developmental and neurological deficits. The Academy also acknowledged that, in this study, they were only referring to well-recognized and clinically diagnosed mental and physical disabilities – therefore, the 25% estimate may in fact be higher.14
What is Your Child Exposed to on a Daily Basis?
A Day in the Life of a Child
Most parents I speak to are completely unaware of the color content of their food, cosmetic products, and medicines. Some who are aware are shocked to find out coloring doesn't come from natural substances. Tables 5-7 offer color information regarding some popular foods, cosmetics, and over-the-counter (OTC) supplementation/medicines used for children.
Table 5: Coloring in Food Items
| Gatorade Fruit Punch | Red #40 |
| Plain M&Ms | Red 40 Lake, Blue 2 Lake, Yellow 5, Yellow 6, Blue 1 Lake, Red 40, Blue 1 |
| Bakery mini chocolate muffin | FD&C Red 40 |
| Kraft Macaroni & cheese | YELLOW 5, YELLOW 6 |
| Eggo Waffles | Yellow #5, Yellow #6 |
| Fruit Loops | Red No. 40, Blue No. 2, Yellow No. 6, Blue No. 1 |
| Dannon Sprinkl'ins Yogurt15 | Yellow 6, Yellow 5, Red 40, Blue 1, Yellow 6 Lake, Red 3, Red 40 Lake, Yellow 5 Lake, Blue 2 Lake, Blue 1, Blue 1 Lake, Blue 2 |
| Nutrigrain Blueberry bars | Red 40, Blue 1 |
| Strawberry Pop tarts | Red 40, Yellow 6, Blue 1 |
Table 6: Coloring in Cosmetic Items
| Bathtime Colorblast Tablets | FD&C Yellow #5, FD&C Blue #!, D&C Red #33 |
| Johnson Baby Shampoo | D&C Yellow #10, D&C Orange #4 |
| Johnson Baby Lotion | D&C Red 33 |
| Pampers hand soap | Yellow 5, Green 5, Orange 4 |
| Dora Foam Soap | May contain FD&C Blue 1, FD&C Red 40, FD&C Yellow 5 |
| Sesame Street Foam Soap | FD&C # 33 |
| Disney Chapstick | D&C Red No. , FD&C Blue 1 alum lk |
| Crest Kids Sparkle Paste | FD&C Blue #1 |
Table 7: Coloring in OTC Supplementation/Medicines
| Flintstones Vitamins (also contain aspartame) | FD&C Red #40 Al Lake, FD&C Yellow 6 Al Lake FD&C Blue #2 |
| Tylenol Plus Cold Infant Drops | Red #33 and Red 40 |
| Delsym Cough Medicine | FD&C Yellow 6 |
Cumulative Effects of Exposure?
What are the cumulative effects of food and cosmetic colorings to us and, more importantly, to our children? According to Dr. Gary Gordon,16 each time a manufacturer prepares a batch of dye for use in its products, it has to submit a sample from that batch to the FDA for certification. Only the FDA can certify colors as safe; no one else has that authority. I was unable to find any studies indicating overall exposure or estimated daily exposure to these metals. I was also unable to find any studies on the mixing of food colorings or the total amount of lead, mercury, arsenic content for products that use a combination of colors. This is concerning.
Colors in Your Cleaners
Cleaning products present an interesting challenge, since manufacturers do not have to identify the ingredients of their products on the labels. Material Safety Data Sheets (MSDS) are available for consumers to view via most companies' websites. However, these MSDS require manufacturers to provide information regarding established exposure limits. They do not provide an ingredient list and are protected by patent laws.
The Effects of Lead, Mercury, and Arsenic
We have all heard that lead is associated with lower IQ, but did you know it could also be responsible for some cavities? According to a study published in the Journal of the American Medical Association (June 23/30; 281:2294), where data was analyzed from 24,901 children, a correlation between lead and cavities were established. Most of the children participating in the study had blood-lead levels of only a few micrograms of lead per deciliter, well below the federal guideline for blood-lead concentrations of 10 mcg per deciliter. For children aged five to 17, an increased burden of 5 mcg per deciliter of blood corresponded to an 80% increase in cavities. The researchers estimate that cavities of 2.7 million US children result from lead, about ten percent of all cases in that age group. The researchers speculated that either the lead stunts development of the glands that produce saliva (which protects teeth from harmful acid and bacteria) or lead might hinder enamel growth.17
The American Academy of Child and Adolescent Psychiatry estimates one out of every six children in the United States has blood lead levels in the toxic range.18
Lead exposure has been linked to developmental delays, peripheral neuropathy, altered thyroid hormone, and reduced fertility. In elderly adults, levels over 4 mcgs can have neurobehavioral effects.
Mercury
So what do you do if you get a cavity? Well, some dentists will fill your teeth with amalgams that contain mercury. Mercury has been implicated in autism, ADHD, learning disabilities, endocrine problems, allergies, asthma, rheumatoid arthritis, and a host of other disorders. According to the FDA, "The toxicity of mercury compounds is extensively documented in scientific literature. It is well-known that mercury compounds are readily absorbed through unbroken skin as well as through the lungs by inhalation and by intestinal absorption after ingestion. Mercury is absorbed from topical application and is accumulated in the body, giving rise to numerous adverse effects… Recently it has also been determined that microorganisms in the environment can convert various forms of mercury into highly toxic methyl mercury which has been found in the food supply and is now considered to be a serious environmental problem."19
Common Dreams newswire reported in 2004 that Environmental Protection Agency (EPA) scientists using data collected by the Centers for Disease Control (CDC) estimated that one in six pregnant women has enough mercury in her blood to pose a risk of brain damage to her developing child.20 Lower levels of mercury exposure can lead to symptoms of fever, insomnia, rapidly changing moods, and tremors.
Arsenic
Arsenic poisoning has been associated with respiratory, neurological, developmental, and cardiovascular issues. It has also been associated with cancer. In fact, an increased risk of skin cancer in humans is associated with chronic exposure to inorganic arsenic in medication, contaminated water, and the workplace.21
Arsenic is present in food such as meat, fish, and poultry and, according to the Department of Health and Human Services, accounts for 80% of our dietary intake (although fish arsenic has a low toxicity in humans and is excreted rapidly in our urine). Fungicides, herbicides, insecticides, paints, and water are other sources of exposure.
An intellectual function study which included 201 children under the age of ten concluded that as little as .0017 mg per day affected children's performance in switching attention task. When the exposure increased to .0034 mg per day, the children showed decreased performance in both switching attention tasks as well as in tests that measured memory.22
What Can We Do?
The first step is to remove colors from your environment. This can be difficult since colors are pervasive, but there are alternatives. For instance, if you need food coloring, health food stores sell colors made from food – turmeric, blueberry, beets, etc. These can be used to make play dough as well as to color foods. Health food stores also make available muffins, toothpastes, snacks, chocolates, drinks, and OTC medications that do not contain colors.
Cooking and eating as many meals as possible at home is also a step in the right direction. You can control what you put in your food. If you need to obtain medication and are not sure if it contains colors, you can check online at www.rxlist.com. If your medication is made with colors, contact a compounding pharmacy to see if they can compound without all the colors. A list of compounding pharmacies can be found at www.iacprx.org.
Debbie C. Lindgren, CIHom, BA, MBA
References
1. Pressinger, R. Chemical Food Additive Exposure During Pregnancy Links to Learning Disabilities, ADD and Behavior Disorders, University of South Florida Special Education Department (online). Available at: http://www.chem-tox.com/pregnancy/artificial.htm. Accessed October 14, 2007.
2. Food and Drug Administration (online). Available at: www.cfsan.fda.gov/~dms/opa-col2.html#table1A Accessed June 10, 2005 and October 14, 2006.
3. Food and Drug Administration (online). Available at: www.cfsan.fda.gov/~dms/opa-col2.html#table1A Accessed June 10, 2005 and October 14, 2006.
4. Canadian Association of Physicians for the Environment (online). Available at: www.cape.ca/children/derm.html Accessed September 13, 2006.
5. Sun CC, et al. Percutaneous absorption of inorganic lead compounds. American Industrial Hygiene Association 2002 Sep-Oct; 63(5):641-6.
6. Filon, et al. Skin absorption of inorganic lead (PbO) and the effect of skin cleansers. Journal of Occupational and Environmental Medicine. 2006 Jul;48(7):692-9.
7. Scheindlin, Transdermal Drug Delivery: Past, Present, Future. Molecular Interventions (online). Dec. 2004, Vol.4 Iss. 6. Available at: http://molinterv.aspetjournals.org/cgi/content/full/4/6/308 Accessed: August 1, 2006.
8. McNeil Consumer & Specialty Pharmaceuticals, ADHD: Answers from the Experts, Science Made Simple. Brochure.
9. Schab, D.W., Trinh, N.H. Do Artificial Food Colors Promote Hyperactivity in Chilcren with Hyperactive syndromes? Journal of Developmental & Behavioral Pediatric (2004)s. 25(6) 423-434 (online). Available at: http://www.fabresearch.org/view_item.aspx?item_id=789. Accessed October 27, 2006.
10. Available at: www.rxlist.com/cgi/generic/methphen.htm Accessed on November 8, 2006.
11. Available at: http://www.rxlist.com/cgi/generic/amox.htm Acessed on November 8, 2006.
12. Available at: http://www.rxlist.com/cgi/generic/cefprozi.htm Accessed on November 8, 2006.
13. Braune, J., et al. Exposure to Environmental Toxicants and Attention Deficit Hyperactivity in Children. Enviornmental Health Perspectives (online) . 2006 Dec. Volume 114, Number 12. Available at: http://www.ehponline.org/members/2006/9478/9478.pdf (507 KB .pdf)
Accessed on October 14, 2006
14. National Environmental Trust (online) Available at: http://www.net.org/health/neighborhood/cehfuture/intro.vtml Accessed on June 24, 2006.
15. Food Facts (online). Available at: http://www.foodfacts.com/members/item_info.cfm?id=18211 Accessed on November 2, 2006
16. Gordon, G. Gordon Research Institute (online). Available at: http://www.gordonresearch.com/answers/lead_in_cosmetics_an_urban_legend.html Acessed on September 30, 2006.
17. Carpenter S. Lead and Bad Diet Give a Kick in the Teeth. Science News Online. Available at: http://www.sciencenews.org/pages/sn_arc99/6_26_99/fob3.htm Acessed on August 27, 2006.
18. American Academy of Child and Adolescent Psychiatry. Facts for Families: Lead Exposure, 1997 (online). Available at: http://www.healing-arts.org/children/ADHD/lead.htm Acessed June 1, 2006.
19. Food and Drug Administration (online). Available at: www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?
CFRPart=700&showFR=1&subpartNode=21:7.0.1.2.10.2 (All one link.)
Accessed: August 10, 2005 and September 10, 2006.
20. Bender, M. FDA Not Protecting Children From Mercury in Fish, Say Advocates, According to New Research. Common Dreams Newscenter (online). http://www.commondreams.org/news2004/0205-14.htm Acessed: October 3, 2007
21. Case Study in Environmental Medicine. Agency for Toxic Substances and Disease Registry (online). Available at: http://www.atsdr.cdc.gov/HEC/CSEM/arsenic/physiologic_effects.html Acessed on November 4, 2007.
22. Wasserman, G. Water Arsenic Exposure and Children's Intellectual Function in Araihazar, Bangladesh. Environmental Health Perspective. Available at: http://www.ehponline.org/members/2004/6964/6964.pdf (172KB .pdf)