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  • mindfulpediatricsk

Food additives and children’s health

Updated: May 29, 2020


Humans need food to provide energy and nutrients. But how we get that food has changed in the last 100 years. The settlers spent most of their time and resources towards growing, gathering, and raising their own food for their family. With time our society transferred this work outside the home. There were some advantages to this. But with most things, humans have taken it to the extreme, and now we are learning some problems that has created, and need to find a balance again. Today, most Americans are far removed from the source of their food. When you rely on someone else to make your food, most of the time they are not as concerned with making it nutritious. Most processed food company’s goal is for profit, and so their goal is to make things desirable to the consumer (with a perfect combination of fat, sugar, salt and flavorings that you can’t just eat 1!), and also make with as cheap of ingredients as possible to make as big of a profit as possible. The result is a society that is eating supernatural tasting “franken-foods” that resemble food but are not real food. Food markets have changed from colorful produce to colorful boxes and containers.

Our goal should be to provide our children with high yield, higher nutrient to calorie foods. But for numerous reasons (for instance easier and cheaper) most children eat more food that is further away from nature. The average American child gets 30-40% of their calories from what the American Academy of Pediatrics terms “energy-dense, nutrient poor foods and drinks”, aka junk food (AAP Snacks and sugar ). The more processed, further away from nature food is, the more good nutrients are taken out, and potentially bad additives are added in. This has potentially bad consequences on the body because not getting nutrients need, but also causing potential harm. In this article I want to focus on potential harm of food additives, because the AAP recently released a policy statement on food additives and children’s health, and more and more families are learning about the new information and asking what they can do. AAP Food additives and child healthI will discuss getting the nutrients kids need in a future article.

Today more than 10,000 chemicals are allowed to be added and in contact with food in the United States. There is increasing concern about processed food additives, not only because it is something that is increasingly being used and eaten without much knowledge about the effects on our bodies, but also because chronic disease in children is on the rise as I pointed out in my environmental exposures article. This increase in illness has prompted research into what factors maybe causing it, and we are starting to learn about some of the effects these compounds. As usual, the AAP is on the forefront of taking this information and giving recommendations to help children. The purpose of the AAP’s policy statement is to highlight emerging health concerns related to food additives. This includes direct additives, such as colorings, flavorings, and other chemicals like preservatives. As well as indirect additives that are in contact with the food through packaging and manufacturing equipment such as adhesives, dyes, coatings, cardboard ingredients, plastic, and other polymers. This is to not only inform pediatricians and families to help them make choices for children, but also to propose urgently needed reforms to current regulation of food products and additives.

Oversight and regulation of food additives

The AAP points out regulation and oversight of food additives by The US Food and Drug Administration (FDA) is inadequate.  A little political background: federal agencies can only follow laws, they are not granted power to do anything outside that law. So the main law the FDA follows is the Federal Food, Drug and Cosmetic act (FDA). This law was originally made in 1938 largely before manufacturing of food substances, so a Food Additives Amendment was made in 1958 (although think of all the new additives that have been added since then!). The amendment’s goal was to set forth a formal agency review, public comment, and open rule-making process for new chemical additives. Unfortunately, very little of food additives went through this formal process that uses agency and public review. Because the law also called for an exemption for common food additives, originally meant for things like vinegar, saying a company can use “generally recognized as safe” (GRAS) designation, and under these specific scenarios a formal rule-making process was not required. Unfortunately, the GRAS process has been used as a loophole for companies and the FDA has allowed this for virtually all new food additives entering the market (remember in my environmental exposure blog how I mentioned the US allows chemicals on the market that other countries do not allow, this is one of the ways that happens). Even the Government Accountability Office has conducted a review of the FDA GRAS program and determined this is not adequate for the FDA to ensure the safety of existing or new additives GAO report.  Concerns also have been raised about conflicts of interest in scientific review of food additives with GRAS designation. An evaluation of 451 GRAS evaluations revealed that 22% of evaluations were made by an employee of the manufacturer and 64% were made by an “expert panel” selected by the manufacturer or manufacturer’s consulting firm. They found that none of the evaluations were done by a non-biased 3rd party: that means the “scientific” evaluations on chemicals in food humans were exposed to were made by parties on the side of the companies Conflict of interest in approvals of additives to food. (On the topic of conflict of interest: I don’t want to get too political, but I just want to add that most legislators who make the laws that govern the FDA, receive campaigning help from the companies that use these chemicals, so this motivates them to not pass legislation against these companies, see information about citizens united decision, again before we can solve a problem we have to get to the root, and the ability for companies to donate to politics is sort of like legal blackmail. But I digress!)

On top of all this, the FDA has NOT been given authority to obtain data on the safety of chemicals already on the market, so that means once a chemical passes as GRAS, it is untouchable. For instance, styrene has been classified by the US National Toxicology Program (report) as reasonably anticipated to cause human cancer, but because it is already passed as GRAS, the FDA is not allowed to reassess the safety. There are so many other problems, such as the FDA does not consider cumulative (dose and time) or synergistic (chemicals with similar effects working to double the effect). This is important because in their lifetime children maybe exposed to daily, large amounts of different chemicals that all cause endocrine disruption, therefore cumulatively and synergistically all effect the thyroid hormone system for example. The AAP and other organizations have said all of this is insufficient to ensure the safety of additives and do not protect against conflict of interest.

Why children are vulnerable 

Children are especially vulnerable to exposure to potentially harmful substances. They are still growing, so they eat, drink and breathe more per weight than adults. They are still developing, so exposures can potentially cause lifelong and irreversible damage. (WHO children and environment).  Children also have less ability to detoxify, since their gut, respiratory, skin and metabolic pathways are not fully developed. But it is more difficult to do research on children due to their personal inability to participate directly in direct recall of what they are exposed to (for instance, you can just ask an adult what they ate today!). But there still is accumulating evidence from nonhuman laboratory and human epidemiological studies that some of these chemicals maybe contributing to pediatric disease and disability.

Endocrine disruption

The potential for endocrine system disruption is of great concern in children (WHO endocrine disruptors).  The endocrine system is the hormone system responsible for things like thyroid hormone for metabolism, adrenal hormones for urine regulation and stress response, pituitary which helps control all the glands, pancreas that helps regulate insulin and weight, and even puberty and fertility hormones from gonads. Therefore, as you can imagine, in children this can have life altering consequences. Endocrine disruptor compounds can mimic hormones or affect the glands, and have the potential to interrupt hormone balances and have lifelong effects such as on metabolism and fertility. International medical and scientific communities have called attention to these issues in several recent landmark reports: Endocrine society, World Health Organizations and United Nations Environmental program joint report, and International Federation of Gynecology and Obstetrics report in 2015.

Summary of key food additives 

The AAP policy statement summarized some of the evidence we currently have on key food additives. Long story short, to be more well, eat real food that is least processed and doesn’t come in a package. Long story about additives to help back that statement up (with the caveat that these indicate increasing risk, doesn’t mean if you eat it will for sure cause, again like I said in my environmental exposures overview, it’s all about decreasing risk when possible. For instance: in this society it’s hard to avoid all driving, but you wear a seatbelt and put down your phone to decrease risk):

Bisphenols: They can be found in plastic containers, resins in cans. Possible effects include endocrine disruption, promotion of obesity, nervous system development disruption. The compound that has gotten the most attention is bisphenol-A (BPA). Despite mounting evidence about harmful effects of BPA, the FDA still says it’s safe in the amount exposed to humans (although with plastic being in and on everything the amount of exposure has increased, and studies have shown low nanomolar concentrations that humans are at least exposed to, have caused toxicity like conversion of cells to fat cells and disrupt pancreatic cell dysfunction BPA Nature article), and has only abandoned BPA’s use from infant bottles and formula cans, not because of safety, but because of public demand such that the companies voluntarily took it out of these products.

Phthalates: Found in plastic food wrap, plastic storage, food manufacturing equipment. Possible effects include endocrine disruption, promotion of obesity, oxidative stress (see my first blog about this causing toxic effects in body), cardiac toxicity

Perfluoroalkyl chemicals (PFCs): Food manufacturing equipment, grease proof paper and paperboard. Possible effects include endocrine disruption, immune suppression, promotion obesity, decreased birth weight

Perchlorate: food packaging. Can cause thyroid hormone disruption and maybe contributing to increase in neonatal hypothyroidism that is occurring in the United States (if untreated can lead to stunted growth and developmental problems)

Nitrates and nitrites: In processed meats like deli meat, hot dogs, sausage, etc. Known carcinogen (cancer causing). Also thyroid hormone disruption

Artificial colors: Maybe associated with exacerbation of attention deficit/hyperactivity (ADHD) symptoms. Again, like in my environmental exposures blog, this is dose and person dependent. But if junk food that is made out of “paint and sugar” isn’t nutritious anyways, it’s also worth avoiding artificial color if it can potentially cause worsening symptoms

Pesticides: This will be in another blog about organic foods, and the AAP wrote a separate policy statement about AAP Organic foods

This policy statement did not address contaminants that inadvertently enter the food and water supply, through environmental contamination like runoff from power plants and factories into fields and water supply. I eluded to this in my environmental exposures blog, and will talk more about it in a climate change article later.  But it’s another reason to be mindful of what you consume, remember when things are “thrown away”, they never really go away, they end up somewhere and in something.

Short story: just eat close to nature

Well that was the long story. But we don’t have to memorize all the chemical names and effects, plus we don’t even know all the chemicals and their potential effects. So what I try to do is choose as close to nature as much as possible to try to avoid the alphabet soup of chemicals. When that’s not possible, choose foods with least number of ingredients, and foods without added artificial color/flavor/preservatives, and with minimal processing and packaging. My plan is to do a video blog to show examples of how I implement this in our household.  But it can be simple, which is closer to nature:

The diet of more unprocessed foods can be easier for families from higher socioeconomic status. There are barriers for families from lower socioeconomic status, such as time (single parent homes maybe less able to make their own food), money, and access (food deserts exist in underserved areas, sometimes the only source of food is a convenient store where there is less fresh food).  This has been shown in studies, such as urinary BPA concentrations inversely associated with family income.  So not only are low income and minority children eating the high calorie low nutrient food, the packed food is exposing them to potential obesity causing chemicals such as BPA.  It makes my heart hurt that America is setting these kids up to be unhealthier.

What can we do?

So what can we do?! There are 2 levels, public health and individual family. For public health, we can help raise awareness, support organizations who are trying to improve knowledge and evoke change, and vote for representation that supports campaign finance and FDA reform.  The AAP is doing what it can to gain more evidence and lobby for FDA reform and GRAS process revision.

For your individual family, you can inform yourself to make best decision and choice possible for your individual family. Again this means different things for different families who have different means, but with what time and money you can apply to the best food you can. Prioritize eating vegetables and fruits and food that doesn’t have an ingredient list. Avoid processed meats (nitrates and nitrites can be found). Consume less food and beverage in contact with plastic as much as possible, remember many of the potentially toxic chemicals and endocrine disruptors are found in plastic. Especially do not heat plastic around food as it releases more of the chemicals, such as avoid microwaving food in plastic. Also avoid placing plastic in dishwasher, as with the microwave, whenever you heat plastic it releases particles onto the food or other dishes in the dishwasher. Use alternatives to plastic, such as glass and stainless steel, when possible (more to come on this in my video blog of my own kitchen!). And for many reasons, hand wash before handling food, not only to get rid of germs, but any chemical residues you may have touched (like my laptop keyboard I’m touching now😉

Remember, consumers have the ultimate power, every time we buy some thing we are telling that company “keep making this”. Simple supply and demand: if we refuse to buy it because it’s not healthy and is potentially harmful, then they won’t make money, and will have to change. We are starting to see it, people are catching on and starting to be more mindful and informed consumers. For instance, Kraft took artificial color out of some of their products because it wasn’t selling. Knowledge is power, and as we do more research and learn more things, we will protect our families more. This is why the more natural food and product market is one of the fastest growing market (natural industry article)

So do we can back to the old settler’s days?! I think there is a balance somewhere between the settler’s way of getting food, and the highly processed food in bags and boxes. More to come in the next eating healthy post😉

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