Health professionals – nurses, dieticians, physicians, public health workers, social workers and others – see every day the downstream impacts of a broken food system. They are on the front lines of the American epidemics of obesity and related chronic diseases, such as heart disease, stroke, diabetes and cancer. Cancer and other diseases are increasingly linked to pesticide use and other toxins rife within our food and farming system. Like successful policy changes to curb tobacco use, public action by health professionals is urgently needed to support a healthier food system for all Americans, including more sustainable farms to grow and produce healthy food.
- Healthy Food Action web site
Because of my role battling on these front lines to keep kids healthy, I was invited to participate in Healthy Food Action’s thought provoking webinar, “Driven to Distraction: Food, chemicals and child behavior.” Moderated by noted food safety expert and advocate, Dr. David Wallinga (Senior Advisor in Science, Food and Health for the Institute for Agriculture and Trade Policy), the panel also included Karen Bowman, RN, an Environmental Health Specialist for the Washington State Nurses Association and Michael Jacobson, Ph.D., Executive Director for the Center for Science in the Public Interest (CSPI). Dr. Jacobsen reviewed the principles behind CSPI’s landmark publication, "Food Dyes: A Rainbow of Risks,” drawing on the most up-to-date scientific evidence regarding adverse effects of food dyes on human health. The CSPI has persistently hounded the U.S. FDA to more effectively regulate food additives in our nation’s food and beverage supply, petitioning the FDA since 2008 to ban the use of food dyes given the growing literature demonstrating neurotoxic effects on children. Dr. Jacobsen also noted that several dyes have been linked to an increased risk of cancer and allergic disorders. For a terrific summary of the scientific and public policy issues related to food dyes, I’d encourage everyone to read Dr. Bernard Weiss’s article for Environmental Health Perspectives, “Synthetic food colors and neurobehavioral hazards: the view from environmental health research.” (Environ Health Perspect. 2012 Jan;120(1):1-5). Dr. Weiss is Professor Emeritus, Departments of Environmental Medicine, Pediatrics, and Neurodevelopmental & Behavioral Pediatrics at the University of Rochester School of Medicine; he is one of the country’s leading authorities on environmental neurotoxicity. Dr. Weiss takes the FDA to task for considering only the narrowly-defined impact of food dyes on hyperactivity and sagely urges the agency to examine “the broader environmental question of behavioral effects in the general population.”
These are the effects I see in clinical practice. I presented during the webinar the case of a young boy in my practice – JT (a fictitious name but a true story), a seven-year old with increasing difficulties at home and at school. I met with his parents to discuss their concerns about JT’s emotional and physical health. His first grade teacher suggested they consult with me regarding JT’s hyperactivity, impulsivity, restlessness, and distractibility in the classroom. At home, he suffered from mood swings and irritability, and he was extremely oppositional with his parents and siblings. His parents explained that JT often complained of headaches, stomach aches, and that he developed strange rashes from time to time. He was always “active” but no had no major issues at home or school until this year, his first time in full day school - in which he predominantly ate school lunches.
There are many explanations for JT’s clinical presentation. Notably, though, there were no other environmental changes over this time period and his behavior and physical difficulties worsened significantly in first grade. He was also eating more processed foods; by not taking time to eat a home-cooked breakfast or lunch, he was drinking and eating many more items with food dyes and additives. After a comprehensive evaluation, we developed an integrative plan for JT that focused on nutritional changes (including avoiding food dyes and additives) and other lifestyle adjustments (e.g., sleep, outdoor play, mind-body components). Within a month, JT was much happier, felt better, able to focus in school and get along better with his family. These lifestyle changes take time and require work – but they usually make a difference. Easier in the short term to prescribe medications? Perhaps, but pills don’t typically address the underlying root causes of health woes and promote sustainable, optimal health.
It is increasingly clear that food dyes and additives pose a direct threat to our children’s health. Possible clinical reactions include restlessness, hyperactivity, distractibility, inattention, cognitive/memory deficits, sleep disruption, mood swings, irritability, disruptive and aggressive behaviors, anxiety, depression, obsessive-compulsive disorder, sensory processing concerns, and motor/vocal tics, as well as rashes, respiratory complaints including asthma and allergies, headaches, joint and muscle pains and gastrointestinal symptoms (chronic abdominal pain, diarrhea, constipation, nausea/vomiting, reflux). Just as the researchers and regulatory agencies must consider the potential for broad health effects of food additives, so must clinicians carefully consider the impact of nutrition on all children presenting with chronic neurodevelopmental and physical symptoms.
Lawrence D. Rosen, MD is a board-certified general pediatrician committed to family-centered, holistic child health care. He practices primary care at the Whole Child Center in Oradell, NJ and consults at the Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, serving as Medical Advisor to The Deirdre Imus Environmental Health Center.
Dr. Rosen is an internationally recognized expert in Pediatric Integrative Medicine. He is a founding member and Chair of the American Academy of Pediatrics Section on Integrative Medicine. Dr. Rosen is appointed as Clinical Assistant Professor in Pediatrics at New Jersey Medical School. He is a graduate of New York Medical College and the Massachusetts Institute of Technology, and he completed his residency and chief residency in pediatrics at Mount Sinai Hospital in New York.
Dr. Rosen is a contributing author/editor for several books, including “Integrative Pediatrics” (Oxford University Press 2009), “Green Baby" (DK 2008), and "Pediatric Clinics of North America: Complementary and Alternative Medicine" (Elsevier 2007). He is a contributing editor and pediatric columnist for Kiwi magazine.