There has long been concern among parents that food additives may exacerbate some of the symptoms of ADHD. ADHD additives are often blamed for increased hyperactivity and learning difficulties in sensitive children, a link first suggested by Feingold in 1975. His research led to the development of the Feingold® Association of the United States, which has provided intolerance testing and dietary advice for children with ADHD since 1976.
What Types of Food are Believed to Make ADHD Worse?
A number of different foods have been investigated by scientists in order to determine whether they have any effect on hyperactivity in children with ADHD. Many foods are implicated following observations from parents and educators, and they include chocolate, monosodium glutamate, artificial colorings, preservatives and caffeine.
What Additives are Believed to Affect ADHD?
Many scientists believe that certain food colorings can increase the level of hyperactivity in children with ADHD. The Food Standards Agency recommends avoidance of a range of food colorings by susceptible individuals. The food colorings to avoid are:
- sunset yellow (E110)
- quinoline yellow (E104)
- carmoisine (E122)
- allura red (E129)
- tartrazine (E102)
- ponceau 4R (E124)
Some experts also believe that benzoate preservatives (E210-E219) may increase hyperactivity. A trial conducted in 2004 showed that hyperactivity decreased in children fed an elimination diet containing no artificial food colorings or benzoate preservatives. When some of the children were later challenged with colorings and benzoate preservatives in a double-blind placebo-controlled experiment, those receiving the additives showed increased hyperactivity compared with the control group.
What are the Effects of Additives on Individuals With ADHD?
Additives are believed to increase hyperactivity in children with ADHD, and they may also have a negative effect on learning ability. It is not known how food additives might cause these effects: some scientists believe it may be due to a food intolerance, while others postulate the additives may in some way interfere with dopamine release or sensitivity.
Is There Any Scientific Evidence that Additives Affect ADHD?
Much of the evidence suggesting ADHD additives can exacerbate the condition is anecdotal, so in order to establish whether there is a significant association between food additives and symptoms of ADHD a number of double-bind placebo controls have been undertaken. A meta-analysis of these studies published in 2004 confirmed that food additives do appear to increase hyperactivity in children with ADHD.
There is some evidence to suggest that additives are more likely to increase hyperactivity in atopic children suffering from ADHD; that is to say those that also demonstrate other allergies. This lends credence to the belief that additives cause hyperactivity through a mechanism linked to food intolerance.
 BF Feingold “Hyperkinesis and Learning Disabilities Linked to Artificial Food Flavors and Colors” The American Journal of Nursing 75:797-803 (1975)
 “Intolerance to Additives” Food Standards Agency website
 B Bateman, JO Warner, E Hutchinson “The Effects of a Double Blind, Placebo Controlled, Artificial Food Colourings and Benzoate Preservative Challenge on Hyperactivity in a General Population Sample of Pre-School Children” Archives of Disease in Children 89:506-511 (2004)
 J Stevenson “Dietary Influences on Cognitive Development and Behaviour in Children” Proceedings of the Nutrition Society 65:1-5 (2006)
 DW Schwab, NT Trinh “Do Artificial Food Colors Promote Hyperactivity in Children with Hyperactive Syndromes? A Meta-Analysis of Double-Blind Placebo-Controlled Trials” Developmental and Behavioral Pediatrics 25:423-434 (2004)
 M Borvis, FS Mandel “Foods and Additives are Common Causes of the Attention Deficit Hyperactive Disorder in Children” Annals of Allergy 73:462-467 (1994)