You don’t say

Thursday, 6th September 2007 at 23:02 UTC 5 comments

Just a quick post, I know I haven’t written for a couple of days, but a news story just made me somewhat bemused: “Parents Warned of Additives Link“. Now, to understand why this is puzzling, I need to add that I was a mildly hyperactive and heavy eczema-suffering baby. Someone suggested my Mum cut all unnatural food colours and some other chemical stuff from my diet, and then I basically calmed down and got a lot less eczema. And now doctors have managed to come up the same advice as my Mum got most of 23 years ago. Gee, who’d have known it?Its like all the myriad confirmations that smoking kills that weren’t the study which first showed irrefutable evidence that, in fact, smoking kills.

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Entry filed under: Health, News, Science.

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5 Comments Add your own

  • 1. Betty  |  Friday, 7th September 2007 at 17:00 UTC

    My mum wouldn’t let me or my sister eat anything blue. It made us fight

    Reply
  • 2. Greg  |  Friday, 7th September 2007 at 21:45 UTC

    There’s more than one cause for eczema – my brother Colin got it if he consumed any dairy products. Cutting out the wrong things can deprive you of nutrients, so I don’t blame the doctors for being catious and taking their time. OTOH some people I know eat a lot of junk and have bad health, and it’s hard not to infer a link.

    And hey, you’re still not exactly the calmest, most laid back person I’ve met.

    Reply
  • 3. Graham Martin  |  Friday, 7th September 2007 at 23:44 UTC

    Greg: I also tried cutting out dairy, but for the moment I’m just being careful and not eating too much of it. And please tell me you’re not implying tartrazine (E102 Bright Yellow) is a vital nutrient, its banned in several countries!

    Betty: Please tell my friends that Blue food is bad for you. They dyed my curry (natural food dye) blue. It was horrible, I couldn’t eat it, despite the fact I liked the curry before they decided to colour it.

    Reply
  • 4. Greg  |  Friday, 7th September 2007 at 23:54 UTC

    Graham: Don’t worry, I’m not going to tell you that tartrazine is a vital nutrient – I was thinking more of a general principle of caution when stopping eating stuff, and trying to make excuses for anyone who didn’t tell you to cut out junk earlier.

    Now tell me, do you mean you’re being converted to vegan ways and drinking soya instead of actual milk?

    Reply
  • 5. Duck  |  Saturday, 8th September 2007 at 10:02 UTC

    The Blue Curry was great. I was amazed that anything could possibly stop a Graham eating.

    However, I’m less than convinced about the study. I’m no great fan of artificial colours, & anecdotally for some of the children with diagnosed behavioural difficulties they have had some effect – but I haven’t seen removing particular additives act as a ‘cure’. There are other reasons why altering a child’s diet by removing artificial colours might have an effect on behaviour – from the Hawthorne effect (the act of paying attention changes what’s being studied independent of experimental manipulation), to overall better nutrient profile if the children are switched to eating proper food instead of highly-processed stuff… I’m sure you can think of more.

    Anyway, I’ve had a look at the actual study, as published in the Lancet. ALWAYS look at the original research. Most newspaper health’ writers wouldn’t know an RCT if if hit them round the head with a placebo.*
    These are some of the reasons I think that it does not show that ‘additives cause ADHD’, as the newspapers have jumped on & the FSA advice seems to suggest:
    – Surrogate endpoints. They have not shown, as the newspapers claim, that ‘additives cause ADHD’. They have shown that two mixes of various colourings plus sodium benzoate cause an increase in certain behavioural & (for older children) attention & executive function tasks. This is not the same thing as ADHD.
    – the second additive mix did NOT produce a significant difference in behaviour compared with placebo in 3-year-olds (though it did in 8-9 year olds). Haven’t seen that reported by the media ‘study says toddlers can be given some additives with no effect on behaviour’. An annoying example of file-drawer bias WRT mass media – people don’t get to find out what the study really showed if it doesn’t fit the ‘hook’.
    – ‘Doses for mixes A and B for 3-year-old children were roughly the same as the amount of food colouring in two 56-g bags of sweets. For 8/9-year-old children, the dose for mix A was equal to about two bags of sweets a day and for mix B about four bags of sweets a day.’
    *shakes head* I’m sure there are some people who think it’s a good idea to feed an 8-year-old coming up on half their daily calories in the form of sweets. There might just be other causes of the child’s poor behaviour than the additives in that case….
    – Parents were asked to take the additives used in the study out of their children’s diet for 6 weeks. I wonder what effects being denied their usual diet had on the children – would there have been so much effect if the children were more habituated to the additives? Compliance was recorded & fairly good.
    – one of the 3 measures used to assess hyperactivity was only really appropriate to classroom behaviour – had to be tweaked rather a lot to suit 3-year-olds. Also of note that they recruited 3-year-olds through pre-schools – ie not stay-at-home 3-year-olds (behavioural differences have been found).

    Probably the most important sentence of the study:
    ‘Children with ADHD are generally about 2 SD higher on hyperactivity measures than those without the disorder,22 thus an effect size of 0·2 is about 10% of the behavioural difference between them.’
    Additives were not shown to ‘give children ADHD’. In 3 of 4 conditions, additives caused typical children to score somewhat higher (but not near a level equivalent to ADHD) than placebo.

    Overall it’s a good study, well controlled, with several outcome measures, & a good degree of ecological validity. But the actual research findings do not justify the ‘woo additives ATE my BABY’ hype. Sloppy newspaper ‘science’ is not just annoying – it’s potentially damaging. It’s particularly annoying in the case of ADHD that people seem so eager to blame food – it’s a lot easier to look at food additives in isolation than the complex neurological, social, and educational causes & needs. If you can decide that ADHD is all the fault of ignorant parents who feed their children nothing but Pop-Tarts, it’s much easier to do nothing about the specific behavioural interventions that work (*not* bad parenting – children with ADHD respond well to specific strategies), to blame the child (if ADHD is no more than too many brightly-coloured sweets, why can’t they control themselves better?), or ignore the rather interesting developments in understanding of brain function & how to help.
    Putting it all down to food additives is simplistic, damaging, and not supported by this study (though you’d not know that from the newspapers). Humph.

    *Insert rant here about why journals should be open-access to everyone – borrow an ATHENS login if yours has run out. The Lancet is a PITA to login to – article is here: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4PKP4D9-1&_user=10&_coverDate=09%2F06%2F2007&_rdoc=1&_fmt=full&_orig=browse&_srch=doc-info(%23toc%234886%239999%23999999999%2399999%23FLA%23display%23Articles)&_cdi=4886&_sort=d&_docanchor=&view=c&_ct=21&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=ed119be1c237ad1b01b6f4b2d69959a9
    though you’ll need to login to sciencedirect first, as you can’t login to the Lancet website.
    ScienceDirect also gets annoyingly confused by Firefox tabs.
    However, particular kudos to The Lancet for their success in convincing their publishers, Reed Elsiver, to stop being involved with DSEI & other arms fairs.

    Reply

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