Food Additives and Allergic Diseases in Childhood

Jae-Won Oh

doi:10.7599/hmr.2011.31.4.261

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Oh: Food Additives and Allergic Diseases in Childhood

Review Article

Hanyang Medical Reviews

Hanyang Medical Reviews 2011; 31(4): 261-268.

Published online: 25 November 2011

DOI: https://doi.org/10.7599/hmr.2011.31.4.261

Food Additives and Allergic Diseases in Childhood

Jae-Won Oh, M.D., Ph.D.

Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea.

Corresponding author (jaewonoh@hanyang.ac.kr)

Received 1 September 2011 Accepted 1 November 2011

Abstract

Many different additives include preservatives, stabilizers, conditioners, thickeners, colorings, flavorings, sweeteners, and antioxidants. Despite the multitude of additives known, only a small number has been associated with hypersensitivity reactions. A number of investigators have suggested that a significant population of patients with allergic diseases has symptoms related to the ingestion of food additives. However, the incidence and mechanism of reactions to additives in patients with chronic urticaria, angioedema, and atopic dermatitis remain unknown. A few studies of monosodium glutamate is reported to be associated with atopic dermatitis, but their relationship remains unknown. The best known dye is tartrazine. The group of azo dyes includes ponceau and sunset yellow. Amaranth (FD&C red no. 5) was banned from use in the US in 1975 because of claims related to carcinogenicity. Most of them are reported to be associated with aggravation of atopic dermatitis. Parabens are aliphatic esters of parahydroxybenzoic acid. Sodium benzoate is a closely related substance usually reported to cross-react with these compounds. These agents, which are widely used as preservatives in both food and drugs, are well recognized as causes of severe contact dermatitis. Additives would have to act as haptens to create a response mediated by IgE. The majority of these reactions are not of the immediate hypersensitivity type. Many cases of additive-provoked urticaria or dermatitis occur as late as 24 hours after challenge, arguing against an IgE-mediated mechanism. In conclusion, the exact relationship between food additives and the allergic diseases still remains to be solved.

Keywords: Dermatitis, Atopic, Food Hypersensitivity, Food Additives

Figures and Tables

Table 1

Non-allergic Adverse Reactions to Foods

Modified from Ref. 7 with permission from Elsevier

Table 2

Food Additives which are Known to Provoke Adverse Reaction or Hypersensitivity

^*Federal Food, Drug, and Cosmetic Act (FD&C Act) from US FDA; FD&D, Food, Drug, and Dye; FD&C, Food, Drug, and Cosmetic.

Ref. 37 with permission from Wiley-Blackwell.

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