How Food is Responsible for Behavioral Issues in children
Introduction
Purpose
Food additives are used in different parts of the world for sweetening, conservation, and coloring. Food additives help to improve how food tastes, its practicality, and the appearance, thus, making it attractive (Kanarek, 2011). According to the European Union, use of additives as well as its authorization is controlled by Regulation (ec) 1333/2008 (Dewinter, et al., 2016). The regulation is mainly concerned with food additives, colors, and sweeteners used in food products (Benko et al., 2014). However, some types of additives pose health risks to consumers including allergies, hyperactivity, or being endocrine disruptors, neurotoxic or carcinogenic (Benko et al., 2014). Acceptable Daily Intake (ADI) refers to the amount of additives that can be contained in beverages on food which is consumed daily without causing any harm (Mancini, et al., 2015). Children and infants are assumed to be at high risk of exposure to harmful chemicals during their growth (Mancini et al, 2015). The objective of this study is to determine the amount of food additives consumed by children below 36 months and behavioral changes. In essence, this paper evaluates the relationship between harmful food products and behavior issues in children below three years old.
Background
Processed Food and Endocrine Disrupting Chemicals
Packaged and processed foods in addition to snacks that are ready to eat have been categorized as potential sources of danger to our health and especially that of children (Omuyi, et al., 2013). Eating such type of foods exposes people to endocrine-disrupting chemicals. According to Omoruyi et al. (2013), there are specific compounds that adversely interfere with the endocrine system of human beings. The harmful compounds, known as endocrine-disrupting chemicals (EDCs), are found in natural water or our immediate environment (Omuyi, et al., 2013). There are those EDCs that seem to mimic the functions of estrogen. The compounds, thus, gain notoriety because they lead to adverse physiological effects, reproductive disorders, and developmental abnormalities in human beings (Omuyi, et al., 2013). It is quite clear that the effects are significantly more serious in children than adults because the hormonal systems of children are not yet balanced and well mature. Therefore, it is important to investigate the issue since few research projects have been done to find out what should be done.
Previous research has shown how estrogen mimics are used as chemicals that are widely used for preserving and processing food (Omuyi, et al., 2013). Most people consume estrogen mimics with or without them being aware of its potential harm. In addition, food products eaten by children especially those based on soya pose health risks to them (Omoruyi, et al., 2013). Materials used to package food are also a major source of exposure to EDCs (Omuyi, et al., 2013).
Depression in Children
Depressive disorders in children have adverse consequences in both functional and developmental aspects. Weiss (2012) posits that the etiology of disorders that are depressive in nature is multi-factorial and complex. They cause an intricate interaction among genetic predispositions and environmental factors. In adults, studies have shown that caffeine is relatively safe (Hendon, 2012; Weiss, 2012). Nevertheless, the effects of caffeine have not been discovered in children brains under rapid development. A systematic research that addresses caffeine consumption and depressive feelings in children has not been developed. Further research should be conducted to determine what should be done to curb the problem and ascertain the consequences of such type of food to children.
The etiology of depression in children is not fully understood since it is complex. Disorders that are depressive in nature result from interaction between social, neurobiology, psychological, and genetic factors (Sparrenberger, et al., 2015). There is increase in evidence that shows how the combination between genetics and environmental variables play a major role in causing depression in children. Caffeine consumption among children has steadily increased over the last few years. Approximately 75-98% of children consume a beverage containing caffeine daily (Sparrenberger, et al., 2015). The effects of caffeine in children are not well known by people in different parts of the world (Sparrenberger, et al., 2015). As a result, parents are not keen on the amounts of caffeine their children consume. However, there are countable studies that have been conducted to investigate the link between development of mood disorders and behavioral changes in children and the consumption of beverages containing caffeine (Hendon, 2009; Sparrenberger, et al., 2015; Tomlinson, et al., 2009).
Consumption of Caffeine
The consumption of caffeine is done on a daily basis especially in the morning by most individuals. Tomlinson et al. (2009) showed that children are also not restricted from consuming it since most parents do not understand the adverse effects of caffeine on children’s behavior. The researchers concluded that on average, young people (adolescents and children) consume about 44mg of caffeine each day. Additionally, there are a significant proportion of energy drinks that focus on the young people as the target market. The so called ‘energetic drinks’ are meant to stimulate the central and peripheral nervous systems (Tomlinson, et al., 2009). After the consumption of such drinks, the user becomes overly active and energetic. The consumption of such energy drinks have long term effects in children and adolescents. Therefore, conducting further research in this area is influential in helping develop policies to sensitize people on adverse effects of caffeine.
Studies that have previously been conducted show that adolescents and children who have high dependency on caffeine show depressive and anxiousness symptoms (Hendon, 2009; Tomlinson, et al., 2009). A study conducted recently shows that young people who were diagnosed with depression consumed more caffeine that those who were not depressed. The findings of the research help to show that there are various behavioral changes that occur to children who consume beverages containing caffeine (Herndon, 2009; Sparrenberger, et al., 2015). Further research should be conducted to investigate other chemicals found in food that may cause behavioral changes in children.
Food Additives
Over the last five decades, chemicals used in food processing have increased by about 500% (Stevens, et al., 2014). Companies producing food products use the chemicals to make the food appear attractive. Additives are also added to make the food taste sweeter and to reduce the production cost since it is expensive to use natural products (Karanek, 2011). Such strategies enable companies to make a lot of profits. About nine synthetic dyes found in food are used by manufacturers in the United States. Out of the nine dyes, three of them (yellow 6, yellow 5, and red 40) make about 90% of color of food products (Stevens, et al., 2014). In the modern day, such food dyes are found all around the world from cough syrup, toothpaste, and apple sauce, among others.
Children are known to be attracted to bright colors. Companies, therefore, use dyes to make food products that will appear attractive to children. As a result, children tend to consume huge amounts of chemicals each day (Stevens, et al., 2014). Removing dyes from the food mainly consumed by children has negative consequences. Most of the children lose appetite, thus, end up eating little amount of food. Since parents want their children to remain healthy and to eat sufficient amount of food, they are find the need to buy food that is not colored with natural products (Stevens, et al., 2014). Studies conducted in the early seventies showed that removing dyes from food products consumed by children have a profound impact on sales (Stevens, et al., 2014).
In most parts of Europe, labels that warn people against food dyes have become common. According to Sparrenberger et al. (2015), the growing concern on the dyes used in food products have caused several countries to ban them. In response to the increasing public concern and legislation, some American companies such as Kraft, General Mills, and Kellogg’s have banned the use of artificial dyes especially in the products they sell overseas (Sparrenberger et al., 2015). However, dyes still remain in the food products that they offer to consumers in America. In 2011, the Food and Drug Administration started a campaign to get rid of warning labels on packaged food products that contain synthetic dyes (Sparrenberger et al., 2015). However, there are certain American food stores that do not include artificial dyes in their products; an example is Whole Food Company.
Soy in Processed Foods
Soy is found in most types of processed foods. It is usually found in bread or infant formula consumed by children. Such types of food are referred to as ‘health food’, and is described by most nutritionist and experienced parents in different parts of the world (Tomlinson, et al., 2009). One major disadvantage of soy is that it contains a high level of manganese. Manganese is an essential nutrient but it is equally unhealthy when excess of it is consumed. Excess manganese is a potent neurotoxin (Tomlinson, et al., 2009). There is sufficient evidence that shows how excess exposure to manganese is harmful to both children and adults. Excess consumption of manganese leads to developmental disorders, neurological problems, ADHD, learning disabilities, and mental health disorders (Tomlinson, et al., 2009).
Effects of Aspartame
Most chemicals in food are linked to certain effects on the body. Rycerz and Jaworska-Adamu (2013) state that aspartame is associated with behavioral and emotional disorders. Serotonin levels may be altered by large amounts of aspartame. Changes in the level of serotonin cause emotional disorders, anxiety, or behavioral problems (Rycerz & Jaworska-Adamu ,2013). Foods containing large amounts of such chemicals should be made known to parents since most of them are not aware of the quantity of chemicals in the food and the effects they have on their bodies; most parents do not understand the impact of different types of food on the behavior of children.
Monosodium Glutamate
MSG (monosodium glutamate) is also one of the excitotoxin that excites the cells of the brain to death is consumed in large quantities (Stevens, et al., 2014). Notably, the chemical has effects on behavior and mood of children. Most soup mixes, processed meats, and salad dressing among other processed foods eaten by children contain MSG. MSG at times crosses the barrier between the brain and blood, thus, causing the nerve fibers to lose direction (Stevens, et al., 2014).
Literature Review
The prevalence of non-communicable chronic diseases and obesity associated with food is growing at a fast rate. A remarkable rate has been noted in the pediatric population, with 25% of children aged between five and nine years have the disease (Sparrenberger, et al., 2015). Scientific evidence shows that increase in the weight of children to undesired levels is as a result of dietary patterns (Sparrenberger, et al., 2015). Sparrenberger et al.’s (2015) study notes that the increase in overweight children is due to substituting traditional food with ready-to-consume beverages/food and other processed foods. Processed foods have saturated fats, high energy density, low fiber content, and high sodium/sugar concentration: Such food products are less perishable, ready to consume, and hyper-palatable (Sparrenberger, et al., 2015). Consequently, processed foods containing chemicals have reduced costs in addition to other commercial advantages. For instance, Sparrenberger et al.’s (2015) determined that the diet taken by children living in Brazil is deficient in vegetables and fruits. The study also shows that beverages added with sugars that are not natural, overconsumption of snacks, cookies, sandwiches, and cold cuts. Additionally, the quality of food consumed by children depends on educational level, children’s diet, and parental income (Sparrenberger, et al., 2015). The researchers also note that a good diet depends on income earned and the education level of parents. These factors go a long way in determining the consumption of these foods and their effects among children.
Additionally, Artificial food colors are common in most beverages and color foods. Administration of drugs and the amount of artificial food colors have increased over the last few years. As Stevens et al. (2014) note, the increase rate is more than five times than what was used since 1950. In 1950, about 12mg/capita/day was used but currently about 68mg/capital/day is used (Stevens, et al., 2014). In the last four decades, various studies have been conducted to understand behavioral reactions in children. Stevens et al. (2014) indicated that more than 50mg of artificial food colors have negative impacts to children. The authors of this study quantify the amount of artificial food colors consumed by children living in the United States. The data given in the report could be helpful to clinicians especially in advising people on beverage consumption and artificial food colors. According to Stevens et al. (2014), most artificially sweetened sports drinks, beverages, energy drinks, punches, and fruit drinks are colored using dye containing AFCs or caramel color. They also concluded that the beverages are consumed every day by children aged below fifteen years in the United States (Stevens, et al., 2014). Therefore, it is important for people to estimate the amount of artificial food colors consumed in their diet.
In a different study, Tomlinson et al. (2009) posit that there is an increase in diet concerns to the mental health of individuals. The issue has gained the interest of public policy makers, parents, professionals, and parents. This study illustrates the role of food chemicals in behavior, school performance, and childhood cognitive development. The report shows that considerations of nutrient supplements and dietary intake should be taken. The study also discusses the effects of nutrient supplements and inadequate dietary intake. The report also discusses psychiatric and diet diagnoses. Psychosis and depression have been discussed in the paper. According to the authors and the findings of their research, the main focus should be on adolescent and child population. Poor maternal nutrition mainly affects the growth of the fetus thus leading to premature birth. It is also indicated that children born with a low weight demonstrate poor reading skills and also have a low IQ. The main cause of low intrauterine growth restrictions and birth weight is low birth weight of babies. High consumption of fish among parents results to children with high IQ. Maternal iodine is essential in utero development. It also prevents severe cognitive deficits in children. Tomlinson et al. (2009) concluded that nutritional intake is important for optimal functioning and growth. They also state that children are supposed to consume a nutritional balance and sufficient amount of food in their diet. Different types of food that are made from unprocessed ingredients and whole ingredients may fulfill a good diet requirement than the processed foods. Some types of food additives may worsen behavior and hyperactivity symptom in children. They also note that reactions in children to different types of food also differ (Tomlinson, et al., 2009). The authors also suggest that parents who are concerned about dietary additives need to be supported as long as their diet is balanced.
Food color concentration in foods is a major concern in environmental health. Weiss (2012) found out that children respond to food colors differently with adverse behavioral effects. The consumption of synthetic food colors is harmful since it induces different adverse behavior changes in children. High sensitivity to additives in food results to hyperactivity in most children (Weiss, 2012). They also reported the connection between hyperactive behavior in children and food additives. The study showed that food colors are a major cause of ADHD. For some children with hyperactivity disorder among other related behavioral problems, the data collected in their study showed that their condition worsens with increased exposure to synthetic color additives (Weiss, 2012). Findings from clinical trials showed that the behavior of children exposed to synthetic food additives is mainly as a result of intolerance of the substances. The food additives neurotoxic properties are not the major factor of change of behavior (Weiss, 2012). It was also found out that there was a connection between adverse behavioral effects and food color.
Moreover, Omoruyi et al. (2013) showed how processed and packaged food items as well as ready-to-eat snacks are neglected and poorly characterized sources of human exposure to endocrine-disrupting chemicals. In the test system conducted by the researchers, most wrapper and foodstuffs gave a negative result. Further, all hamburgers prepared in industries and pepper salami a luciferase activity in yeast, thus, showing that there are xenoestrogens present. Omoruyi et al. (2013) found out that humburger among other food products contained ingredients with soy. The soy-based ingredients contributed to people’s high estrogenic activity. No significant change was observed with chemicals from the packaging materials. The findings from their experiment indicate that chemicals used in packaging and processing foodstuffs in Finland are a major source of xenoestrogens (Omoruyi, et al., 2013). The findings from the study are important since hamburgers are consumed by most people and especially children. It was concluded that soy-derived ingredients in some foods may make food highly estrogenic (Omoruyi, et al., 2013). The study, therefore, shows how such types of foods containing high estrogenic levels should be of major concern to researchers and the general population.
Research Project
Study Population
Mancini, et al. (2015) estimated the amount of exposure of seven additives to children who were less than three years old. The seven additives include nitrites, nitrates, aspartame, BHA, nitrates, and parabens. The data was collected over a period of three months for a random population of children who were less than three years old) (Mancini, et al., 2015). Breastfed infants were not included in the study because it would have been difficult to know the amount of breast milk they consume. The children who also attended kindergarten and nursery were not included in the study because it would have been quite challenging to collect data of how much food they consume daily. Data on the diet was collected on 706 children. The children were divided into four age groups: 1 to 4 months (124 children), 5 to 6 months (127 children), 7 to 12 months (196 children), 13 to 36 months (259 children) (Mancini, et al., 2015).
Methods
Selection of children was made through quota sampling that was based on the children’s age, the socioeconomic activity of the family, and the mother’s occupation (Mancini, et al., 2015). Data on the liquid and solid food consumed by the children was collected three consecutive days in a food diary (Mancini, et al., 2015). The individuals responsible for collecting the data were the carer, the father, or the mother. A questionnaire was prepared to collect information about the weight of food consumed, food intake, the brand of the product, and the name of the food consumed (Mancini, et al., 2015). For the drink or food consumed daily, the amount was estimated using a scale found at home. The information given on the picture-calibrated or packaging portion was used.
A database for the additives of food consumed was developed in the Flavoring Additives Contact Materials Exposure Task (FACET) research project (Mancini, et al., 2015). The database has the amount of additives found in different types of foods. From the database, the amount of food additives were linked to the additives found in the BEBE-SFAE 2005 dietary survey (Mancini, et al., 2015). For additives such as aspartame, parabens, and benzoate, which are allowed in some parts of foods such as fillings and toppings, it was assumed that they were about 70% of quantity of food consumed (Mancini, et al., 2015). For those types of additives overstepping the ADI, intake was assessed using the occurrence data. For the food containing authorized additives, the additive was assumed to be equal to that indicated on the label. A random sample on the amount of additives contained in the food was taken (Mancini, et al., 2015). The amount of food products from different food categories was taken. Random sampling and Oqali database were used to give the amount of additives indicated on the labels (Mancini, et al., 2015).
For food products that had no label, assumptions were made to quantify the additives contained. The first assumption (upper-bound scenario) was that the food additives were 100% of the products of food that were not labeled (Mancini, et al., 2015). The second assumption (lower-bound scenario), was that the additives were 0% in the food products that did not have any information given on the label (Mancini, et al., 2015). The actual additives finally replaced with MPLs in the food. The contribution of additives to each food product was attributed to the type of food consumed. In Tier 2a the amount of different categories of food to the intake of nitrites, BHA, benzoates, were calculated for the upper- and low-bound scenarios (Mancini, et al., 2015).
Results
The MPLs for the entire population (non-consumers and consumers) were used to calculate the exposure of the median, 90th percentile, the mean, and the number of individuals that exceed the ADI (Mancini, et al., 2015). For nitrites, BHA, and benzoate, the exposure to children was more than the ADI. For parabens, BHT, and nitrates, exposure was less than ADI for all classes of age (Mancini, et al., 2015). The exposure to aspartame was more than the ADI (40mg kg/ bw day). Less than 1% (95% Cl=0- 1.6%) to the age between (13-36 months) (Mancini, et al., 2015). For all additives, it can be noted that exposure was high as the age increased. The age group with the highest exposure level of additives was 13 to 36 months. The age class between 1 to 4 months had an exposure level that was equal to zero (Mancini, et al., 2015). The only difference is that aspartame had an exposure of about 0.20 mg kg/bw day.
Source (Mancini, et al., 2015)
Source (Mancini, et al., 2015)
Source (Mancini, et al., 2015)
Exposure (90th percentile, mean, median, and percentage of people that exceed the ADI) to 7 selected additives of food per age group were calculated using MPLs for non-consumers and consumers (Mancini, et al., 2015). For BHA, nitrites, benzoate, nitrates, exposure was more than ADI for a large percentage of people who participated in the study. Regarding exposure to BHA, ADI (1mg/bw/day) was exceeded for children in age groups 7-12 months, 13-36 months (Mancini, et al., 2015). The BHA for the entire population was on an average of 0.39mg kg/bw/day. The average exposure to nitrates for the entire population was 0.09mg kg/bw day. For children in age groups 13-36 months, 7-12 months old the exposure to nitrites was above ADI (0.07mg kg/ bw day) (Mancini, et al., 2015). Meat and delicatessen were identified as the main contributors for nitrates in children aged between 7 to 36 months. It is important to also note that mixed dishes contributed to approximately 10% of nitrates in children aged between 13 to 36 months as shown in table 1. Regarding exposure to BHA, ADI (1mg kg/ bw day) exceeded for children aged between 7 to 12 months 13% [95% CI = 7–19%]) and 13–36 months (26% [95% CI = 22–30%]) (Mancini et al. 2015).
Source (Mancini, et al., 2015)
Source (Mancini, et al., 2015)
Delicatessen contributed the highest amount of additives for the study. Data for BHA occurrence covered about 83% of all food additives (Mancini, et al., 2015). For the lower-bound scenario, average BHA exposure was equivalent to zero for all age groups. The 90th percentile exposure was (0 mg kg–1 bw day–1). For the upper-bound scenario, the average exposure for children between 7–12, 5–6, and 13–36 months was 0.02 mg kg–1 bw day–1 (90th percentile exposure = 0 mg kg–1 bw day–1), 0.02mg kg–1 bw day–1 (90th percentile exposure = 0mg kg–1bw day–1), and 0.03 mg kg–1 bw day–1 (90thpercentile exposure = 0.01mg kg–1 bw day–1) respectively (Mancini, et al., 2015). An excess of ADI was estimated in the 13-36 months’ children upper bound as shown in table 3. Most BHA intake was contributed by the consumption of broths and vegetable soup (Mancini et al. 2015).
In all ages except that between 1 to 4 months, benzoate was above 5mg kg/bw day. For the age group of children between 13 to 36 months, the intake of the food additives was the highest (35% [95% CI =31–39%]) (Mancini, et al., 2015). The consumption of benzoate was as a result of exposure to broths and vegetable soup for children who were between 5 to 6 months. About 12% and 20% of the intake of benzoate was as a result of savory and sweet biscuit consumption in children aged between 7 to 12 months. Cold drinks and fish contributed to benzoate in children aged between 12 to 36 months (Mancini, et al., 2015). The average consumption of nitrites was about 0.09 mg kg/bw/day. For children aged between 12 and 13 months, the amount of nitrite exposure was more than the ADI (0.07 mg kg/bw day (Mancini, et al., 2015). An average of 0.39mg kg/bw day of BHA for the population was taken. Broths and vegetable soup contributed to the high intake of BHA in all age groups. Durum wheat and rice contributed to high intake of BHA in children aged between 7 and 12 months (Mancini, et al., 2015). In children aged between 13 and 36 months, the high amount of BHA was as a result of high consumption of BHA in sauces, durum wheat, condiments, delicatessen, and rice.
Discussion
Research Weaknesses/ Limitations
The cost of conducting the study was relatively high as compared to secondary research. The cost was high to the high expenses incurred in preparing research as well as conducting it. Buying equipment and travelling was also expensive) (Mancini, et al., 2015). Carrying out experiments and getting information from people is time consuming. Collection of data also requires execution and development of a research plan. Preparation of the plan also takes a lot of time. The process of deciding to conduct the project and getting the results takes more time than collecting data using secondary sources (Mancini, et al., 2015).
Carrying out a research while involving a large population may not be possible. Conducting research while interviewing every individual is not feasible. If a large population is used, more researchers would be needed and the expenses would be unrealistic (Mancini, et al., 2015). This research is not quite feasible since there were several errors encountered while collecting data. The sample used might not be representative of the whole population. The results were also subject to error especially by the parents or carers (Mancini, et al., 2015).
Research Strengths
Due to strict control and strictness in collecting data, the results achieved were good. The results obtained gave great confidence. The other advantage is that the data obtained helped to gain insight to combine rigidity methods, performing the experiment, and giving great transferability (Mancini, et al., 2015). The method was appropriate for drawing conclusions. The method used to obtain data is straightforward and efficient for collecting data. Since results obtained could be verified to see if they are consistent with the rest. Better results were achieved since they depicted the occurrences in a real human population.
Future Research
Instead of only using additives, in research, natural sources and dietary supplements should be used for conducting further research to determine any type of exposure to harm. While conducting future research, additives that pose a risk of harm should be determined and the level of their harm determined . The actual amount of such additives in food products should be determined. Determining the concentration of such additives is also important. Research should also be conducted to determine how mothers are affected with food additives and whether the problem is passed to their babies.
Conclusion
Exposure to food additives such as nitrates, benzoates, BHT, BHA, nitrates, and aspartame are a threat to children below three years. Processed, packaged foods, and ready-to-eat snacks have been neglected and not characterized as sources of human exposure to endocrine-disrupting chemicals. As a result, people consume them and feed them to children without considering the type of risks the expose to themselves and their kids. Endocrine disrupting chemicals lead to developmental abnormalities and physiological disorders in children. The effects of EDCs are more severe in children than adults because the hormonal systems of children are not well developed. Some of the food types that contribute to high intake of additives in children include vegetable soups, biscuits, broths, cold drinks, and fish. The ADI for the amount of benzoate (E210), BHA (E320), and Nitrites (Es50), exceeded 25%, 20%, and 54% of all children respectively. For Parabens (E214), BHT (E321), aspartame (E951), and nitrates (E251) was not exceeded in any group of children who participated in the study. According to the findings, aspartame exposure in all children involved was less than the ADI. Therefore, this study recommends that food additives should not be included or their quantities be reduced in foods consumed by children less than 36 months old.
Call to Action
People should be keen on the type of food they give to their children. It is important to understand what type of additive is found in food by checking the labels on the food. While buying food it is important to check the ingredients to see which type of additives are contained. Having good knowledge on different types of food additives and their effects is important since it will enable people to be keen with the type of food they consume. People should seek the advice of nutritionists so that they may understand the kind of food that is healthy for their body.
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