ARTIFICIAL COLORS, FLAVORS &  ADDITIVES Do they matter ? <ul><li>Dr. Gaurav Gupta,  Pediatrician, Ex PGI MIAP, MAAP (USA),...
<ul><li>HISTORY </li></ul><ul><li>1500.B.C.-Food & Drug Colors. </li></ul><ul><li>Mid. of Ninteenth century-Natural Source...
<ul><li>NEED FOR COLORS & FLAVORS </li></ul><ul><li>Psychological Benefits </li></ul><ul><li>Maintain product consistency ...
The GRAS list <ul><li>Three classes of AFCA (Artificial Food Colors & Additives) –  Colors, Additives, Flavors </li></ul><...
<ul><li>Vulnerability in children </li></ul><ul><li>Young children serve as first victims of any environmental contaminati...
Most Important & well studied  SIDE EFFECT OF ARTIFICIAL COLOURS Attention Deficit Hyperactivity Disorder (ADHD)  Symptoms...
<ul><li>School-going Hyperactive </li></ul><ul><li>Children </li></ul><ul><li>Restlessness, inattentive, </li></ul><ul><li...
What evidence have we got? <ul><li>Do artificial food colors promote hyperactivity in children with hyperactive syndromes?...
Interesting thing about these studies ! <ul><li>Preservatives used as a challenge …. </li></ul><ul><li>sunset yellow, 5 mg...
What I found in my “samples”? Lupin Ponceau4R Nizonide Dr. Reddy’s Sunset Yellow Pedicloryl Novartis Sunset Yellow Calcium...
<ul><li>The art of medicine consists of amusing the patient while nature cures the disease -- Voltaire   </li></ul>
OTHER SIDE EFFECTS  OF ARTIFICIAL  COLORS
1.  Artificial colors cause  skin rashes in Children. Clinical Pediatrics, Vol. 37, No. 10, 601-607 (1998)  2.   Tartrazin...
http://mbm.net.au/health/guide.htm Hypersensitivity reaction, asthma, ? Neurological  Synthetic benzoin derivative Benzoic...
<ul><li>TARTRAZINE TERRORS </li></ul><ul><li>Coal-tar – Industrial waste. </li></ul><ul><li>Hyperactivity/ADHD </li></ul><...
<ul><li>Banned in USA, Austria and Norway. </li></ul><ul><li>Used in Febrex syrup, Ambrodil- S syrup, Shelcal kid, Tus-Q X...
SUNSET YELLOW FCF <ul><li>Side Effects :  Urticaria, rhinitis, nasal congestion, allergy, hyperactivity, kidney tumours, a...
CARMOISINE <ul><li>Side Effects :   Carcinogenic, Hyperactivity,Cross  sensitivity with aspirin. </li></ul><ul><li>Contrai...
Inhibitor:   Dopamine uptake - Hyperactivity Side Effects:  Childhood hyperactivity, Photosensitivity,  Erythroderma. Bann...
<ul><li>PONCEAU 4 R  </li></ul><ul><li>Animal study :  Hepatoma, Reticulum cell sarcoma, pulmonary lymphosarcoma, adenocar...
<ul><li>QUINOLINE  </li></ul><ul><li>Side Effect –  Hyperactivity in children </li></ul><ul><li>Banned in USA, Austria and...
 
<ul><li>DRUG ADDITIVES </li></ul><ul><li>Benzyl Alcohol </li></ul><ul><li>Lactose  </li></ul><ul><li>Propylene Glycol   </...
<ul><li>Benzyl Alcohol </li></ul><ul><li>Preservative </li></ul><ul><li>Adverse effects- </li></ul><ul><li>Gasping baby sy...
<ul><li>Lactose </li></ul><ul><li>Filler in tablets & capsules.  </li></ul><ul><li>Lactose intolerant individual </li></ul...
Propylene Glycol   <ul><li>A commonly used solvent in Paracetamol syrup </li></ul><ul><li>Adverse effects  -  Respiratory ...
<ul><li>Other flavors: </li></ul><ul><li>Calcium dihydrogen, </li></ul><ul><li>L-glutamate,  </li></ul><ul><li>Disodium gu...
Here is the list of ingredients for artificial strawberry flavour   <ul><li>amyl acetate,  </li></ul><ul><li>amyl butyrate...
<ul><li>WHY DO PHARMACEUTICAL COMPANIES USE THESE AGENTS? </li></ul><ul><li>Low cost substitute, </li></ul><ul><li>FDA/WHO...
 
IS THERE AN   A L T E R N A T I V E TO ARTIFICIAL COLORS & FLAVORS?
Natural Colors And  Flavors Better & Safer Alternatives
<ul><li>Natural Colors </li></ul><ul><li>Annatto </li></ul><ul><li>Anthrocyanin </li></ul><ul><li>Carotenoids </li></ul><u...
<ul><li>Carotenoids </li></ul><ul><li>Yellow & Red colors . </li></ul><ul><li>Sources-  S weet potatoes,  </li></ul><ul><l...
<ul><li>Carotene </li></ul><ul><li>Yellow to Orange colors . </li></ul><ul><li>Sources: Carrots, yellow </li></ul><ul><li>...
<ul><li>Chlorophyll </li></ul><ul><li>Green coloring agent . </li></ul><ul><li>Occurs naturally in  </li></ul><ul><li>all ...
<ul><li>Curcumin </li></ul><ul><li>Extracted from turmeric. </li></ul><ul><li>Coloring and medicinal uses </li></ul><ul><l...
<ul><li>Riboflavin (Vitamin B 2 ) </li></ul><ul><li>Yellow to Orange colors. </li></ul><ul><li>Sources- Leafy vegetables, ...
<ul><li>Sweet Orange Oil </li></ul><ul><li>Sweet  orange  fruit peel </li></ul><ul><li>Stress reducing agent </li></ul><ul...
<ul><li>Chocolate Flavor </li></ul><ul><li>Cocoa seeds </li></ul><ul><li>Psychological Benefits. </li></ul><ul><li>Patient...
<ul><li>ADVANTAGES OF NATURAL COLORS & FLAVORS </li></ul><ul><li>1) Sensitivity rare.  </li></ul><ul><li>2) Allergic side ...
<ul><li>Natural Colors & Flavors Are Costly But Definitely Not Costlier Than Health! </li></ul><ul><li>Then Why To Comprom...
<ul><li>REMEMBER </li></ul><ul><li>ARTIFICIAL COLORS , FLAVORS AND ADDITIVES MAY BE A LITTLE CHEAPER. </li></ul><ul><li>BU...
 
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Problems with AFCA - Artificial Colors, Additives &

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  • Dear Nina,
    I would like to know the reference for the comments that artificial colors are 'similar' and 'safer' than natural additives.
    This is actually old thinking and as shown by my presentation not really true. The natural colors / preservatives have to be tested too, and generally the chances of adverse effects including allergic reactions are far lower with these!
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  • I am confused, many told me that artificial is actually safer which makes sense. read below:

    The compounds used to produce artificial flavors are almost identical to those that occur naturally, and a natural origin for a substance does not necessarily imply that it is safe to consume. In fact, artificial flavors may be safer to consume than natural flavors due to the standards of purity and mixture consistency that are enforced either by the company or by law. Natural flavors in contrast may contain toxins from their sources while artificial flavors are typically more pure and are required to undergo more testing before being sold for consumption.
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Artificial Colors, Flavors And Additives 3 1 1

  1. 1. ARTIFICIAL COLORS, FLAVORS & ADDITIVES Do they matter ? <ul><li>Dr. Gaurav Gupta, Pediatrician, Ex PGI MIAP, MAAP (USA), Consultant FORTIS, Charak Clinics </li></ul>
  2. 2. <ul><li>HISTORY </li></ul><ul><li>1500.B.C.-Food & Drug Colors. </li></ul><ul><li>Mid. of Ninteenth century-Natural Sources. </li></ul><ul><li>20 th - Synthetic Colors ( Aniline). </li></ul><ul><li>In 1975, Dr. Feingold proposed link between food additives and hyperactivity </li></ul>
  3. 3. <ul><li>NEED FOR COLORS & FLAVORS </li></ul><ul><li>Psychological Benefits </li></ul><ul><li>Maintain product consistency </li></ul><ul><li>Identification - Manufacturing & Distribution </li></ul><ul><li>Reduce contamination risk </li></ul><ul><li>Unattractive medication – Acceptable. </li></ul><ul><li>Patient compliance – combination of color and flavor. </li></ul>
  4. 4. The GRAS list <ul><li>Three classes of AFCA (Artificial Food Colors & Additives) – Colors, Additives, Flavors </li></ul><ul><li>The U.S. FDA has a list of food additives generally recognized as safe. </li></ul><ul><li>Regarded as safe by the scientific community. </li></ul><ul><li>These substances are put on the GRAS list, which contains approximately 700 items. </li></ul>
  5. 5. <ul><li>Vulnerability in children </li></ul><ul><li>Young children serve as first victims of any environmental contamination </li></ul><ul><li>Immaturity of enzymatic detoxifying mechanism </li></ul><ul><li>Incomplete excretory organs </li></ul><ul><li>Partial development of physiological barriers (BBB). </li></ul>
  6. 6. Most Important & well studied SIDE EFFECT OF ARTIFICIAL COLOURS Attention Deficit Hyperactivity Disorder (ADHD) Symptoms: Lack of concentration, distractibility, excitability, impulsiveness, temper tantrum, anxiety, antisocial behavior, difficulties with coordination, disabilities of both cognitive and learning functions. J.Human Nutr,34:167-174,1980 Report on Colour Additives. FACT, June, 1987 Pediatrics. 1978 Jun;61(6):811-7.
  7. 7. <ul><li>School-going Hyperactive </li></ul><ul><li>Children </li></ul><ul><li>Restlessness, inattentive, </li></ul><ul><li>poor academic performance, </li></ul><ul><li>distractible, aggressive and </li></ul><ul><li>anti-social tendencies. </li></ul>
  8. 8. What evidence have we got? <ul><li>Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis. Journal of Developmental & Behavioral Pediatrics. 2004 </li></ul><ul><li>The effects of artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Arch Dis Child. 2004 </li></ul><ul><li>Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community. Lancet Nov 2007 </li></ul>
  9. 9. Interesting thing about these studies ! <ul><li>Preservatives used as a challenge …. </li></ul><ul><li>sunset yellow, 5 mg; </li></ul><ul><li>carmoisine, 2.5 mg; </li></ul><ul><li>tartrazine, 7.5 mg; </li></ul><ul><li>and ponceau 4R, 5 mg </li></ul><ul><li>and 45 mg of sodium benzoate. </li></ul>
  10. 10. What I found in my “samples”? Lupin Ponceau4R Nizonide Dr. Reddy’s Sunset Yellow Pedicloryl Novartis Sunset Yellow Calcium Sandoz Macleods Sunset Yellow Zithrox Ranbaxy Sunset Yellow Zanocin Ranbaxy Ponceau4R Chericof Dr. Reddy’s Sunset Yellow Relent Wallace Tartrazine Waltuz Br Company Additive Medicine
  11. 11. <ul><li>The art of medicine consists of amusing the patient while nature cures the disease -- Voltaire </li></ul>
  12. 12. OTHER SIDE EFFECTS OF ARTIFICIAL COLORS
  13. 13. 1. Artificial colors cause skin rashes in Children. Clinical Pediatrics, Vol. 37, No. 10, 601-607 (1998) 2. Tartrazine, Erythrosine, Sunset yellow, Ponceu 4 R, Amaranth, Fast red E, Allura red, Brilliant Blue. Inhibit mitochondrial respiration - Oxidative stress. The Chinese journal of physiology 2001 Mar 31; 44(1):1-11. Wei YH, Lu CY, Ma YS, Lee HC. 3. Azo dyes (Amaranth & Sunset yellow) - Genotoxicity . Environmental health perspectives 1994 October; 102(Suppl 6): 119–122. 4. Allergy to tartrazine in psychotropic drugs. The Journal of clinical psychiatry 2000 Jul;61(7):473-6
  14. 14. http://mbm.net.au/health/guide.htm Hypersensitivity reaction, asthma, ? Neurological Synthetic benzoin derivative Benzoic Acid Sensitivity to light, learning difficulties, thyroid cancer. Other uses: to kill maggots & flies! Coal Tar Erythrosine 1:10,000 allergic, potential carcinogen Synthetic coal tar and azo dye Ponceau 4R Asthma, Eczema, Hyperactivity. Birth Defects and Fetal Death! Azo dye Amaranth Cancer risk, Nasal congestion, Asthma, decreased appetite Naphthalene-6-sulfonate Sunset Yellow Asthma, ADHD, Rashes Synthetic Coal Tar dye Quinoline Yellow 1: 10,000 risk of Urticaria ADHD, possible risk of cancer Allergy Coal Tar – Industrial Waste Tartazine Problems Made From Additive
  15. 15. <ul><li>TARTRAZINE TERRORS </li></ul><ul><li>Coal-tar – Industrial waste. </li></ul><ul><li>Hyperactivity/ADHD </li></ul><ul><li>Asthma, Urticaria, Angio-oedema . </li></ul><ul><li>The Journal of asthma 1985;22(3):139-43. </li></ul><ul><li>Deficiency of Vitamin B 6 and Zinc. </li></ul><ul><li>Migraine, Thyroid cancer, Eosinophilia, and Lupus. </li></ul><ul><li>Cross – sensitivity in Aspirin sensitive and NSAID sensitive patients </li></ul><ul><li>Allergy to tartrazine in psychotropic drugs </li></ul><ul><li>J Clin Psychiatry. 2000 Jul;61(7):473-6 </li></ul>
  16. 16. <ul><li>Banned in USA, Austria and Norway. </li></ul><ul><li>Used in Febrex syrup, Ambrodil- S syrup, Shelcal kid, Tus-Q X syrup, etc. </li></ul>
  17. 17. SUNSET YELLOW FCF <ul><li>Side Effects : Urticaria, rhinitis, nasal congestion, allergy, hyperactivity, kidney tumours, abdominal cramps & Quincke’s oedema. </li></ul><ul><li>Usage is banned in Norway. </li></ul><ul><li>Present in Relent, Zanocin, Zithrox, Pedicloryl, Calcium Sandoz </li></ul><ul><li>Ref-Martindale,32nd Edition, pg 1001. </li></ul>
  18. 18. CARMOISINE <ul><li>Side Effects : Carcinogenic, Hyperactivity,Cross sensitivity with aspirin. </li></ul><ul><li>Contraindicated : Asthmatics </li></ul><ul><li>Banned in USA, Austria, Norway & Sweden. </li></ul><ul><li>Used- Calpol, Cobadex, Febrex plus syrup & drops,etc. </li></ul>
  19. 19. Inhibitor: Dopamine uptake - Hyperactivity Side Effects: Childhood hyperactivity, Photosensitivity, Erythroderma. Banned in USA and Norway Used in Shelcal suspension, Macalvit, Dexorange, etc. ERYTHROSINE
  20. 20. <ul><li>PONCEAU 4 R </li></ul><ul><li>Animal study : Hepatoma, Reticulum cell sarcoma, pulmonary lymphosarcoma, adenocarcinoma, mammary fibroadenoma. </li></ul><ul><li>Side Effect : Oxidative stress. </li></ul><ul><li>Banned in USA & Norway. </li></ul><ul><li>Used in Wikoryl syrup & drops, Sinarest drops, Febrex syrup, etc. </li></ul>
  21. 21. <ul><li>QUINOLINE </li></ul><ul><li>Side Effect – Hyperactivity in children </li></ul><ul><li>Banned in USA, Austria and Norway. </li></ul><ul><li>Used in Cavit Syrup, Digene, Mahacef etc. </li></ul>
  22. 23. <ul><li>DRUG ADDITIVES </li></ul><ul><li>Benzyl Alcohol </li></ul><ul><li>Lactose </li></ul><ul><li>Propylene Glycol </li></ul>
  23. 24. <ul><li>Benzyl Alcohol </li></ul><ul><li>Preservative </li></ul><ul><li>Adverse effects- </li></ul><ul><li>Gasping baby syndrome- Gasping respirations,metabolic acidosis and haematological abnormalities. </li></ul><ul><li>Kernicterus, Intraventricular Hemorrhage. </li></ul><ul><li>Hypersensitivity, Dermatitis. </li></ul><ul><li>US FDA, AAP- Avoid benzyl Alcohol . </li></ul><ul><li>Important reason why we avoid giving Diazepam injection in Neonatal Seizures </li></ul>
  24. 25. <ul><li>Lactose </li></ul><ul><li>Filler in tablets & capsules. </li></ul><ul><li>Lactose intolerant individual </li></ul><ul><li>Diarrhoea, Dehydration, Cramps, etc. </li></ul>
  25. 26. Propylene Glycol <ul><li>A commonly used solvent in Paracetamol syrup </li></ul><ul><li>Adverse effects - Respiratory problems, lactic acidosis, low blood pressure, haemolysis, hyperosmolality, skin rashes & CNS toxicity in Children. </li></ul>1000 mg of PG is needed for dissolving 100 mg of Paracetamol Concentration of PG exceeds far above that recommended by FDA/WHO expert committees.
  26. 27. <ul><li>Other flavors: </li></ul><ul><li>Calcium dihydrogen, </li></ul><ul><li>L-glutamate, </li></ul><ul><li>Disodium guanylate, </li></ul><ul><li>Disodium inosinate : </li></ul><ul><li>Avoid : </li></ul><ul><li>Hyperactivity, Asthma, </li></ul><ul><li>Aspirin sensitivity & Gout. </li></ul>ARTIFICIAL FLAVORS Synthetic Raspberry Flavoring : Vanillin, Ethyl vanillin, Alphainone, Maltole, Dimethyl sulphide & dimethyl N-pyrrole, etc.
  27. 28. Here is the list of ingredients for artificial strawberry flavour   <ul><li>amyl acetate, </li></ul><ul><li>amyl butyrate, </li></ul><ul><li>amyl valerate, </li></ul><ul><li>anethol, </li></ul><ul><li>anisyl formate, </li></ul><ul><li>benzyl acetate, </li></ul><ul><li>benzyl isobutyrate, </li></ul><ul><li>butyric acid, </li></ul><ul><li>cinnamyl isobutyrate, </li></ul><ul><li>cinnamyl valerate, </li></ul><ul><li>cognac essential oil, </li></ul><ul><li>diacetyl, dipropyl ketone, ethyl acetate, </li></ul><ul><li>ethyl amyl ketone, </li></ul><ul><li>ethyl butyrate, </li></ul><ul><li>ethyl cinnamate, </li></ul><ul><li>ethyl heptanoate, </li></ul><ul><li>ethyl heptylate, </li></ul><ul><li>ethyl lactate, </li></ul><ul><li>ethyl methylphenylglycidate, </li></ul><ul><li>ethyl nitrate, </li></ul><ul><li>ethyl propionate, </li></ul><ul><li>ethyl valerate, </li></ul><ul><li>heliotropin, </li></ul><ul><li>a-ionone, </li></ul><ul><li>hydroxyphenyl-2-butanone (10 percent solution in alcohol), </li></ul><ul><li>isobutyl anthranilate, </li></ul><ul><li>isobutyl butyrate, </li></ul><ul><li>lemon essential oil, </li></ul><ul><li>maltol, 4-methylacetophenone, </li></ul><ul><li>methyl anthranilate, </li></ul><ul><li>methyl benzoate, </li></ul><ul><li>methyl cinnamate, </li></ul><ul><li>methyl heptine carbonate, </li></ul><ul><li>methyl naphthyl ketone, </li></ul><ul><li>methyl salicylate, </li></ul><ul><li>mint essential oil, </li></ul><ul><li>neroli essential oil, </li></ul><ul><li>nerolin, </li></ul><ul><li>neryl isobutyrate, </li></ul><ul><li>orris butter, </li></ul><ul><li>phenethyl alcohol, </li></ul><ul><li>rose, </li></ul><ul><li>rum ether, </li></ul><ul><li>g-undecalactone, </li></ul><ul><li>vanillin, and solvent.   </li></ul>Yummmmy!
  28. 29. <ul><li>WHY DO PHARMACEUTICAL COMPANIES USE THESE AGENTS? </li></ul><ul><li>Low cost substitute, </li></ul><ul><li>FDA/WHO. </li></ul><ul><li>Food Manufacturers. </li></ul><ul><li>Children – Guinea pigs. </li></ul><ul><li>  </li></ul>
  29. 31. IS THERE AN A L T E R N A T I V E TO ARTIFICIAL COLORS & FLAVORS?
  30. 32. Natural Colors And Flavors Better & Safer Alternatives
  31. 33. <ul><li>Natural Colors </li></ul><ul><li>Annatto </li></ul><ul><li>Anthrocyanin </li></ul><ul><li>Carotenoids </li></ul><ul><li>Carotene </li></ul><ul><li>Chlorophyll </li></ul><ul><li>Curcumin </li></ul><ul><li>Iron oxides </li></ul><ul><li>Riboflavin </li></ul><ul><li>Titanium dioxides </li></ul>
  32. 34. <ul><li>Carotenoids </li></ul><ul><li>Yellow & Red colors . </li></ul><ul><li>Sources- S weet potatoes, </li></ul><ul><li>spinach and tomatoes. </li></ul><ul><li>Antioxidant - Cancer research. </li></ul>
  33. 35. <ul><li>Carotene </li></ul><ul><li>Yellow to Orange colors . </li></ul><ul><li>Sources: Carrots, yellow </li></ul><ul><li>or orange fruits. </li></ul><ul><li>Rich in Vitamin A. </li></ul>
  34. 36. <ul><li>Chlorophyll </li></ul><ul><li>Green coloring agent . </li></ul><ul><li>Occurs naturally in </li></ul><ul><li>all plants </li></ul>
  35. 37. <ul><li>Curcumin </li></ul><ul><li>Extracted from turmeric. </li></ul><ul><li>Coloring and medicinal uses </li></ul><ul><li>Wound healing </li></ul><ul><li>Antiulcer </li></ul><ul><li>Anti inflammatory </li></ul><ul><li>Antimicrobial & antiviral </li></ul><ul><li>Hepatoprotective </li></ul><ul><li>Antioxidant </li></ul><ul><li>No toxicity. </li></ul>
  36. 38. <ul><li>Riboflavin (Vitamin B 2 ) </li></ul><ul><li>Yellow to Orange colors. </li></ul><ul><li>Sources- Leafy vegetables, </li></ul><ul><li>Eggs, Milk & Wheat. </li></ul><ul><li>Safe & Beneficial for health. </li></ul>
  37. 39. <ul><li>Sweet Orange Oil </li></ul><ul><li>Sweet orange fruit peel </li></ul><ul><li>Stress reducing agent </li></ul><ul><li>Aroma therapy: </li></ul><ul><li>Peace of mind </li></ul>
  38. 40. <ul><li>Chocolate Flavor </li></ul><ul><li>Cocoa seeds </li></ul><ul><li>Psychological Benefits. </li></ul><ul><li>Patient Compliance. </li></ul>
  39. 41. <ul><li>ADVANTAGES OF NATURAL COLORS & FLAVORS </li></ul><ul><li>1) Sensitivity rare. </li></ul><ul><li>2) Allergic side effects rare. </li></ul><ul><li>Additional Medicinal Properties </li></ul>( Role of natural color additives in food allergy, Lucas CD, Hallagan JB, Taylor SL. Adverse Food Nutrition Res. 2001;43: 195-216
  40. 42. <ul><li>Natural Colors & Flavors Are Costly But Definitely Not Costlier Than Health! </li></ul><ul><li>Then Why To Compromise? </li></ul>CONCLUSION
  41. 43. <ul><li>REMEMBER </li></ul><ul><li>ARTIFICIAL COLORS , FLAVORS AND ADDITIVES MAY BE A LITTLE CHEAPER. </li></ul><ul><li>BUT THEY EXTRACT A BIG PRICE IN TERMS OF OUR & CHILDREN’S HEALTH. </li></ul><ul><li>GO NATURAL. </li></ul>&quot;If you think you're too small to be effective, you've never been in bed with a mosquito.&quot;

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