Food additives in childhood: a review on consumption and health consequences

Authors

  • Mariana Vieira dos Santos Kraemer Universidade Federal de Santa Catarina. Núcleo de Pesquisa de Nutrição em Produção de Refeições. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil http://orcid.org/0000-0002-0265-090X
  • Ana Carolina Fernandes Universidade Federal de Santa Catarina. Núcleo de Pesquisa de Nutrição em Produção de Refeições. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil https://orcid.org/0000-0002-8179-4855
  • Maria Cecília Cury Chaddad Pontifícia Universidade Católica. Faculdade de Direito. São Paulo, SP, Brasil https://orcid.org/0000-0001-9219-0179
  • Paula Lazzarin Uggioni Universidade Federal de Santa Catarina. Núcleo de Pesquisa de Nutrição em Produção de Refeições. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil https://orcid.org/0000-0003-2696-0539
  • Vanessa Mello Rodrigues Universidade Federal de Santa Catarina. Núcleo de Pesquisa de Nutrição em Produção de Refeições. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil https://orcid.org/0000-0002-8214-9137
  • Greyce Luci Bernardo Universidade Federal de Santa Catarina. Núcleo de Pesquisa de Nutrição em Produção de Refeições. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil https://orcid.org/0000-0003-0411-012X
  • Rossana Pacheco da Costa Proença Universidade Federal de Santa Catarina. Núcleo de Pesquisa de Nutrição em Produção de Refeições. Programa de Pós-Graduação em Nutrição. Florianópolis, SC, Brasil https://orcid.org/0000-0001-6149-8752

DOI:

https://doi.org/10.11606/s1518-8787.2022056004060

Keywords:

Child Nutrition, Eating, Industrialized Foods, Food Additives, toxicity, Review

Abstract

OBJECTIVE To discuss the context of scientific publications on the consumption of food additives by children and the possible health consequences in this age group. METHODS A literature review, with a search carried out between April 2020 and April 2021 in the Web of Science, Scopus, PubMed and Google Scholar databases, as well as in websites of Brazilian and foreign official bodies. Official documents and studies published since 2000 were selected. Keywords related to food additives, children, food consumption, and health were used for the search. RESULTS Food additives are substances intentionally added to foods for technological purposes. Processed foods are the main sources of additives in food and their consumption occurs since childhood. It is observed, however, that there are limitations inherent to the scientific method regarding the analysis of consumption and toxicity of food additives in humans, causing scarcity of data in the scientific literature. Additionally, existing data suggest that the additives have a higher toxic potential in children, considering that the body weight in this age group is lower than in adults. This context emphasizes the need to observe the precautionary principle, according to which risks of harm must be prevented. CONCLUSIONS This is a scenario in which the literature points to a risk to people’s health and, in particular, to children, about whom the duty of protection must be even greater, with absolute priority. Thus, the relevance of an expanded technical-scientific debate regarding the establishment of specific and stricter parameters for children is considered, regarding the consumption and toxicity of additives, as well as the different sources of exposure to these substances.

References

Vandevijvere S, Jaacks LM, Monteiro CA, Moubarac JC, Girling-Butcher M, Lee AC, et al. Global trends in ultraprocessed food and drink product sales and their association with adult body mass index trajectories. Obes Rev. 2019;20 Suppl 2:10-19. https://doi.org/10.1111/obr.12860

Karnopp EVN, Vaz JS, Schafer AA, Muniz LC, Souza RLV, Santos I, et al. Food consumption of children younger than 6 years according to the degree of food processing. J Pediatr. 2017;93(1):70-8. https://doi.org/10.1016/j.jped.2016.04.007

Popkin BM. Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases. Am J Clin Nutr. 2006;84(2):289-98. https://doi.org/10.1093/ajcn/84.1.289

Monteiro CA, Cannon G, Levy RB, Mourabac JC, Louzada ML, Rauber F, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936-41. https://doi.org/10.1017/S1368980018003762

Martins APB, Levy RB, Claro RM, Moubarach JC, Monteiro CA. Participação crescente de produtos ultraprocessados na dieta brasileira (1987-2009). Rev Saude Publica. 2013;47(4):656-65. https://doi.org/10.1590/S0034-8910.2013047004968

Theurich MA, Zaragoza-Jordana M, Luque V, Gruszfeld D, Gradowska K, Xhonneux A, et al. Commercial complementary food use amongst European infants and children: results from the EU Childhood Obesity Project. Eur J Nutr. 2020;59(4):1679-92. https://doi.org/10.1007/s00394-019-02023-3

Assis MAA, Calvo MCM, Kupek E, Vasconcelos FAG, Campos VC, Machado M, et al. Qualitative analysis of the diet of a probabilistic sample of schoolchildren from Florianópolis, Santa Catarina State, Brazil, using the Previous Day Food Questionnaire. Cad Saude Publica. 2010;26(7):1355-65. https://doi.org/10.1590/s0102-311x2010000700014

Conceição SIO, Santos CJN, Silva AAM, Silva JS, Oliveira TC. Consumo alimentar de escolares das redes pública e privada de ensino em São Luís, Maranhão. Rev Nutr. 2010;23(6):993-1004. https://doi.org/10.1590/S1415-52732010000600006

Matuk TT, Stancari PCS, Bueno MB, Zaccarelli EM. Composição de lancheiras de alunos de escolas particulares de São Paulo. Rev Paul Pediatr. 2011;29(2):157-63. https://doi.org/10.1590/S0103-05822011000200005

Instituto Brasileiro de Geografia e Estatística. Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE; 2011. 351 p.

Costa FF, Assis MAA, Leal DB, Campos VC, Kupek E, Conde WL. Mudanças no consumo alimentar e atividade física de escolares de Florianópolis, SC, 2002-2007. Rev Saude Publica. 2012;46 Suppl 1:117-25. https://doi.org/10.1590/s0034-89102012005000058

Hinnig PF, Bergamaschi DP. Itens alimentares no consumo alimentar de crianças de 7 a 10 anos. Rev Bras Epidemiol. 2012;15(2):324-34. https://doi.org/10.1590/S1415-790X2012000200010

Nobre LN, Lamounier JA, Franceschini SCC. Padrão alimentar de pré-escolares e fatores associados. J. Pediatr. 2012;88(2):129-36. https://doi.org/10.2223/JPED.2169

Polônio MLT, Peres F. Consumo de corantes artificiais por pré-escolares de um município da baixada fluminense, RJ. Rev Pesq Cuid Fundam. 2012 [citado 15 abr 2021];4(1):2748-57. Disponível em: http://www.seer.unirio.br/index.php/cuidadofundamental/article/view/1609/pdf_487

Costa CS, Rauber F, Leffa PS, Sangalli CN, Campagnolo PDB, Vítolo MR. Ultra-processed food consumption and its effects on anthropometric and glucose profile: a longitudinal study during childhood. Nutr Metab Cardiovasc Dis. 2019;29(2):177-84. https://doi.org/10.1016/j.numecd.2018.11.003

Ferreira CS, Silva DA, Gontijo CA, Rinaldi AEM. Consumption of

minimally processed and ultra-processed foods among students from public and private schools. Rev Paul Pediatr. 2019;37(2):173-80. https://doi.org/10.1590/1984-0462/;2019;37;2;00010

Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc. 2010;110(10):1477-84. https://doi.org/10.1016/j.jada.2010.07.010

Piernas C, Popkin BM. Increased portion sizes from energy-dense foods affect total energy intake at eating occasions in US children and adolescents: patterns and trends by age group and sociodemographic characteristics, 1977-2006. Am J Clin Nutr. 2011;94(5):1324-32. https://doi.org/10.3945/ajcn.110.008466

Louzada MLC, Martins APB, Canella DS, Baraldi LG, Levy RB, Claro RM, et al. Ultra-processed foods and the nutritional dietary profile in Brazil. Rev Saude Publica. 2015;49:38. https://doi.org/10.1590/S0034-8910.2015049006132

Rodrigues VM, Rayner M, Fernandes AC, Oliveira RC, Proença RPC, Fiates GMR. Nutritional quality of packaged foods targeted at children in Brazil: which ones should be eligible to bear nutrient claims? Int J Obes. 2017;41(1):71-5. https://doi.org/10.1038/ijo.2016.167

Louzada MLC, Ricardo CA, Steele EM, Levy RB, Cannon G, Monteiro CA. The share of ultra-processed foods determines the overall nutritional quality of diets in Brazil. Public Health Nutr. 2018;21(Spec Nº 1):94-102. https://doi.org/10.1017/S1368980017001434

Lorenzoni ASG, Cladera-Olivera F. Food additives in products for children marketed in Brazil. Food Public Health. 2012;2(5):131-6. https://doi.org/10.5923/j.fph.20120205.03

Teixeira AZA. Sodium content and food additives in major brands

of Brazilian children’s foods. Cienc Saude Colet. 2018;23(12):4065-75. https://doi.org/10.1590/1413-812320182312.21812016

Braga LVM, Silva ARCS, Anastácio LR. Levantamento de aditivos alimentares em produtos alimentícios voltados para o público infantil. Segur Aliment Nutr. 2021;28:e021013. https://doi.org/10.20396/san.v28i00.8659994

Rodrigues VM, Rayner M, Fernandes AC, Oliveira RC, Proença RPC, Fiates GMR. Comparison of the nutritional content of products, with and without nutrient claims, targeted at children in Brazil. Br J Nutr. 2016;115(11):2047-56. https://doi.org/10.1017/S0007114516001021

Food and Agriculture Organization of the United Nations; World Health Organization. Codex Alimentarius: general standard for food additives. Rome (IT); FAO; 1995 [citado 10 abr 2021]. Disponível em: http://www.fao.org/fao-who-codexalimentarius/sh-proxy/en/?lnk=1&url=https%253A%252F%252Fworkspace.fao.org%252Fsites%252Fcodex%252FStandards%252FCXS%2B192-1995%252FCXS_192e.pdf

Ministério da Saúde (BR), Secretaria de Vigilância Sanitária. Portaria Nº 540, de 27 de outubro de 1997. Aprova o Regulamento técnico Aditivos Alimentares - definições, classificação e emprego. Diário Oficial da União. 28 out 1997; Poder Executivo.

Tomaska LD, Brooke-Taylor S. Food Additives – general. In: Montarjemi Y, Moy G, Todd E, editors. Encyclopedia of Food Safety. Vol 2. Cambridge, Mass: Academic Press; 2014. p.449-54. https://doi.org/10.1016/B978-0-12-378612-8.00234-1

Dybing E, Doe J, Groten J, Kleiner J, O’Brien J, Renwick AG, et al. Hazard characterization of chemicals in food and diet: dose response, mechanisms and extrapolation issues. Food Chem Toxicol. 2002;40(2-3):237-82. https://doi.org/10.1016/s0278-6915(01)00115-6

Renwick AG, Barlow SM, Hertz-Picciotto I, Boobis AR, Dybing E, Edler L, et al. Risk characterization of chemicals in food and diet. Food Chem Toxicol. 2003;41(9):1211-71. https://doi.org/10.1016/s0278-6915(03)00064-4

World Health Organization. Children’s health and the environment: a global perspective: a resource manual for the health sector. Geneva (CH): WHO; 2005. 367p.

Landrigan PJ, Trasande L, Thorpe LE, Gwynn C, Lioy PJ, D'Alton ME, et al. The National Children's Study: a 21-year prospective study of 100,000 American children. Pediatrics. 2006;118(5):2173- 86. https://doi.org/10.1542/peds.2006-0360

Brasil, Constituição (1988). Constituição da República Federativa do Brasil de 1988. Brasília, DF: Senado Federal; 1988.

Brasil. Lei Nº 8.078, de 11 de setembro de 1990. Dispõe sobre a proteção do consumidor e dá outras providências. Diário Oficial da União. 12 set 1990.

Hartmann IAM. O princípio da precaução e sua aplicação no direito do consumidor: dever de informação. Direito Justiça. 2012 [citado 9 jul 2021];38(2). Disponível em: https://revistaseletronicas.pucrs.br/ojs/index.php/fadir/article/view/12542

Chaddad MCC. Rotulagem de alimentos: o direito à informação, à proteção da saúde e à alimentação adequada da população com alergia alimentar. Curitiba, PR: Juruá; 2014.

Jain A, Mathur P. Estimation of food additive intake: overview of the methodology. Food Rev Int. 2015;31(4):355-84. https://doi.org/10.1080/87559129.2015.1022830

Choi SH, Suh HJ. Determination and estimation of daily nitrite intake from processed meats in Korea. J Consum Prot Food Saf. 2017;12(1):15-22. https://doi.org/10.1007/s00003-016-1075-8

Long NH, Hao LTH, Trang VT, Son TC, Hung LQ. Assessing dietary risks caused by food additives: a case study of total diet in Vietnam. Health Risk Anal. 2019;2:74-82. https://doi.org/10.21668/health.risk/2019.2.08.eng

Trasande L, Shaffer RM, Sathyanarayana S. Food additives and child health. Pediatrics. 2018;142(2):e20181408. https://doi.org/10.1542/peds.2018-1408

Prado MA, Godoy HT. Teores de corantes artificiais em alimentos determinados por cromatografia líquida de alta eficiência. Quim Nova. 2007;30(2):268-73. https://doi.org/10.1590/S0100-40422007000200005

Schab DW, Trinh NHT. Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials. J Dev Behav Pediatr. 2004;25(6):423-34. https://doi.org/10.1097/00004703-200412000-00007

Polônio MLT, Peres F. Consumo de aditivos alimentares e efeitos à saúde: desafios para a saúde pública brasileira. Cad Saude Publica. 2009;25(8):1653-66. https://doi.org/10.1590/s0102-311x2009000800002

Kanarek RB. Artificial food dyes and attention deficit hyperactivity disorder. Nutr Rev. 2011;69(7):385-91. https://doi.org/10.1111/j.1753-4887.2011.00385.x

Husain A, Sawaya W, Al-Omair A, Al-Zenki S, Al-Amiri H, Ahmed N, et al. Estimates of dietary exposure of children to artificial food colours in Kuwait. Food Addit Contam. 2007;23(3):245-51. https://doi.org/10.1080/02652030500429125

Schumann SPA, Polônio MLT, Gonçalves ECBA. Avaliação do consumo de corantes artificiais por lactentes, pré-escolares e escolares. Food Sci Technol. 2008;28(3):534-9. https://doi.org/10.1590/S0101-20612008000300005

Sardi M, Haldemann Y, Nordmann H, Bottex B, Safford B, Smith B, et al. Use of retailer fidelity card schemes in the assessment of food additive intake: Sunset Yellow a case study. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2010;27(11):1507-15. https://doi.org/10.1080/19440049.2010.495728

Dixit S, Purshottam SK, Khanna SK, Das M. Usage pattern of synthetic food colours in different states of India and exposure assessment through commodities preferentially consumed by children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2011;28(8):996-1005. https://doi.org/10.1080/19440049.2011.580011

Larsson K, Darnerud PO, Ilback NG, Merino L. Estimated dietary intake of nitrite and nitrate in Swedish children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2011;28(5):659-66. https://doi.org/10.1080/19440049.2011.555842

Lok KYW, Chung YW, Benzie IFF, Woo J. Synthetic colourings of some snack foods consumed by primary school children aged 8-9 years in Hong Kong. Food Addit Contam Part B Surveill. 2011;4(3):162-7. https://doi.org/10.1080/19393210.2011.585246

Urtiaga C, Amiano P, Azpiri M, Alonso A, Dorronsoro M. Estimate of dietary exposure to sulphites in child and adult populations in the Basque Country. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2013;30(12):2035-42. https://doi.org/10.1080/19440049.2013.840930

Vin K, Connolly A, McCaffrey T, McKevitt A, O'Mahony C, Prieto M, et al. Estimation of the dietary intake of 13 priority additives in France, Italy, the UK and Ireland as part of the FACET project. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2013;30(12):2050-80. https://doi.org/10.1080/19440049.2013.851417

Diouf F, Berg K, Ptok S, Lindtner O, Heinemeyer G, Heseker H. German database on the occurrence of food additives: application for intake estimation of five food colours for toddlers and children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2014;31(2):197-206. https://doi.org/10.1080/19440049.2013.865146

Mancini FR, Paul D, Gauvreau J, Volatier JL, Vin K, Hulin M. Dietary exposure to benzoates (E210-E213), parabens (E214-E219), nitrites (E249-E250), nitrates (E251-E252), BHA (E320), BHT (E321) and aspartame (E951) in children less than 3 years old in France. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2015;32(3):293-306. https://doi.org/10.1080/19440049.2015.1007535

Suomi J, Ranta J, Tuominen P, Putkonen T, Backman C, Ovaskainen ML. Quantitative risk assessment on the dietary exposure of Finnish children and adults to nitrite. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2016;33(1):41-53. https://doi.org/10.1080/19440049.2015.1117145

Reddy MV, Aruna G, Parameswari SA, Banu BH, Reddy PJ. Estimated daily intake and exposure of sodium benzoate and potassium sorbate through food products in school children of Tirupati, India. Int J Pharm Pharmaceutical Sci. 2015 [citado 15 abr 2021];7(7):129-33. Disponível em: https://innovareacademics.in/journals/index.php/ijpps/article/view/6114

Martyn DM, Nugent AP, McNulty BA, O’Reilly E, Tlustos C, Walton J, et al. Dietary intake of four artificial sweeteners by Irish pre-school children. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2016;33(4):592-602. https://doi.org/10.1080/19440049.2016.1152880

Feitosa LCA, Rodrigues PS, Silva AS, Rios AO, Cladera-Olivera F. Estimate of the theoretical maximum daily intake of Sunset Yellow FCF by the Brazilian population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2017;34(5):687-94. https://doi.org/10.1080/19440049.2017.1290829

Bastaki M, Farrell T, Bhusari S, Bi X, Scrafford C. Estimated daily intake and safety of FD&C food-colour additives in the US population. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2017;34(6):891-904. https://doi.org/10.1080/19440049.2017.1308018

Choi SH, Suh HJ. Determination and estimation of daily nitrite intake from processed meats in Korea. J Consum Prot Food Saf. 2017;12(1):15-22. https://doi.org/10.1007/s00003-016-1075-8

Martyn D, Lau D, Darch M, Roberts A. Benzoates intakes from non-alcoholic beverages in Brazil, Canada, Mexico and the United States. Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2017;34(9):1485-99. https://doi.org/10.1080/19440049.2017.1338836

Bel S, Struyf T, Fierens T, Jacobs G, Vynks C, Bellemans M. Dietary exposure of the Belgian population to emulsifiers E481 (sodium stearoyl-2-lactylate) and E482 (calcium stearoyl-2-lactylate). Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2018;35(5):828-37. https://doi.org/10.1080/19440049.2018.1435911

Garavaglia MB, García VR, Zapata ME, Rovirosa A, González V, Marcó FF, et al. Non-nutritive sweeteners: children and adolescent consumption and food sources. Arch Argent Pediatr. 2018;116(3):186-91. https://doi.org/10.5546/aap.2018.eng.186

Martínez X, Zapata Y, Pinto V, Cornejo C, Elbers M, Graaf M, et al. Intake of non-nutritive sweeteners in Chilean children after enforcement of a new food labeling law that regulates added sugar content in processed foods. Nutrients. 2020;12(6):1594. https://doi.org/10.3390/nu12061594

Chazelas E, Druesne-Pecollo N, Esseddik Y, Edelenyi FS, Agaesse C, Sa A, et al. Exposure to food additive mixtures in 106,000 French adults from the NutriNet-Santé cohort. Sci Rep. 2021;11:19680. https://doi.org/10.1038/s41598-021-98496-6

Ministério da Saúde (BR), Agência Nacional de Vigilância Sanitária. Resolução - RDC Nº 45, de 3 de novembro de 2010. Dispõe sobre aditivos alimentares autorizados para uso segundo as Boas Práticas de Fabricação (BPF). Brasília, DF: Anvisa; 2010 [citado 20 set 2021]. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2010/rdc0045_03_11_2010.html

Canella DS, Levy RB, Martins APB, Claro RM, Moubarac JC, Baraldi LG, et al. Ultra-processed food products and obesity in Brazilian households (2008-2009). PLoS One. 2014;9(3):e92752. https://doi.org/10.1371/journal.pone.0092752

Lane MM, Davis JA, Beattie S, Gómez-Donoso C, Loughman A, O'Neil A, et al. Ultraprocessed food and chronic noncommunicable diseases: a systematic review and meta-analysis of 43 observational studies. Obes Rev. 2021;22(3):e13146. https://doi.org/10.1111/obr.13146

Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, et al. Consumption of ultraprocessed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ. 2018;360:k322. https://doi.org/10.1136/bmj.k322

Swidsinski A, Ung V, Sydora BC, Loening-Baucke V, Doerffel Y, Verstraelen H, et al. Bacterial overgrowth and inflammation of small intestine after carboxymethylcellulose ingestion in genetically susceptible mice. Inflamm Bowel Dis. 2009;15(3):359-364. https://doi.org/10.1002/ibd.20763

Chassaing B, Koren O, Goodrich JK, Poole AC, Srinivasan S, Ley RE, et al. Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature. 2015;519(7541):92-6. https://doi.org/10.1038/nature14232

Viennois E, Merlin D, Gewirtz AT, Chassaing B. Dietary emulsifier-induced low-grade inflammation promotes colon carcinogenesis. Cancer Res. 2017;77(1):27-40. https://doi.org/10.1158/0008-5472.CAN-16-1359

Tobacman JK. Review of Harmful gastrointestinal effects of carrageenan in animal experiments. Environ Health Perspect. 2001;109(10):983-94. https://doi.org/10.1289/ehp.01109983

Bhattacharyya S, O-Sullivan I, Katyal S, Unterman T, Tobacman JK. Exposure to the common food additive carrageenan leads to glucose intolerance, insulin resistance and inhibition of insulin signalling in HepG2 cells and C57BL/6J mice. Diabetologia. 2012;55(1):194-203. https://doi.org/10.1007/s00125-011-2333-z

Bhattacharyya S, Feferman L, Unterman T, Tobacman JK. Exposure to common food additive carrageenan alone leads to fasting hyperglycemia and in combination with high fat diet exacerbates glucose intolerance and hyperlipidemia without effect on weight. J Diabetes Res. 2015;2015:513429. https://doi.org/10.1155/2015/513429

Moutinho ILD, Bertges LC, Assis RVC. Prolonged use of food dye tartrazine (FD&C yellow nº5) and its effects on the gastric mucosa of Wistar rats. Braz J Biol. 2007;67(1):141-5. https://doi.org/10.1590/s1519-69842007000100019

Mehedi N, Ainad-Tabet S, Mokrane N, Addou S, Zaoui C, Kheroua O, et al. Reproductive toxicology of tartrazine (FD and C Yellow No. 5) in Swiss albino mice. Am J Pharmacol Toxicol. 2009;4(4):130-5. https://doi.org/10.3844/ajptsp.2009.130.135

Abou-Donia MB, El-Masry EM, Abdel-Rahman AA, McLendon RE, Schiffman SS. Splenda alters gut microflora and increases intestinal p-glycoprotein and cytochrome p-450 in male rats. J Toxicol Environ Health A. 2008;71(21):1415-29. https://doi.org/10.1080/15287390802328630

Suez J, Korem T, Zeevi D, Zilberman-Schapira G, Thaiss CA, Maza O, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014;514(7521):181-6. https://doi.org/10.1038/nature13793

Simon BR, Parlee SD, Learman BS, Mori H, Scheller EL, Cawthorn WP, et al. Artificial sweeteners stimulate adipogenesis and suppress lipolysis independently of sweet taste receptors. J Biol Chem. 2013;288(45):32475-89. https://doi.org/10.1074/jbc.M113.514034

Swithers SE, Davidson TL. A role for sweet taste: calorie predictive relations in energy regulation by rats. Behav Neurosci. 2008;122(1):161-73. https://doi.org/10.1037/0735-7044.122.1.161

Albasher G, Maashi N, Alfarraj S, Almeer R, Albrahim T, Alotibi F, et al. Perinatal exposure to tartrazine triggers oxidative stress and neurobehavioral alterations in mice offspring. Antioxidants. 2020;9(1):53. https://doi.org/10.3390/antiox9010053

Raya SA, Aboul-Enein AM, El-Nikeety MMA, Mohamed RS, Abdelwahid WMA. In Vivo comet assay of food additives’ combinations and their effects on biochemical parameters in albino rats. Biointerface Res Appl Chem. 2021;11(2):9170-83. https://doi.org/10.33263/BRIAC112.91709183

Landrigan PJ, Straif K. Aspartame and cancer – new evidence for causation. Environ Health. 2021;20:42. https://doi.org/10.1186/s12940-021-00725-y

Organisation for Economic Cooperation and Development. OECD Guidelines for the testing of chemicals, Section 1: Physical-Chemical properties. Paris (FR): OECD; 2021 [citado 20 set 2021]. https://doi.org/10.1787/20745753

Ministério da Saúde (BR), Agência Nacional de Vigilância Sanitária. Esclarecimentos sobre a declaração de alegações de conteúdo para aditivos alimentares na rotulagem de alimentos e bebidas. Informe Técnico. 2016 jan 19 [citado 20 abr 2021];(70):1-9. Disponível em: https://www.gov.br/agricultura/pt-br/assuntos/inspecao/produtos-vegetal/legislacao-1/biblioteca-de-normas-vinhos-e-bebidas/informe-tecnico-no-70-de-19-de-janeiro-de-2016.pdf/view

Leisenring W, Ryan L. Statistical properties of the NOAEL. Regul Toxicol Pharmacol. 1992;15(2 Pt 1):161-71. https://doi.org/10.1016/0273-2300(92)90047-d

Dorato MA, Engelhardt JA. The no-observable-adverse-effect level in drug safety evaluations: use, issues, and definition(s). Regul Toxicol Pharmacol. 2005;42(3):265-74. https://doi.org/10.1016/j.yrtph.2005.05.004

Younes M, Aquilina G, Castle L, Engel KH, Fowler P, Fernandez MJF, et al. Safety assessment of titanium dioxide (E171) as a food additive. EFSA J. 2021;19(5):e6585. https://doi.org/10.2903/j.efsa.2021.6585

France. Arrêté du 17 avril 2019 portant suspension de la mise sur le marché des denrées contenant l'additif E 171 (dioxyde de titane - TiO2). Journal Officiel de la République Française. 26 avril 2019 [citado 8 out 2021]. Disponível em: https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000038410047?r=LNz0mqURAZ

Ministério da Saúde (BR), Agência Nacional de Vigilância Sanitária. Webinar com a Gerência de Padrões e Regulação de Alimentos aborda a Agenda Regulatória de Alimentos 2021/2023. Brasília, DF: Anvisa; 2021 [citado 08 out 2021]. Disponível em: https://www.gov.br/anvisa/pt-br/assuntos/educacaoepesquisa/webinar/alimentos/arquivos/apresentacao-we-22-21-agenda-regulatoria-de-alimentos-2021-2023.pdf

Paula Neto HA, Ausina P, Gomez LS, Leandro JGB, Zancan P, Sola-Penna M. Effects of food additives on immune cells as contributors to body weight gain and immune-mediated metabolic dysregulation. Front Immunol. 2017;8:1478. https://doi.org/10.3389/fimmu.2017.01478

Piper JD, Piper PW. Benzoate and sorbate salts: a systematic review of the potential hazards of these invaluable preservatives and the expanding spectrum of clinical uses for sodium benzoate. Compr Rev Food Sci Food Saf. 2017;16(5):868-80. https://doi.org/10.1111/1541-4337.12284

Brown RJ, Banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes. 2010;5(4):305-12. https://doi.org/10.3109/17477160903497027

Reid AE Chauhan BF Rabbani R, Lys J, Copstein L, Mann A, et al. Early exposure to nonnutritive sweeteners and longterm metabolic health: a systematic review. Pediatrics. 2016;137(3):e20153603. https://doi.org/10.1542/peds.2015-3603

Blot WJ, Henderson BE, Boice JD Jr. Childhood cancer in relation to cured meat intake: review of the epidemiological evidence. Nutr Cancer. 1999;34(1):111-8. https://doi.org/10.1207/S15327914NC340115

Dietrich M, Block G, Pogoda JM, Buffler P, Hecht S, Preston-Martin S. A review: dietary and endogenously formed N-nitroso compounds and risk of childhood brain tumors. Cancer Causes Control. 2005;16(6):619-35. https://doi.org/10.1007/s10552-005-0168-y

Lohner S, Toews I, Meerpohl JJ. Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutr J. 2017;16:55. https://doi.org/10.1186/s12937-017-0278-x

Shankar P, Ahuja S, Sriram K. Non-nutritive sweeteners: review and update. Nutrition. 2013;29(11-12):1293-9. https://doi.org/10.1016/j.nut.2013.03.024

Fowler SPG. Low-calorie sweetener use and energy balance: results from experimental studies in animals, and large-scale prospective studies in humans. Physiol Behav. 2016;164(Pt B):517-23. https://doi.org/10.1016/j.physbeh.2016.04.047

Daher MI, Matta JM, Abdel Nour AM. Non-nutritive sweeteners and type 2 diabetes: should we ring the bell? Diabetes Res Clin Pract. 2019;155:107786. https://doi.org/10.1016/j.diabres.2019.107786

United Nations Conference on Environment and Development; 3-14 Jun 1992; Rio de Janeiro, Brazil. New York: UN; 1993 [citado 20 abr 2021]. https://undocs.org/en/A/CONF.151/26/Rev.1(vol.I)3-4

Vally H, Misso NLA, Madan V. Clinical effects of sulphite additives. Clin Exp Allergy. 2009;39(11):1643-51. https://doi.org/10.1111/j.1365-2222.2009.03362.x

Song P, Wu L, Guan W. Dietary nitrates, nitrites, and nitrosamines intake and the risk of gastric cancer: a meta-analysis. Nutrients. 2015;7(12):9872-95. https://doi.org/10.3390/nu7125505

Romo-Romo A, Aguilar-Salinas CA, Brito-Córdova GX, Gómez Díaz RA, Valentín DV, et al. Effects of the non-nutritive sweeteners on glucose metabolism and appetite regulating hormones: systematic review of observational prospective studies and clinical trials. PLoS One. 2016;11(8):e0161264. https://doi.org/10.1371/journal.pone.0161264

Azad MB, Abou-Setta AM, Chauhan BF, Rabbani R, Lys J, Copstein L, et al. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ. 2017;189(28):E929-39. https://doi.org/10.1503/cmaj.161390

Crowe W, Elliott CT, Green BDA. Review of the in vivo evidence investigating the role of nitrite exposure from processed meat consumption in the development of colorectal cancer. Nutrients. 2019;11(11):2673. https://doi.org/10.3390/nu11112673

Shum B, Georgia S. The effects of non-nutritive sweetener consumption in the pediatric populations: what we know, what we don’t, and what we need to learn. Front Endocrinol (Lausanne). 2021;12:625415. https://doi.org/10.3389/fendo.2021.625415

Cai C, Sivak A, Davenport MH. Effects of prenatal artificial sweeteners consumption on birth outcomes: a systematic review and meta-analysis. Public Health Nutr. 2021;24(15):5024-33. https://doi.org/10.1017/S1368980021000173

McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, et al. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007;370(9598):1560-7. https://doi.org/10.1016/S0140-6736(07)61306-3

Connoly A, Hearty A, Nugent A, McKevitt A, Boylan E, Flynn A, et al. Pattern of intake of food additives associated with hyperactivity in Irish children and teenagers. Food Addit Contam Part A. 2010;27(4):447-56. https://doi.org/10.1080/19440040903470718

Petrus M, Bonaz S, Causse E, Rhabbour M, Moulie N, Netter JC, et al. Asthme et intolérance aux benzoates. Arch Pediatr. 1996;3(10):984-7. https://doi.org/10.1016/0929-693X(96)81719-2

Jacob SE, Hill H, Lucero H, Nedorost A. Benzoate allergy in children: from foods to personal hygiene products. Pediatr Dermatol. 2016;33(2):213-5. https://doi.org/10.1111/pde.12759

Inomata NA, Osuna HA, Fujita HA, Ogawa TA, Ikezawa Z. Multiple chemical sensitivities following intolerance to azo dye in sweets in a 5-year-old girl. Allergol Int. 2006;55(2):203-5. https://doi.org/10.2332/allergolint.55.203

Vojdani A, Vojdani C. Immune reactivity to food coloring. Altern Ther Health Med. 2015;21 Suppl 1:52-62.

Skrie VC, Orellana JC. Reacción adversa por aditivos alimentarios en un paciente pediátrico. Rev Alerg Mex. 2018;65(2):187-91. https://doi.org/10.29262/ram.v65i2.288

Mueller NT, Jacobs DR Jr, MacLehose RF, Demerath EW, Kelly SP, Dreyfus JG, et al. Consumption of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche. Am J Clin Nutr. 2015;102(3):648-54. https://doi.org/10.3945/ajcn.114.100958

Ali F. Consumption of artificial sweeteners in pregnancy increased overweight risk in infants. Arch Dis Child Educ Pract Ed. 2017;102(5):277. https://doi.org/10.1136/archdischild-2017-312618

Zhu Y, Olsen SF, Mendola P, Halldorsson TI, Rawal S, Hinkle SN, et al. Maternal consumption of artificially sweetened beverages during pregnancy, and offspring growth through 7 years of age: a prospective cohort study. Int J Epidemiol. 2017;46(5):1499-508. https://doi.org/10.1093/ije/dyx095

Taheri S. Effect of exclusion of frequently consumed dietary triggers in a cohort of children with chronic primary headache. Nutr Health. 2017;23(1):47-50. https://doi.org/10.1177/0260106016688699

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2022-05-06

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Vol. 56 (2022)

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Review

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Copyright (c) 2022 Mariana Vieira dos Santos Kraemer, Ana Carolina Fernandes, Maria Cecília Cury Chaddad, Paula Lazzarin Uggioni, Vanessa Mello Rodrigues, Greyce Luci Bernardo, Rossana Pacheco da Costa Proença

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Kraemer, M. V. dos S., Fernandes, A. C., Chaddad, M. C. C., Uggioni, P. L. ., Rodrigues, V. M., Bernardo, G. L. ., & Proença, R. P. da C. (2022). Food additives in childhood: a review on consumption and health consequences. Revista De Saúde Pública, 56, 32. https://doi.org/10.11606/s1518-8787.2022056004060

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