Today’s PrimalMed Prescription…Seeing Red?
On this Valentine’s Day, PrimalRD takes a deep dive on Red Dyes!
Roses are red, candy is sweet,
How strict should we be, in what we eat?
It’s Valentine’s Day!
Stores have been stocking their shelves for weeks in preparation for this day.
Red candy, or should I say Red Dyed candy.
Although there are safe and natural alternatives available, manufacturers prefer artificial food dyes over natural food colorings. Using dyes is cost effective and produces a vibrant color, making it more appealing to provide a full sensory experience. Artificial dyes may also be used to help hide the fact that many processed foods don’t contain much (or any) of the nutrients that would provide that vibrant color. For example, without Red Dye 40, the chocolate instant pudding would actually look green (because there’s VERY little real chocolate in it).
But first a little history. Artificial food colorings were created in 1856 from coal tar. Now, artificial colorings or dyes are primarily chemical substances, made from petroleum, or crude oil, a fossil fuel. Color Additives History
Current research suggests potential health concerns, specifically regarding red dyes: Red Dye 3 and Red Dye 40. So far, the evidence is inconclusive, as negative health effects have been found in animals, not humans.
Red dyes, however, have been banned from human consumption in some countries and not in others, making it extremely confusing to assess their safety and thus creating controversy among consumer groups here in the U.S. Such groups continue to question overall safety and potential behavioral implications, especially in children. Despite evidence of potential safety issues, The Office of Environmental Health Hazard Assessment (OEHHA), does not establish a causal relationship between synthetic colors and negative health or behavior effects. They concluded that there is insufficient data that an association may exist. Read the OEHHA Report.
However, there is certainly sufficient evidence to raise some concern. Dating as far back to 2012, the International Journal of Occupational and Environmental Health found food dyes have long been controversial because of safety concerns.
Other research indicates artificial coloring and flavors, as well as the preservative sodium benzoate, can make some non-ADD/ADHD kids hyperactive.
Multiple studies published in journals such as Pediatrics, The Lancet, and Journal of Pediatrics noted a potential association with red dye consumption and a higher number of children with ADHD behaviors. Although the evidence was inconclusive, it was ‘too substantial to dismiss.’
The science here is unsettled. The question is, do we knowingly want to ingest excessive amounts of these dyes?
So where do we find these Red Dyes?
Foods – breakfast cereals/bars, baked goods, pastries, packaged fruits/fruit snacks, dairy products/frozen desserts, ice cream and popsicles, flavored milk/yogurt, sports drinks, protein powders, iced tea, chips/crackers, vegetarian products, dressings, condiments such as ketchup, barbecue sauce and mustard. Halloween candy too!
Supplements - Red Dye 40 can be found in over-the-counter medications and vitamins, while Red Dye 3 is found predominately in foods, candy and beverages. For example, some vitamin/mineral gummies have dyes, other such products have real fruit and vegetable juices and extracts used to color. Some manufactures use natural food dyes, such as beet juice, beet powder, Beta-carotene (a pigment found in plants), blueberry juice, pomegranate juice, grape juice, cranberries, cherries, strawberries, dried hibiscus flowers. The FDA has a list of exempt color additives, meaning the pigments are derived from natural sources like plant-based foods and minerals. Some gel food colorants are made with these safer, natural ingredients. FDA list.
It seems ironic, given its potential link to inattentiveness and hyperactivity in kids, that Red Dye No. 3 is an inactive ingredient in certain prescription medications used to treat ADHD. CHECK the drug insert! Drug Insert.
Over the counter medications - decongestants, pain relievers, liquid cough syrups, often have coloring to make it more visually appealing to consume.
Am I seeing red?
Let’s discuss Red Dye 3.
More than three decades ago, the Food and Drug Administration (FDA) banned the use of Red Dye 3 in cosmetics, like lipsticks and blushes, because studies had found that high doses of the dye caused thyroid cancer in rats, due to a substance called p-Cresidine . The FDA cites animal studies as the core reason for banning Red Dye 3 in cosmetics but not foods, as the study in rats had limited relevance to humans. Thus there was no action to revoke the authorization of Red Dye 3 in food.
It is Erythrosine, a synthetic made from petroleum, that actually gives foods and drinks that bright, cherry-red color, called Red Dye 3.
Studies have also linked Red Dye 3 to increased behavioral problems in children, such as hyperactivity and other neurobehavioral issues. Behavioral Issues Neurobehavioral Effects
California took the step in the U.S. to officially ban Red Dye 3 in food products beginning in 2027, giving companies time to reformulate their products to exclude the additives. California bans Red Dye 3
Many other states, including New York, Illinois, and Washington, have introduced bills to ban Red Dye 3. It is prohibited for almost all food uses in the European Union since the early ’90s. It is also banned in Japan, China, the UK, Australia, and New Zealand.
The Environmental Working Group notes its food database has more than 3000 foods currently sold in the US that contain Red Dye 3, mostly found in artificially flavored and artificially colored foods, drinks and candy, mostly marketed to American children.
Public pressure has been mounting for months, urging the FDA to eliminate the dye, which has been on the market since 1907.
“Young children are the ones that are most affected because of their small body weight and because they are exposed to much more of these dyes in food,”
- Environmental Working Group.
Am I still seeing red?
The Other Red Dye, 40
Red dye 40, a synthetic food dye made from petroleum, contains benzene, a known cancer-causing substance.
Research in both animals and humans has shown synthetic color additives such as Red Dye 40 are linked to certain behavioral conditions. According to a 2021 report from the state of California, research does indicate that children who consume synthetic food dyes, including Red Dye 40, can experience hyperactivity and other neurobehavioral issues.
Red Dye 40 has also been noted to be linked to inflammatory bowel diseases (IBD). A 2022 study on mice in Nature Communications found that frequent consumption of artificially colored red foods such as Lifesavers, Jell-O, and Gatorade increases the chances of developing IBD, such as Crohn’s disease or ulcerative colitis.
Despite current controversies, Red Dyes are considered ‘safe’ by the FDA. Under the Federal Food, Drug, and Cosmetic Act, all color additives and new uses for listed color additives must meet safety criteria and be approved before used in foods. Red dye must always be included in the ingredient list. Color Additives in Food
What does the future hold?
A new field called Nutritional Psychiatry shows how important food is for mental health, emotional well-being, cognitive function, and behavioral stability. It supports the notion ‘you are what you eat.’ The scientific community is finally beginning to see how food is so strongly linked to brain health/mental health. Nutritional medicine as mainstream in psychiatry
Dietary modification and improvement may provide an efficacious and accessible treatment strategy for the management of psychiatric issues, the benefits of which could extend to the management of common co-morbidities. Dietary Interventions
“…diet is as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology.” - The Lancet Psychiatry
So how can we avoid Red Dyes OR be cautious if we choose…
• Read the label: The FDA mandates food and medicine manufacturers list Red Dyes on labels, and that they are always listed in descending order. Manufacturers must list ingredients by weight, but are not required to disclose the amount.
Recognize the various dye names on the label:
Red Dye No. 3, FD&C Red No. 3 and Red Dye 3
Red Dye No. 40, Red Dye 40, Red 40, Red 40 lake, FD&C Red No. 40, FD&C Red No. 40 aluminum lake, Allura red AC, CI Food Red 17, INS No. 129 and E129.
• Identify what Supplements and over the counter medications have dyes, finding products that are ‘cleaner’ brands. On medicine packaging, you’ll find dyes listed under ‘inactive ingredients.’
• Go to the Environmental Working Group. and download the app to scan barcodes on your phone, revealing concerning ingredients.
• Look for The USDA Organic seal on food labels, as this notes foods which cannot contain synthetic dyes. ‘Natural’ does not necessarily mean there are no AFC (artificial food colorants), so read the label to identify.
So, am I still seeing red?
It depends.
Research is inconclusive when it comes to whether red dye is harmful or not to human health. Studies show a link between artificial coloring and our health, but perhaps the dose makes the poison – or genetics plays a role - or does it simply depend on how much is actually getting absorbed…and utilized.
Striving for perfection is not sustainable. But you make your choice!
A daily breakfast of brightly colored-dyed cereal, with a color-dyed pastry, finished off with a few color-dyed gummies, then washed down with a color-dyed sports drink - perhaps falls into that poor choice category.
Figure out where you want to be…
On this Valentine’s Day, when we celebrate Red…
Take note and be aware, of what you are fed.
Ted Metzger, MD is a practicing board certified Radiologist as well as founder and owner of PrimalMed, LLC. PrimalMed educates and advocates on Metabolic Health and Wellness, as seen through the lens of a curious radiologist.
Ellen Metzger MS, RD - the other half of the PrimalMed team, is an Integrative Registered Dietitian, addressing ancestral and primal nutrition principles as drivers of metabolic health and wellness.
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on the PrimalMed website.
Ellen, you are so on target. Yes I see red not only on Valentine’s Day but Halloween, holidays, birthdays, etc. you have given us the information about artificial dyes that are present in our food and cosmetics. That information should give us the power to make healthy choices to rely on ourselves And not so much the federal agencies that are not banning these additives that are banned in Europe. Much of these foods are targeted to children and we must ask, is diet a contributing factor in low test scores and problems we see in schools. Thank you Ellen for showing us the way to a healthy life.
No red dyes. I’ll stick to the green M&M’s!