Removing food additives from a hyperactive child’s diet should be considered standard treatment, new research suggests.

Although a substantial body of evidence shows a link between attention deficit hyperactivity disorder (ADHD) and artificial food colourings and preservatives, removing them is still considered as an alternative rather than a standard treatment, according to Prof Andrew Kemp from the University of Sydney.

Of the three main treatments for ADHD in children – drugs, behavioural therapy, and dietary modification – only drugs and dietary modification are supported by clinical trials.

Yet behavioural therapy, which has no scientific evidence base, is still thought of as necessary for ‘adequate treatment’, Prof Kemp said.

“So why, despite evidence to the contrary, does the removal of food additives remain an alternative rather than a standard part of treatment for ADHD?” he asked.

Research published in 2007 showed that normal (not hyperactive) children were significantly more hyperactive after they ate a mixture of food colourings and a preservative (sodium benzoate), with obvious implications for children with ADHD.

The European Food Safety Authority (EFSA) reviewed the evidence linking preservatives and colourings with hyperactive behaviours from 22 studies and found that 16 studies reported positive effects in at least some of the children.

Prof Kemp said removing colours and preservatives is a relatively harmless intervention, so a properly supervised and evaluated trial period of eliminating them should be considered as part of the standard treatment.

He makes his comments in the British Medical Journal.