Tartrazine exclusion for allergic asthma.
BACKGROUND
Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There has been conflicting evidence as to whether tartrazine causes exacerbations of asthma with some studies finding a positive association especially in individuals with cross-sensitivity to aspirin.


OBJECTIVE
To assess the overall effect of tartrazine (exclusion or challenge) in the management of asthma.


METHODS
A search was carried out using the Cochrane Airways Group specialised register. Bibliographies of each RCT was searched for additional papers. Authors of identified RCTs were contacted for further information for their trials and details of other studies.


METHODS
RCTs of oral administration of tartrazine (as a challenge) versus placebo or dietary avoidance of tartrazine versus normal diet were considered. Studies which focused upon allergic asthma, were also included. Studies of tartrazine exclusion for other allergic conditions such as hay fever, allergic rhinitis and eczema were only considered if the results for subjects with asthma were separately identified. Trials could be in either adults or children with asthma or allergic asthma (e.g. sensitivity to aspirin or food items known to contain tartrazine).


METHODS
Study quality was assessed and data abstracted by two reviewers independently. Outcomes were analysed using RevMan 4.1.1.


RESULTS
Ninety abstracts were found, of which 18 were potentially relevant. Six met the inclusion criteria, but only three presented results in a format that permitted analysis and none could be combined in a meta-analysis. In none of the studies did tartrazine challenge or avoidance in diet significantly alter asthma outcomes.


CONCLUSIONS
Due to the paucity of available evidence, it is not possible to provide firm conclusions as to the effects of tartrazine on asthma control. However, the six RCTs that could be included in this review all arrived at the same conclusion. Routine tartrazine exclusion may not benefit most patients, except those very few individuals with proven sensitivity.
Ardern
K D
KD
Department of Public Health, Liverpool Health Authority, Hamilton House, Pall Mall, Liverpool, UK, L3 6AL. kate.ardern@liverpool-ha.nhs.uk
Ram
F S
FS
D001249:Asthma / Q000139:chemically induced* / Q000517:prevention & control*; D005505:Food Coloring Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013645:Tartrazine / Q000008:administration & dosage / Q000009:adverse effects*
D005505:Food Coloring Agents; D013645:Tartrazine