title: Controlled trial of cumulative behavioural effects of a common bread preservative.
abstract: OBJECTIVE
  Many anecdotes and one scientific report describe cumulative behavioural effects of bread preservative on children.
  
  
  METHODS
  Twenty-seven children, whose behaviour improved significantly on the Royal Prince Alfred Hospital diet, which excludes food additives, natural salicylates, amines and glutamates, were challenged with calcium propionate (preservative code 282) or placebo through daily bread in a double-blind placebo-controlled crossover trial.
  
  
  RESULTS
  Due to four placebo responders, there was no significant difference by ANOVA of weighted placebo and challenge Rowe Behaviour Rating Inventory means, but a statistically significant difference existed in the proportion of children whose behaviours 'worsened' with challenge (52%), compared to the proportion whose behaviour 'improved' with challenge (19%), relative to placebo (95% confidence intervals 14-60%).
  
  
  CONCLUSIONS
  Irritability, restlessness, inattention and sleep disturbance in some children may be caused by a preservative in healthy foods consumed daily. Minimizing the concentrations added to processed foods would reduce adverse reactions. Testing for behavioural toxicity should be included in food additive safety evaluation.
authors.affiliation: sdengate@ozemail.com.au
authors.forename: S
authors.initials: S
authors.lastname: Dengate
authors.forename: A
authors.initials: A
authors.lastname: Ruben
mesh_terms: D000704:Analysis of Variance; D001939:Bread; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005512:Food Hypersensitivity / Q000209:etiology*; D005520:Food Preservatives / Q000009:adverse effects*; D006801:Humans; D008297:Male; D015876:Northern Territory; D011422:Propionates / Q000009:adverse effects*
chemical_list: D005520:Food Preservatives; D011422:Propionates; C514136:calcium propionate; C029658:propionic acid