The association between the ingestion of tartrazine synthetic food coloring and behavioral change in children referred for assessment of hyperactivity was investigated at the Royal Children’s Hospital, University of Melbourne, Australia. Two hundred hyperactive children whose parents had noted changes in behavior with diet were included in a 6-week open trial of a diet free of synthetic colorings. The parents of 150 reported behavioral improvement with the diet, and deterioration when foods containing synthetic colorings were introduced. A 30-item inventory with 5 behavior clusters (irritability, sleeplessness, restlessness, aggression, and inattention) discriminated between dye ingestion and placebo. A double-blind, placebo-controlled, 21-day study of 34 reactive children, using each child as his or her own control, identified 24 atopic children as clear reactors to tartrazine at all six dose levels, between 1 and 50 mg. They were irritable and restless and had sleep disturbance. A dose response was obtained and the effect was prolonged with doses >10 mg. 
COMMENT. The authors appear to have demonstrated a relation between tartrazine ingestion and behavior in 24 atopic children,aged 2 to 14 years. Parents were found to be reliable observers and raters of their children’s behavior. The strict criteria of ADDH, and a score of >15 on the Conners Abbreviated Parent-Teacher Questionnaire, required for inclusion in many previous studies of diet and hyperactivity may have missed some reactors, accounting for inconclusive results. Further, the Conner’s scale places little emphasis on irritability and sleeplessness, symptoms that were prominent in the reactors in the University of Melbourne study. The number of reactors to tartrazine identified in this study contrasts markedly with those of previous studies, and may have been related to the method used for selection of subjects. In Australia, the Feingold hypothesis is still alive.