Concerned with growing scientific evidence showing common chemical food additives causing harm to children’s health, the American Academy of Pediatrics and the AAP Council on Environmental Health* published two important documents this week sounding the alarm. Roni Caryn Rabin says the AAP is suggesting simple steps to avoid exposure and urging more stringent testing and regulation of the more than 10,000 chemicals that are allowed to be added to food directly during processing or indirectly as a result of packaging:

A major pediatricians’ group is urging families to limit the use of plastic food containers, cut down on processed meat during pregnancy and consume more whole fruits and vegetables rather than processed food. Such measures would lower children’s exposures to chemicals in food and food packaging that are tied to health problems such as obesity, the group says.

The American Academy of Pediatrics issued the guidelines in a statement and scientific technical report on Monday. The group joins other medical and advocacy groups that have expressed concern about the growing body of scientific evidence indicating that certain chemicals that enter foods may interfere with the body’s natural hormones in ways that may affect long-term growth and development.


The chemicals include colorings, flavorings, and preservatives that are directly added at the time the food is processed to enhance flavor, appearance, and shelf life. Other chemicals that come into contact with, and so are indirectly added to food, include a variety of plastic substances, coatings, adhesives, and other synthetic materials associated with food packaging that have been linked to health problems. Children, every pediatrician will tell you, are more vulnerable than adults to develop adverse health effects, especially from the chemicals that act as endocrine disrupters.

Hormones are responsible for normal metabolic functions that regulate the growth and development of the body and the brain. Endocrine disrupting chemicals (EDCs) either mimic or block the body’s normal hormone activities. EDCs have been shown to cause birth deformities, cancers (especially in hormone-sensitive organs like the breast, prostate, and thyroid gland), and neurodevelopment disorders that affect cognition and learning. They can interfere with the development and migration of organs in the fetus and impact the development of secondary sexual characteristics in adolescents. And then, Rabin learned, there is a hormonal influence underlying the epidemic of child obesity:

Child obesity in the United States has more than tripled since the 1970s, with nearly one in five children aged 6 to 19 now considered obese; the prevalence of developmental disorders in children increased from the 1990s to the mid-2000s; and rates of diagnoses of both Type 1 and Type 2 diabetes among children and teenagers are also on the rise, according to the Centers for Disease Control and Prevention.


Interfering with the normal processes of growth and development, which proceed throughout childhood with tremendous complexity and often at great speed, can be permanent and costly:

Potentially harmful effects of food additives are of special concern for children, according to the AAP. Children are more sensitive to chemical exposures because they eat and drink more, relative to body weight, than adults do, and are still growing and developing.

“Chemicals that affect the endocrine system, for example, can have lasting effects on a child since hormones coordinate complex functions throughout the body,” Dr. Trasande said. “Even small disruptions at key moments during development can have lifelong consequences,” he said. Annual estimated health-care costs tied to endocrine disrupting chemicals, he added, are estimated to be roughly $340 billion.


In its technical report, the AAP lists the food additives that scientists are finding most concerning regarding their impact on child health:

  • Bisphenols, such as BPA, used to harden plastic containers and line metal cans, can act like estrogen in the body and potentially change the timing of puberty, decrease fertility, increase body fat, and affect the nervous and immune systems. BPA is now banned in baby bottles and sippy cups.
  • Phthalates, which makes plastic and vinyl tubes used in industrial food production flexible, may affect male genital development, increase childhood obesity, and contribute to cardiovascular disease. In 2017, the Consumer Product Safety Commission banned the use of some phthalates in child-care products such as teething rings.
  • Perfluoroalkyl chemicals (PFCs), used in grease-proof paper and cardboard food packaging, may reduce immunity, birth weight, and fertility. Research also shows PFCs may affect the thyroid system, key to metabolism, digestion, muscle control, brain development, and bone strength.
  • Perchlorate, added to some dry food packaging to control static electricity, is known to disrupt thyroid function, early life brain development and growth.
  • Artificial food colors, common in children’s food products, may be associated with worsened attention-deficit/hyperactivity disorder (ADHD) symptoms. Studies cited in the report found a significant number of children who cut synthetic food colorings from their diets showed decreased ADHD symptoms.
  • Nitrates/nitrites are used to preserve food and enhance color, especially in cured and processed meats. These chemicals can interfere with thyroid hormone production and the blood’s ability to deliver oxygen in the body. Nitrates and nitrites also have been linked with gastrointestinal and nervous system cancers.


The AAP’s new policy statement provides recommendations to pediatricians to help guide their patients and families away from chemicals in food:

  • Eat fresh or frozen fruits and vegetables when possible.
  • Avoid microwaving food or beverages (including infant formula and pumped human milk) in plastic, if possible.
  • Avoid placing plastics in the dishwasher.
  • Use alternatives to plastic, such as glass or stainless steel, when possible.
  • Look at the recycling code on the bottom of plastic products and avoid plastics with recycling codes 3 (phthalates), 6 (styrene) and 7 (bisphenols) unless plastics are labeled as biobased or greenware, indicating they are made from corn and do not contain bisphenols.
  • Encourage handwashing before handling foods/drinks.
  • Wash all fruits and vegetables that cannot be peeled.


In an era when critical safeguards to public health are being rolled back at an astonishing rate, it is important to take a step back and remember what is really at stake here: The health, well-being, and livelihoods of the best things each of us has ever created — our children.

You can read the extensive list of allowed food additives by visiting the FDA’s “Substances Added to Food” web page (formerly named “Everything Added to Food in the United States”) here.

*Dr. Ketyer is a member of the AAP Council on Environmental Health.


(Google Images: “How Death Came, Unbidden, to Mrs. Sales Dinner Party” — The Philadelphia Inquirer, Nov. 30, 1919, FDA History.)