Lizzie Vann Foundation
Find out more about why we focus on the role of additives and contaminants in the health and well-being of pregnant women, infants and children here:
Pregnant women
Infants
Children aged 1-3 years
Children aged 4-17 years
Pregnant women
Why are pregnant women particularly vulnerable to additives and contaminants in food?
Pregnancy is a time of physiological change and it is well established that the foetus is sensitive to its environment in the womb. The many changes that occur in how mother and baby process and handle substances that enter the mothers’ body from conception onwards increase both maternal and foetal exposure to additives and contaminants.
During pregnancy there are:
Changes in metabolism: during pregnancy there are hormonal changes and a change in how the body metabolises food which can alter the exposure or effects of chemicals ingested.
Chemical transfers via the placenta: the placenta provides the developing foetus with both oxygen and the nutrients it needs to develop and grow. These transfers are also the main route of the transfer of unwanted substances to the foetus.
The foetus is also vulnerable:
The foetus is developing rapidly: cells have to differentiate and tissues develop and this happens very rapidly particularly in the first trimester of pregnancy, making it highly sensitive to substances in its environment.
It takes time to develop the protective blood-brain barrier: the foetus’s main mechanism of protection takes time to develop to protect the foetus from harmful substances.
We have of course been alert to the risks of exposure of the foetus to substances such as cigarette smoke, alcohol, caffeine and some pharmaceutical drugs for many years and have public health guidance to support parents in the choices they make during pregnancy to mitigate known damage.
There are a number of ways the foetus can be exposed to chemicals:
Through the mother’s diet: the diet is a major source of exposure to contaminants. These may be substances which enter food from farming practices or the soil in which they grow, may be added to food during manufacturing, may be substances which develop as food is processed, may be formed as food is stored or be formed as food is cooked.
Through everyday products we all use: There are chemicals in many everyday products such as food packaging and food preparation and storage materials as well as in non-food items such as cleaning supplies and toiletries.
Some contaminants we breathe in: Sometimes the air we breathe may contain contaminants. It is important that public health policy works hard to minimise this.
Whilst the consequence of some lifestyle choices on pregnancy outcome are well known by women, and those that care for them and support them in pregnancy, there remains little clear evidence-based guidance related to exposure to chemicals and the potential risks of these and how to mitigate them. It is also important not to create anxiety through ‘scare stories’ where families may have less control over the chemicals in their food and environment and it remains the role of regulators to minimise risks where these are established.
Pregnant women may also change their diet for lots of reasons: they may change their diet as they feel nauseous or uncomfortable (e.g. with heartburn), they may have read or heard about things to avoid and make changes (e.g. from caffeinated to decaffeinated beverages) and they may eat more of some foods because they believe them to have useful nutrients for infant development (e.g. oil rich fish). Some of these changes may also impact on the amount of additives and contaminants consumed either because of the particular foods and drinks chosen or because the diet becomes less diverse.
You can find practical information on how to eat well in pregnancy for both teenage mums to be and all mums to be at www.firststepsnutrition.org
We do however know that the majority of women take their role as the guardian of a baby’s future health very seriously and want the very best outcomes for their baby. Many families may however be unaware of the importance of foetal development in the womb on future health and may be less familiar with links between chemicals a foetus is exposed to and current or future health risk. Some chemicals may be a risk to getting pregnant at all, to the birth outcome or to longer term illnesses and disabilities. But we also have to acknowledge that we don’t always have good data which gives us clear cut answers about exposure and outcome and so we have to consider how to balance being ‘better safe that sorry’ with potentially causing anxiety unnecessarily. In all the information we provide here we try and take a practical but evidence-based approach, but also believe in ‘the precautionary principle’ and you can find out more about what that means here
Infants
Why are infants more vulnerable to additives and contaminants in food?
Infants are defined as those in the first year of life: from birth to their first birthday. It is no surprise that infants are considered highly vulnerable to the impact of food additives and contaminants due to the relatively higher intake they are often exposed to because of their low body weight. Infants consume more food per kilogram body weight than adults so will consume relatively higher amounts of additives and contaminants. Infants are also growing rapidly, their digestive systems, immune systems and organs are still developing and this makes them more susceptible to the potential effects of chemical damage. This means that they may absorb more of a chemical relatively to an older child or adult and have less ability to eliminate it. In addition infants have a higher metabolic rate and this can make them more sensitive to toxins. To ‘detoxify’ humans need efficient functioning organ systems like the urinary system and the liver to filter and eliminate toxins and these are still maturing in an infant.
One of the key principles for minimising damage from any toxic substance is to have as varied a diet as possible. The more different foods consumed the less likelihood of one ‘contaminated’ food being dominant. The diets of many infants however is very limited: breastmilk or infant formula in the first 6 months and then often a limited variety of foods being introduced with a reliance on some common ready prepared foods like baby cereals. A less varied diet also puts infants at greater risk from additives and contaminants. We have very specific guidance about how to ensure infants from 6 months of age receive the energy and nutrients they need from their diet and are protected from unnecessary components. You can find out all the information you need to practically support an infant to eat well here www.firststepsnutrition.org.
Whilst there are a number of additives and contaminants that may pose a threat to both the infant and the child and adult’s future health, many of these are well known, with attempts taken to minimise the amounts an infant may be exposed to. Some of this minimisation however does involve families making choices in the food and drink they consume, how they cook food, store food and manage their environment. Families should however also be able to have confidence in the wider food system to regulate, monitor and minimise risk and it is important that those responsible for food regulation and food safety are held to account to ensure they also remember that when it comes to infants, it is definitely better to be ‘safe than sorry.’
Children aged 1-3 years
Why are children aged 1-3 years vulnerable to additives and contaminants in food?
Children from their first birthday to their 4th birthday are often called toddlers or pre-schoolers. This is also a period of rapid growth and development and a time when the developing child is exploring the world around them. This means they may be more exposed to chemicals in their environment but it is of course essential for their development that they are given lots of time to play outdoors and be adventurous. Children in this age group will be increasingly out and about in the world, may be looked after by multiple groups and individuals and exposed to lots of new dietary experiences. They are however not ‘little adults’ and exposing them to foods and drinks which are designed for adults can be detrimental to their health. We have specific guidance around the food and nutrition needs of young children and you can find out all the practical information you need at www.firststepsnutrition.org.
Pre-school children are also more likely to be exposed to foods and drinks that are designed for older children or adults, with many families offering them foods that everyone is eating and young children being keen to copy what they see other family members do. Despite recommendations that some food and drink items are not suitable for very young children we know from food studies that many ‘adult’ foods are given, and many families may be unsure of why they might restrict certain food items or what to avoid since powerful advertising and marketing of foods often overrides public health messaging. It is also not surprising that families believe foods would not be available for sale if they were ‘unsafe’ in any way, and whilst of course we do have many regulations around food safety that must be adhered to, there are some areas where foods are freely available that may well have adverse effects on some members of society. After all, we know of the devastating impacts of alcohol on health but do not restrict purchase and consumption.
Children 4-17 years
Why are children 4-17 years vulnerable to additives and contaminants?
Children often start attending school from their 4th birthday onwards and as they grow up they will make more independent decisions about what to eat and put in their bodies. Children are however still considered children up until their 18th birthday. Some teenagers may still be growing beyond this age. As children are growing, developing, going through puberty and facing all the pressures and pleasures of life during this period they are more vulnerable than adults. Whilst their increasing body weight makes their risk lower in terms of their proportional exposure to additives and contaminants, they are still at increased risk when we consider that the composition of most foods and drinks is based on tolerable intakes by adults. We know that some food components and contaminants can impact on the development of children and in some ways this group may be at greater risk as society fails to see them as vulnerable in the same way as infants and pre-school children. The diets of children in this age group may also be poor, lacking in variety as they may choose foods high in fat, salt and sugar and eat the same foods regularly thus exposing themselves to some additives and contaminants in much higher amounts than they would be exposed to from a more varied diet.
Many foods aimed at children are designed to be ‘attractive’ with brighter colours, softer textures and uniform tastes. Ultra-processed foods are those which have been through extensive industrial processing and usually have additives and ingredients added that you would not find in the kitchen at home. They often have long ingredients lists, are packaged in ways that make them convenient, desirable to children and give them a long shelf-life. The high volume of these foods produced often make them cheaper than healthier alternatives and so the diets of children in lower income households may be particularly high in these foods and drinks. There is considerable concern at the volume of ultra-processed foods consumed by many children in countries like the UK. Whilst diets will vary it has been estimated that many children have 60-70% of their foods as ultra-processed foods and that the intake of these foods starts when they are very young. Teenagers may take on more responsibility for purchasing food outside the home and be more likely to use corner shops and take-aways exposing them frequently to more ultra-processed options.
The advice for eating well in this age group is similar to that for adults, but with a greater need for energy and nutrients relative to body size. The golden rule of dietary variety is particularly important for children and teenagers: exposure to as many different foods as possible (preferably reducing those that are ultra-processed) will mitigate damage from the additives and contaminants that might be present in particular foods and drinks. To find out more about ultra-processed foods and the risk they pose to human health we recommend the book ‘Ultra-processed people’ by Dr Chris van Tulleken (Puffin publications and available at libraries).
You can also find useful information at Ultra-processed foods – what to avoid | Good Food
