The study, led by Professor Jim Stevenson and published in The Lancet last September, found that certain food colourings and sodium benzoate promoted hyperactivity in children. New advice that will be put to the FSA could call for the food industry to remove additives named in the study, which would require massive investment for reformulation by some manufacturers. "We suggest that since the colours being tested in this study are of no nutritional value, even the small overall benefit of removing them from children's diets would come at no cost or risk to the child," said Stevenson and colleagues in a letter forwarded to the board. "Under these circumstances a benefit, even a small one, would be worthwhile achieving." Despite causing widespread concern since the time of publication, the European Food Standards Agency's (EFSA) concluded in March that the study gave no basis for changing acceptable daily intakes (ADI) of food additives, due to inconsistencies and the inability to attribute the effect to any additives in particular. Still, many trade associations and individual companies have reported steps to remove the colours used in the study from products manufactured in the UK. However, debate over the impact of additives shows no signs of slowing down. Defence of study's findings The study concluded that the consumption of mixtures of additives including sunset yellow (E110), tartrazine (E102), carmoisine (E122), ponceau 4R (E124), allura red (E129) and sodium benzoate led to increased hyperactivity in children. Any formal ban on these ingredients for use in Europe would have to come from the Commission via EFSA. However, because the study looked at mixtures and not individual additives, and because there were also some inconsistencies in the effects on different children, no such move was implemented. The researchers responded to criticisms saying that: "We recognise that the Southampton Study was not designed to identify the effects of specific additives. Despite not being able to differentiate the effects of AFCs [artificial food colours] from those of sodium benzoate, we suggest that the similarities between the present findings and previous studies of effects of AFCs are striking." While they said there is the need for further study, they drew analogies to studies looking at links between lead and IQ in children. They said the effect size found in studies, which led to the phasing out of leaded petrol from all petrol stations, was similar to levels found in the Southampton study. As a result, they say there is "justification for action now". Reformulation The FSA said five trade associations and six individual companies who responded to questions on their position regarding additives reported efforts to remove those named in the study, though their imports may still contain the colours. Over 900 food and drink products containing the additives investigated in the study are named on a website set up by the Food Commission. The FSA said some companies mentioned difficulties concerning certain ingredients that were necessary for preservation in products such as processed peas, tinned strawberries, Turkish delight and angel cake. Indeed, for example, Nestle took two years to find a natural replacement blue colouring for its Smarties brand. While the colouring formally used was not mentioned in the study, it both indicates difficulties experienced by the industry in reformulating products, and efforts made by manufacturers to respond to consumer concerns and remove artificial additives. A mandatory ban would therefore place substantial strain on the industry to cut out the additives in a given timeframe.