34. Food Colorings and Flavors

  1. Dean D. Metcalfe MD2,
  2. Hugh A. Sampson MD3,
  3. Ronald A. Simon MD4,5 and
  4. Gideon Lack MBBCh (Oxon), MA (Oxon), FRCPCH6
  1. Matthew J. Greenhawt and
  2. James L. Baldwin

Published Online: 24 FEB 2014

DOI: 10.1002/9781118744185.ch34

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

How to Cite

Greenhawt, M. J. and Baldwin, J. L. (2013) Food Colorings and Flavors, in Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition (eds D. D. Metcalfe, H. A. Sampson, R. A. Simon and G. Lack), John Wiley & Sons Ltd, Chichester, UK. doi: 10.1002/9781118744185.ch34

Editor Information

  1. 2

    Chief, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

  2. 3

    Kurt Hirschhorn Professor of Pediatrics, Dean for Translational Biomedical Sciences, Director, Jaffe Food Allergy Institute Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

  3. 4

    Head, Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA

  4. 5

    Adjunct Professor, Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, CA, USA

  5. 6

    Professor of Paediatric Allergy, King's College London Clinical Lead for Allergy Service, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK

Author Information

  1. Division of Allergy and Clinical Immunology, Food Allergy Center, University of Michigan Medical School, Ann Arbor, MI, USA

Publication History

  1. Published Online: 24 FEB 2014
  2. Published Print: 10 DEC 2013

ISBN Information

Print ISBN: 9780470672556

Online ISBN: 9781118744185



  • natural colorant;
  • natural flavor;
  • carmine;
  • cochineal extract;
  • annatto;
  • noncertified color;
  • Food;
  • Drug;
  • and Cosmetic Act;
  • spice allergy;
  • dye allergy


Food flavorings and colorings are a heterogeneous group of compounds that are often derived from potential allergens. This chapter will discuss non-synthetic food colorings and flavorings that have been implicated in adverse food reactions. Many of these items are derived from plants or other biogenic sources and may contain allergenic epitopes or haptens, which can be recognized by specific IgE or T cells. The overall prevalence of reactions attributable to food colorings and flavorings is unknown, but thought to be low. Labeling of natural food coloring and flavor is often problematic. Natural colorants are not subject to the Food, Dye, and Cosmetic (FD&C) labeling regulations. Flavorings are exempted from labeling unless widely suspected to cause allergy (e.g., sulfites). Spices used as additives but not ingredients are also exempted. The exemption for carmine/cochineal extract was recently changed and must now be declared by name on product labels. This chapter will review known mechanisms of reaction, treatment strategy, and labeling regulations. Synthetic color additives are discussed elsewhere in this book.