In April, the U.S. Department of Health and Human Services and the U.S. Food and Drug Administration announced a series of new measures to phase out all petroleum-based synthetic dyes from the nation’s food supply. Studies in the 1950s were done because of concerns about petroleum-based food dyes and their potential toxicity (1). By the 1990s, it was well established that artificial colorants were harmful to humans (2). Yet here in 2025, their use remains prolific in many items, including obvious sources such as Skittles, Twizzlers, and Mountain Dew Code Red, and less obvious sources like pickles, yogurt, breakfast cereals, and processed meats.

This shocking situation is a microcosm of the chasm that often forms between scientific investigative findings and knowledge translation to practical applications. Scientists have long known these substances to be harmful, yet they have remained highly prevalent in our food supply all these years. Unfortunately, “for too long, some food producers have been feeding Americans petroleum-based chemicals without their knowledge or consent. These poisonous compounds offer no nutritional benefit and pose real, measurable dangers to our children’s health and development” (3). These artificial food dyes have been linked to cancer, inflammatory bowel diseases, neurodevelopmental disorders, and beyond (2, 4, 5).

Sometimes it’s difficult to wrap our minds around the fact that it has taken until this moment - 2025 - for the HHS and FDA to take action based on decades of research demonstrating the toxicity of these ubiquitous substances in our nation’s food supply – substances such as Red No. 40 – the most commonly used dye by the food industry that is present in over 40% of foods marketed to children (6). Many of us grew up surrounded by artificial food dyes. Today’s children are inundated with ultra-processed foods – many of them loaded with chemical ingredients, including these petroleum-based food dyes. Researchers have been looking at this issue for some time and have determined that for all populations and all exposure scenarios, the highest cumulative exposures are from FD&C Red No. 40, FD&C Yellow No. 5, and FD&C Yellow No. 6 (7). These, among others, are slated to be eliminated from our food supply by the end of next year.

A curious question might be: if so many of us have had long-term consistent exposure to such chemicals, might there be links between this and the rise in Early Onset Colorectal Cancer (EOCRC)? Attention deficit disorder? Other systemic inflammatory conditions? Current research stands firm: artificial food dyes cause DNA damage, colonic inflammation, and impact the microbiome negatively – all of which can contribute to colorectal cancer, whose incidence has been on the rise in those under 50 years of age over the last 40 years (8). Further, the underlying inflammation caused by such toxic exposure is a key mechanism triggering neurobehavioral dysregulation due to the impact on the gut-brain axis (4, 5). Correspondingly, it is well established that systemic inflammation underpins many non-communicable diseases such as Type 2 diabetes, autoimmune conditions, and even chronic pain. These dyes have been a contributor to this toxic load for years.

So, wouldn’t we want to do whatever is possible to minimize exposure to such substances - as soon as humanly possible? Even if it’s politically contentious?

It is necessary to approach such egregious missteps in the delay in safeguarding citizens’ health from an apolitical standpoint. The good news is that your cells and your microbiome, your colon, and your stomach, and even the structural part of your brain do not hold political affiliation. Whether our parts operate in health or dysfunction is a truly independent matter – from a political standpoint that is. But our health or dysfunction is highly dependent upon the foodstuffs we consume or nourishing foods we fail to consume. This phase-out of synthetic food dyes is a win for all US citizens of all ages.

The bottom line is that we as healthcare providers – now more than ever – need to have a foundational working knowledge of nutrition as it relates to overall health and a framework to take what we know from science and apply it to our patient care practices as soon as possible - vs. decades later! We must ask meaningful questions. We must share what we know to be important and relevant based on the literature. We must be curious investigators. Many of the answers we seek to the omnipresent health concerns of the 21st century await our discovery.

While we wait for the petroleum-based synthetic dyes to tiptoe quietly off of our grocery store shelves by the end of 2026, it would be wise to check food labels and leave those products with artificial food dyes at the grocers. It will be an adjustment for food producers and consumers, but the move away from highly processed ingredients such as these artificial food dyes is one critically important step toward improving the health and well-being of all.

To be ahead of the curve, please join me in my two-day remote course, Nutrition Perspectives in Pelvic Rehabilitation. The next class is scheduled for June 7-8, but you can also join me later in the year on October 11-12 or December 6-7. Remember, the food we eat impacts every system of the body, and our nourishment status directly relates to our overall health picture - affecting a multitude of conditions treated in pelvic rehabilitation. This course provides a unique opportunity to explore multi-dimensional connections between physical therapy, pelvic rehabilitation, and nutritional sciences. 

References:

1. Allmark, M. G., Grice, H. C., & Mannell, W. A. (1956). Chronic toxicity studies on food colours. II. Observations on the toxicity of FD&C green No. 2 (light green SF yellowish), FD&C orange No. 2 (orange SS) and FD&C red No. 32 (oil red XO) in rats. The Journal of pharmacy and pharmacology, 8(6), 417–424.
2. Hofseth LJ, Hebert JR, Murphy EA, Trauner E, Vikas A, Harris Q, Chumanevich AA. Allura Red AC is a xenobiotic. Is it also a carcinogen? Carcinogenesis. 2024 Oct 10;45(10):711-720. doi: 10.1093/carcin/bgae057. PMID: 39129647; PMCID: PMC11464682.
3. HHS, FDA to Phase Out Petroleum-Based Synthetic Dyes in Nation’s Food Supply. https://www.fda.gov/news-events/press-announcements/hhs-fda-phase-out-petroleum-based-synthetic-dyes-nations-food-supply  Accessed April 28, 2025.
4. He, Z., Chen, L., Catalan-Dibene, J., Bongers, G., Faith, J. J., Suebsuwong, C., DeVita, R. J., Shen, Z., Fox, J. G., Lafaille, J. J., Furtado, G. C., & Lira, S. A. (2021). Food colorants metabolized by commensal bacteria promote colitis in mice with dysregulated expression of interleukin-23. Cell metabolism, 33(7), 1358–1371.e5. https://doi.org/10.1016/j.cmet.2021.04.015
5. Sudhakaran G. (2023). Artificial food dyes are toxic: Neurobehavioral implications in children. Brain & spine, 4, 102869. https://doi.org/10.1016/j.bas.2024.102869
6. Batada, A., & Jacobson, M. F. (2016). Prevalence of Artificial Food Colors in Grocery Store Products Marketed to Children. Clinical pediatrics, 55(12), 1113–1119. https://doi.org/10.1177/0009922816651621
7. Doell, D. L., Folmer, D. E., Lee, H. S., Butts, K. M., & Carberry, S. E. (2016). Exposure estimate for FD&C colour additives for the US population. Food additives & contaminants. Part A, Chemistry, analysis, control, exposure & risk assessment, 33(5), 782–797. https://doi.org/10.1080/19440049.2016.1179536
8. Zhang, Q., Chumanevich, A. A., Nguyen, I., Chumanevich, A. A., Sartawi, N., Hogan, J., Khazan, M., Harris, Q., Massey, B., Chatzistamou, I., Buckhaults, P. J., Banister, C. E., Wirth, M., Hebert, J. R., Murphy, E. A., & Hofseth, L. J. (2023). The synthetic food dye, Red 40, causes DNA damage, causes colonic inflammation, and impacts the microbiome in mice. Toxicology reports, 11, 221–232. https://doi.org/10.1016/j.toxrep.2023.08.006
9. Potera C. (2010). The artificial food dye blues. Environmental health perspectives, 118(10), A428. https://doi.org/10.1289/ehp.118-a428

AUTHOR BIO
Megan Pribyl, PT, CMPT, CMTPT/DN, PCES

Megan Pribyl, PT, CMPT, CMTPT/DN, PCES (she/her) is a mastery-level physical therapist at the University of Kansas Health System in Olathe, KS treating a diverse outpatient population in orthopedics including pelvic health, pregnancy, and postpartum rehabilitation – all with integration of health and wellness. She began her PT career in 2000 after graduating from the University of Colorado Health Sciences Center with her Master of Science in Physical Therapy. Prior, she earned her dual degree in Nutrition and Exercise Sciences (B.S. Foods & Nutrition, B.S. Kinesiology) in 1998 from Kansas State University. Later, she obtained her CMPT from the North American Institute of Orthopedic Manual Therapy and became certified in dry needling in 2019. Since 2015, she has been a faculty member of Herman & Wallace Pelvic Rehab Institute and enjoys both teaching and developing content. She created and instructs Nutrition Perspectives for the Pelvic Rehab Therapist offered remotely through Herman & Wallace. She also teaches Pelvic Function – Level 1, Pregnancy Rehabilitation and Postpartum Rehabilitation. She brings many years of experience and insight to all courses. As a content developer, Megan has also contributed to the Herman & Wallace Oncology Series, Pelvic Function Level 2A, as well as the Pelvic Function Series Capstone Course.

Megan’s longstanding passion for both nutritional sciences and manual therapy culminated in her creating Nutrition Perspectives for the Pelvic Rehab Therapist designed to propel understanding of human physiology as it relates to pelvic conditions, pain, healing, and therapeutic response. She harnesses her passion to integrate ancient and traditional practices with cutting-edge discoveries creating a unique experience sure to elevate your level of appreciation for the complex and fascinating nature of clinical presentations in orthopedic manual therapy and pelvic rehabilitation. Clinicians will come away from this course with both simple and practical integrative tools that can be immediately utilized to help clients and providers alike - along their path of healing.

Megan enjoys her many fulfilling roles as an instructor, clinician, wife, and mom to two active teenagers and owner of two rambunctious golden retrievers. She loves to read, cook, be in the great outdoors, travel, and spend time with her family and friends. She has a passion for both the mountains and the beach, exploring scientific literature, and learning all she can about the power of using nature, nurture, and nutrition to heal and sustain health.