Impact of Food Additives and Ultra-Processed Dietary Patterns on the Pathogenesis of Pediatric Asthma and Allergic Diseases: A Comprehensive Review

The global escalation of pediatric asthma and allergic diseases amounts to a significant public health challenge, frequently described as the second wave of the allergy epidemic. While genetic factors provide a baseline of susceptibility, the rapid increase in prevalence points to environmental factors, particularly the considerable shift in eating habits. The modern diet is characterized by a high intake of ultra-processed foods (UPF), which are industrial formulations containing multiple additives, including emulsifiers, synthetic colorants, and non-nutritive sweeteners. This review analyzes the epidemiological evidence and biological mechanisms underlying UPF consumption and specific food additives and their effects on respiratory and allergic outcomes in children, based on an extensive review of PubMed-indexed literature. Current evidence suggests that high UPF intake is associated with an increased risk of current asthma, wheezing, and allergic rhinitis. Longitudinal cohort data indicate that maternal consumption of artificially sweetened beverages during pregnancy substantially increases the risk of asthma in offspring. Key biological mechanisms identified include the disruption of the intestinal epithelial barrier, gut microbial dysbiosis—indicated by a reduction in short-chain fatty acid-producing taxa—and the induction of systemic inflammation through oxidative stress and the activation of the NF-κB pathway. Furthermore, additives such as tartrazine and sodium benzoate have been shown to exacerbate airway inflammation by upregulating leukotriene B4 and promoting Th2-skewed immune responses. These findings show the significant need for dietary interventions and stricter regulation of food additives to reduce the chronic inflammatory burden in the pediatric population.