Food additives have been implicated as aetiological factors in many different disease states. Concern arose from a suggested link with food additives and hyperactivity in children. They have also been implicated in many other disease states. This perception, often made by parents on behalf of their children, is not confirmed by double-blind placebo-controlled challenge studies. The discrepancy between public perception and the true prevalence of food additive reactions is great and this discrepancy between perception and confirmed reactions also exists with food-related symptoms. The discrepancy is much greater in the case of food additives than in foods. The mechanism of food additive reactions is not immunological and there is no in vivo or in vitro confirmatory test.