Effects of a few foods diet in attention deficit disorder

by C. M. Carter, M. Urbanowicz, R. Hemsely, L. Mantilla, S. Strobel, P. J. Graham & E. Taylor

A new British study has yielded some very positive data on the connection between diet and behavior/learning.

This is the newest in a series of studies conducted in England, adding support to the use of diet for children with learning or behavior problems.

The children who participate in the study all met DSM 111 criteria for attention deficit disorder and were between ages 3 and 12, with an average range of IQ scores.  Prior to the start of the study, the children were given extensive assessment tests.

For a period of three to four weeks, the children were on a very restricted diet, generally consisting of: turkey, lamb, rice, potato, banana, pear, various vegetables, bottled water, sunflower oil and milk-free margarine.   In some cases diets were adjusted to avoid suspect allergy foods or avoid those a child disliked.

Seventy eight children completed the first part of the study.  The parents of 59 of the children reported a worthwhile improvement in behavior; 17 reported no improvement; and 2 were said to become worse.  This represents:

Improved: 76%

No change: 22%

Worse: 3%

The 59 children who responded were then challenged with various foods and some food additives.  Additive-containing foods were found to be the worst offenders (70% reacted). 

Chocolate was the second most often reported culprit (64%). [We assume the researchers used chocolate free of synthetic additive vanillin]. Cow's milk also provoked reactions in 64%, followed by orange (57%), cow's cheese (45%), wheat (45%), other fruits (36%), tomato (22%) and egg (18%).

The additives used consisted of a blend of ten dyes, only 4 of which are used in foods in the US, benzoic acid and sodium metabisulphite. [These preservatives are not routinely eliminated on the Feingold Program].  Those which we do remove - BHA, BHT and TBHQ - are restricted in England.

The amount of additives given to the children was quite small, the upper limit for the dyes being 26mg per day.  Despite the small quantity of dyes in the challenge, they had a significant effect. The authors write, "When food colours were suspected, we asked parents to give their children colour capsules.  Sixteen agreed to do this.  Three children were not affected, two had behavioural problems and physical symptoms, eight had behavioural problems only, and three had physical symptoms only."  Of the sixteen children who were challenged with 26 mg or less of food dyes, thirteen had adverse reactions.

There are many differences between this study and the Feingold program so while it cannot be seen as a test of our program, it offers some valuable support.  One of the conclusions the researchers emphasized was that parental observations should be taken seriously.  They write: "this trial indicates that diet can contribute to behaviour disorders in children and that this effect can be shown in a double blind, placebo controlled trial."

They also state: "The ways in which diet worked remain unclear.  Toxic, pharmacological, or allergic mechanisms could be involved, and the physiological effects of different foods might induce changes in brain perfusion similar to those reported in attention deficit disorder by Lout et al.   These results argue against the notion that the only mechanism involved is the 'placebo effect' of expectation and suggestion, and testing this was a main purpose of the study."

Throughout the paper, the authors refer to the dietary regimen as difficult and restrictive.  Unlike the Feingold Program, which permits a tremendous variety of foods, even in Stage One, the Carter study did severely restrict food choices.  They suggest that a study design limiting only the most likely offenders might be worth pursuing.

The authors believe that a study testing additives alone would not be of much benefit since so few children appeared to react to them alone.   Considering the small amount and limited number of additives used in the challenges, this conclusion is understandable.

The researcher's design allowed for two week 'wash-out' period between testing the active material and the placebo; this is a welcomed improvement over many of the old tests.  they also improved on early studies by having the children evaluated daily. 

Although the children in this study met the criteria for diagnosis with attention deficit disorder, and their scores improved on one of the learning tests, the major improvements were seen in their behavior.  Parents noted the children exhibited fewer of these symptoms: restless, disturbs others, cries often, and temper outbursts.  The authors suggest this indicates more of an effect on irritability than on "attention deficit".

Feingold did not place learning difficulties in a category separate from behavior problems, but felt that, for most of the children he helped, they were simply different characteristics of the same problem.

While some children on the Feingold Program show an immediate improvement in their ability to attend and learn, many parents report that the child's behavior improves first, and school work improves gradually.

Increase in ADD and behavior problems

Research published in the Journal of the American Academy of child and Adolescent Psychiatry documents a significant increase in troubled children.

In a study covering 2000 children between 1976 and 1989 the number of childhood disorders increased significantly, according to Dr. Thomas Achenback director of the Center for Children, Youth and Families at the University of Vermont.
In 1976 the data collected indicated that about 10% of the children exhibited problems serious enough to make them candidates for mental health services. By 1989 the number needing help increased to 18%.

Of the 118 problems listed, the most frequent of the troubling characteristics seen include: inability to sit still and to concentrate, daydreaming, impulsiveness, poor school performance, aggressive/delinquent behavior, stubborn, disobedient, demands attention, talks too much, feels sad/anxious/depressed, sulks, is withdrawn/lonely, has a hot temper.

Sound familiar?

Feingold Association - Pure Facts March 1994.