ADHD, Food Coloring and Additives
A recent British study found that certain artificial colorings and preservatives commonly found in sweets and beverages can increase hyperactivity in children with and without ADHD.
Whether or not there is a relationship between food colorings and additives has been controversial for many years. In 1975, Dr. Benjamin Feingold proposed that synthetic flavorings and colors in the diet might be a cause of hyperactivity, and proposed an elimination diet, the Feingold Diet. Dr. Feingold's opinions were not based upon research studies, but on his own clinical experience. In response, the federal government funded several large research studies. The results of these and other studies have consistently found that elimination diets are not generally effective for treating hyperactivity except in about 1% of children.
Occasionally a parent will feel that her child is more hyperactive after eating sweets, Kool-Aid, or certain cereals and foods, or after taking medications with red or yellow dyes. This might be a child who does respond to an elimination diet with reduced hyperactivity. However, most core symptoms of ADHD would remain (inattention, distractibility, problems with planning, organization, time management, and follow-through) and would still need treatment.
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Technorati Tags: adhd, additives, hyperactivity
Whether or not there is a relationship between food colorings and additives has been controversial for many years. In 1975, Dr. Benjamin Feingold proposed that synthetic flavorings and colors in the diet might be a cause of hyperactivity, and proposed an elimination diet, the Feingold Diet. Dr. Feingold's opinions were not based upon research studies, but on his own clinical experience. In response, the federal government funded several large research studies. The results of these and other studies have consistently found that elimination diets are not generally effective for treating hyperactivity except in about 1% of children.
Occasionally a parent will feel that her child is more hyperactive after eating sweets, Kool-Aid, or certain cereals and foods, or after taking medications with red or yellow dyes. This might be a child who does respond to an elimination diet with reduced hyperactivity. However, most core symptoms of ADHD would remain (inattention, distractibility, problems with planning, organization, time management, and follow-through) and would still need treatment.
Related Topics:
Technorati Tags: adhd, additives, hyperactivity
15 Comments:
Sir,
I presume you are discussing the early studies undertaken after Dr. Feingold's presentation to the AMA in 1973 and his call for research. But I am at a loss to find the large government-funded studies you cite.
Could you mean the 1978 Harley study which is widely quoted, and which was supported by a government grant? But it is hardly a "large study" since it consisted of a total of 46 children and was divided into 2 parts. And if you actually read it, you will find that of the 10 preschoolers given the two blinded diets, ALL TEN improved on the Feingold diet. Of the 36 school-age children, more than half improved on the diet in spite of the fact that they were only on the diet for 3 weeks (not the 6 weeks recommended by Dr. Feingold then and the Feingold Association today). It has been known from the beginning that older children take longer to respond to dietary change, and those previously medicated take even longer to respond; this likely explains the order effect seen in the Harley study because those children who were on the "control" diet first were also off medication longer and besides the "control" diet was really much better itself than the usual American kid's diet even in 1978.
But details aside -- although it was an expensive set of studies, 10 kids and 36 kids cannot be considered "large."
Usually you see a reference to 190 kids in the early studies -- but they were divided between 7 studies which gives an average of only 27 kids per study. And these are the studies funded and designed by the Nutrition Foundation - are you aware that the Nutrition Fdn is NOT the US Government? It is an industrial organization of companies that make or distribute the additives eliminated by the Feingold diet. You can see who was on it at http://www.feingold.org/nut.html For the life of me I cannot find your "large study" funded by any government agency. In fact, I cannot find any LARGE study at all that claims to disprove the Feingold diet. Please enlighten me.
Perhaps you have not kept up with the newer literature? Are you aware of the 1986 Schoenthaler study on a million school children? Sure, it's a retrospective quasi-experimental study which is not as lovely as a double-blind study, but a million kids who improved shouldn't be ignored.
How about the 1994 Rowe study on 200 kids? He got a 75% response to his open diet, and 82.5% of them reacted to double-blind challenge with a variety of amounts of one single food dye challenge - and he got a dose effect.
The 1982 Salamy study is interesting for the fact that he found ALL the children reacted to food dyes with physiological changes, although those with ADHD reacted more strongly. This certainly appears to foreshadow the current findings in the UK.
In the 1994 Boris study, 73% of he 26 kids responded to an elimination diet, and ALL of them reacted to double blind challenge.
Reyes in 1996 did a lab study on a number of food colorings and found that they inhibited mitochondrial respiration, with a dose effect. Interesting.
Ward in 1990 had already shown that kids with ADHD (but not normal kids) lost zinc through their urine when exposed to artificial coloring. As their zinc levels dropped, their behavior and other symptoms got worse.
In 1997, a rigorous study by Schmidt on conduct disordered kids was interesting. Only 44% of these difficult kids responded to medication, and only 24% responded to an elimination diet. What is interesting? That those who responded to the elimination diet did just as well on the diet as they had done on medication.
There are other studies in the past quarter-century but even just these few should be enough.
It is time we recognized that those who claim the diet "doesn't work" continue to quote the studies done in the 1970s and the reviews of THOSE STUDIES in the 1980s simply because none of the newer studies suit their purposes - ALL the newer studies support the idea of diet as a valid treatment by itself or in conjunction with medication. Even the "old" studies support it when analyzed properly (Weiss 1982). Dr. Weiss was a toxicologist and his analysis was paid for by the NIMH & the Natl Institute of Environmental Health Sciences.You can see an excerpt at http://diet-studies.com/weiss.html
One final point -- in no study EVER does your 1% "success rate" appear. Now there are a few studies that took children who had improved on the diet and challenged them with an unreasonably small amount of a single food dye and these studies found that most of the kids were not sensitive to the dye. So what? That only proves that such a dose of DYE didn't do anything, and it doesn't say anything at all about the DIET. If you challenge kids with only 1 mg of cocaine, probably nothing will happen. Would you consider that a license to put it in the kids' lunch? But that is exactly what we have done with food coloring. We haven't even done that much study with the preservatives and flavorings.
I apologize for the length, but one final point is required. When a child responds to the Feingold diet, hyperactivity is not the only symptom that improves. Not only do kids on the diet improve in their attention and ability to focus, but most of the time the other symptoms so common with ADHD also improve - sleep disorder, asthma, enuresis, eczema, chronic earache - symptoms not even touched by stimulant meds. There is research on each of these symptoms and its improvement by dietary change at http://www.diet-studies.com
Instead of continuing to beat this dead horse of WHETHER the diet works, how about somebody do some research to follow up on Ward and Salamy and Stevenson and find out WHY the diet works for these kids?
Finally, the Feingold Association today, as it was in the beginning, is a volunteer-run service organization. Consider this: Volunteers would not stick around for something that only helps 1% of members. They would give it up and go do something else.
Believe it or not video games have shown promising results for children with ADHD. see the linked article
http://www.wqad.com/Global/story.asp?S=5167491&nav=7k8p
Bravo in your posting on this topic. My son was put on Ritalin at age 4. At age 7 I began investigating possible causes for his behavior instead of contentedly giving him his little yellow pill every morning. I used trial and error in eliminating suspected dietary influences, as well as adding suspected dietary deficiencies. What I found was that he will exhibit extreme ADHD behaviors after consuming high fructose corn syrup--not sugar, not corn syrup, specifically the high fructose corn syrup version--as well as yellow FD&C#5. The yellow food coloring we can offset with supplemental zinc, there is no offsetting the other. We also found that he needs to take supplementary calcium, magnesium, zinc, and DHA. The DHA was the clincher for him. He's been off Ritalin for 6 years, has grown normally, eats normally, and for the most part behaves as a normal kid. The ADHD tendencies are still there, but with careful monitoring of his diet and supplement doses it no longer controls his life. You're right...if only studies would now be done on the how and why to support this treatment approach our children would be much better off.
I have been with the Feingold diet for years and raised my girls with it. WHat a wonderful affect it has had on them. It works if you take the time to educate yourself and it becomes a way of life for your family. Definitely healthy. It gave us the basics as we are doing the orgainics. It can be done with careful planning. Shouldn't it be our concern and goal to live healthy and teach our children?
Even pet food needs to be checked so much bad is in the stores. It's all about education and desire.
I have a son who eight and his teacher wants to up his medicine but we are trying food supplements.CJ
Sir, I work with a co-worker (adult) who has ADHD. She does not eat healthy lots of sugar and caffine. She is on medication but you wouldn't be able to tell. Is her eating habits counteracting with the medication?
We love the Feingold plan! Not only has it helped my kids but my husband also. I have seen improvement on sleeplessness, leg cramps, constipation, being busy-accomplishing nothing, staying focused and grumpiness/moodiness even in my husband. Yes, that's right it helps adults too! It's normal foods. You may just need to change the brand you buy. We saw improvement within 3 days for several things. I would recommend to ALL parents!!
My 14 yr. old son and I have been adhering to the FG diet way of life for over 8 years. His behavior at the start - which included physical aggression, non-stop movement, extreme distraction, impulsiveness to the point of harming himself, panic in public places, no frustration tolerance, speech delays, delays in learning and a bunch of other symptoms, have all vastly improved and most have disappeared completely. You would not know by looking at him now that he was diagnosed with EXTREME ADHD.
I also have found that following this very healthy diet has helped me with ringing in my years, gastrointestinal issues, and achy joints.
I recommend it to everyone I come across that talk to me about the problems with their kids. As Shula said, research proves it out, but I don't think we can disregard YEARS of anectodal evidence (not just stories, but they are actually prove-able) from many, many families that are dedicated to removing these harmful substances from their diets.
"However, most core symptoms of ADHD would remain and would still need treatment" -- translated: Give 'em drugs.
Bah! You can take your advice and "expert opinion" and move on, pal...
I was told recently by a teacher that the Feingold program does not work. How funny, considering all the boys in her class were stoned on Ritalin. How could she know. Our family has been on the program for four years. My son was non-verbal and profoundly ADHD. Not anymore. Nicest kid you could ever meet. Your 1% is laughable. But it also proves that the writer has a lot to learn!
Maryellen--mother of five, well behaved children
The Feingold Progrsam works great for us! My doctor said he would medicate my son once he was of school age. By then, the Feingold Program had eliminated all his unmanageable behaviors and medication was unecessary. In the meantime, my husband, who had taken Ritalin as a child, got a promotion and a raise at work soon after starting FG. We thank God daily for the wisdom He gave Dr. Feingold.
Here's a list of symptoms that we no longer deal with in our home, and haven't since we started the Feingold Diet nearly 3 years ago (and yes, they ALL reoccur if we eat off diet):
Mom (Me): Asthma, PMS, Anger/rage, Migraines, Sensory integration problems
Dad: won't stay 100% on the diet, but when he eat off we notice a marked decrease in his energy levels.
Daughter #1(8 yrs old) Daytime wetting, Nighttime wetting, No impulse control (seems to shut down the part of her brain that says “That’s a bad idea. Don’t do it.) Includes: Hitting & Randomly breaking things, concentration/ability to attend, Poor handwriting
Daughter #2 (6yo) Anger/rage, Temper tantrums, Bouncies (We call her Tigger), Insomnia
Daughter #3 (5yo) Nighttime wetting, Sinusitis, Volume sensitivity
Daughter #4 (33mos - on diet since birth) With infractions we notice daytime wetting - she was potty trained at 20 mos.
Journalism 101: make sure you quote reliable sources.
Ok!!! Lets start with keeping in mind that every one responds differently to diet and medication. What works for one person may not work for another. I am a 26 years old male diagnosed by three different doctors throughout my life as ADHD. I stopped taking Ritalin and Cylert when I was 9. It took me years to do but I learned to identify my symptoms when they spiked and could adapt to them for the most part. I live with it tolerate it and taught my mind how to make positive use of it some times.
A few years ago I started looking into ways to naturally treat my ADHD. I found a set of vitamin supplements designed to help my body naturally regulate the chemical imbalances causing ADHD. In the past I have tried special diets and they help me a bit. I did find that if I drink a cup or two of strong black coffee in the morning with breakfast the caffeine actually helps me concentrate better. I avoid sugar in large amounts but even if I do eat a lot I don’t notice much change.
I have been a mental health worker for nearly five years.. (I am by far no professional but a little wiser than some.) I have seen many cases of ADD and ADHD. A small hand full of them found significant change from any type of diet. Many of them found that Strattera (a none stimulant drug) worked very well for them. Keep in mind many of these cases had what has some times been called extreme ADHD. I my self had tried Strattera for a very short time with noticeable change. Unfortunately I developed an allergic reaction to it. I had an outbreak of hives, but that was the only side effects I had and was the first time I saw any one with such reactions.
My doctor told me that the best improvements in ADHD he has seen came from balancing diet, supplemental vitamins, and when needed, taking low to moderate doses of medication.
Teaching children better time management and organizational skill is also another good way to help teach them how to deal with their ADHD. When I was in school I was just "special ed." they didn’t know how to deal with ADHD students other than “cram more medication down them.” I was a freaking zombie half my childhood. If a TEACHER is telling you, your kid needs more meds ask them for their doctrine in mental health. I hear all too many people say “oh he/she is ADHD give them medication that will mellow them out.” when really the kid is just being a kid. Some parents just need to learn to tolerate their energetic children.
I am by far no expert on ADHD but I have lived with it and learned as much as I can about it. The things I have talked about are all from personal experience. I don’t expect what’s worked for me to work for others, but I figure you all could use some input from some one who has actually lived with ADHD, not sat on the side lines watching it in others, not truly knowing what having it feels like.
Do you people travel in groups verbally assaulting any one who dares say that your fiengold diet's effects are limited to a subsection of hyperactive people?
Maybe it has escaped you that hyperactivity that is totally eliminated by the mere removal of a "offending food" that maybe there was no ADD but a FOOD allergy which isn't the same thing -
If ADD were just a dietary problem wouldn't the symptoms of ADD fluctuate over the life span of ADHD people?
Maybe due to the fact that none of you actually have ADHD you do not know that although ADD may express it self differently as we age the symptoms of ADD themselves remain pretty constant through out life - I have been hyperactive from womb to middle age and my diet has changed
several times over the decades - if my ADHD is all due to my diet please explain why my symptoms do not fluctuate along with my diet .
By all mean go back to your bee-hive and enjoy your dietary stuff - I don't see hoards of Adderall and Ritalin users swarming your forums and blogs - oh but I forgot people have to pay money to get on your support sites {I am not sure but hassling your guys the way you are hassling the folks I know may be worth $69.00} Money is basically what this is all about is it not - I clicked on this shula edelkind and her site wants money. . .
If your approach was so successful why do all you people need to come and attack this one blogger? - Who are you trying to convince him or your selves?
I was diagnosed with A.D.D. (A.D.H.D) when I was 6 in 1984. about a decade ago I tried a self directed elimination diet after I had returned from living in Europe: where my symptoms of hyperactivity had completely disappeared. It took me 5 years, but I finally realized that I was allergic to CORN, including HFCS, corn syrup and all the other 1,200 derivatives of corn that are in 70% of our US foods. This allergy caused my A.D.H.D. I felt good and Europe (and since in Canada) because they use wheat not corn in most their foods. It took me so long to figure this out in the US, because in the ingredient lists of most products corn can be called, gluten, dextrose, and is used to make food coloring and food additives...etc.. etc..
The other interesting parallel that I discovered is that after the US initiated its trade embargo with Cuba in the mid-70s our supply of cheap cane sugar was cut-off and manufacturers had to find another source of sweetener. It was at this point that the corn suppliers stepped in and corn has been a major additive of our foods since. This addition of corn to our foods in non-traditional ways parallels exactly the increase in diagnosis of disruptive children with A.D.H.D. in the late 70s and early 80s. So my advice, take a week off corn (and A.D.H.D. medications)... Make your own food from scratch and just see if this makes a difference in your life. I can feel the difference with in 2 or 3 days.
Good references for learning about corn in US food are the book "The Omnivores Dilemma" and the new documentary "King Corn".
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