Scientific study: Fiengold Diet falls short of success
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There is plenty of reason to believe the anecdotal evidence that eliminating artificial colors, flavors and preservatives might help some kids with ADHD. There are many parents and an organization that swears by it. So I went looking for scientific evidence.

From Wikipedia:
The Feingold diet is a food elimination program developed by Ben F. Feingold, MD to treat hyperactivity. It eliminates a number of artificial colors and artificial flavors, aspartame, three petroleum-based preservatives, and (at least initially) certain salicylates. There has been much debate about the efficacy of this program. The mainstream medical establishment dismissed it as an “outmoded approach” lacking evidence and efficacy,[1] however some medical practitioners, as well as many people living with ADHD and parents of children with ADHD, claim that it is effective in the management of ADHD as well as a number of other behavioral, physical and neurological conditions including salicylate sensitivity. The debate has continued for more than 30 years, involving not only consumers and physicians, but scientists, politicians, and the pharmaceutical and food industries.

Dr. Feingold was a doctor with Kaiser Permanente. On of my closest friends is a pediatrician with them and I mentioned to her the other day that when I searched the Kaiser website I found nothing about the diet. She indicated that there was not good enough scientific evidence to warrant making it part of a treatment plan for her patients.

That sounds about right for MD’s. They should follow normal procedures that falls within their knowledge base and scientific evidence. In fact in cases that require expertise and knowledge beyond what a GP knows they have an obligation to make a referral to a specialist. As parents we should keep that in mind. We have an obligation to our children to get the best medical care possible.

a new study was reported today on NPR http://www.npr.org/blogs/thesalt/2012/01/09/144796050/for-kids-with-adhd-the-elimination-diet-falls-short-of-success

As they tend to do they changed the headline to read: For Kids With ADHD, Some Foods May Complement Treatment Subtitle: Eliminating junk food from a child’s diet is usually not enough to effectively treat attention deficit disorders, a paper shows.

So there it is, more scientific evidence. Clearly eating well is important but from my perspective unless there is a “food allergy” you should not take the risk and bet the farm on one treatment method that has not scientifically proven effective when there are so many that have. Your results may vary, Just my opinion.

 

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Scientific study: Fiengold Diet falls short of success — 3 Comments

  1. Dr. Feingold was Chief Emeritus, Department of Allergy, Kaiser Permanente Medical Center in San Francisco until his death in 1982. He traveled the world speaking about the role of diet and behavior.

    That “study” in the recent Pediatrics is Millichamp’s REVIEW of studies and is full of factual errors and omissions. And the studies he included were NOT recent–they were more than 30 yrs old! For example, he did not include the McCann study of 2007 that led to the requirement in the EU to put warning labels on products using artificial dyes! That study showed that ALL kids react to food dyes, not just those with ADHD.

    He said the Feingold Diet eliminates lunch meat and orange dye. Wrong. It does not eliminate lunch meat and there is no such thing as an orange dye used in food. He claims that the Feingold diet is difficult and disruptive but does not cite any studies or offer any documentation to support this claim.

    Eliminating food dyes is certainly not “taking a risk!”

    Check out http://www.feingold.org There is lots of good information there including a lot of good science showing the link between diet and behavior. I know that if you contact this parent organization, you can talk with people knowlegeable.

    I hope you will rewrite your article with better information for your readers.

    • Thanks for your interest in promoting the program. If it works for you great, that’s all that matters. What I hope people will learn from all of the posts is that their is no 100% correct thing for everyone. There are 2 sides of the story and while I did go to to the Feingold site before I wrote one word I was unable to find anything that was scientific. Maybe I missed it.

      On the other hand the Dutch Study makes claims of success and is more scientific. http://www.adhdenvoeding.nl/cms/wp-content/uploads/2011/02/Pelsser-The-Lancet-2011-Publication-INCA-study.pdf.

      I still believe: The efficacy of drug intervention is proven over decades with virtually no ill affects provided the MD’s and parents properly monitor and adjust medications as needed.
      There is no physical harm in the dietary restrictions and if they fail traditional drug treatments can be administered. In the event drug treatments are not effective in the patient than it is prudent to give diet therapy a chance.

      Thanks again
      Augie

  2. Augie, I am so sorry you missed the science on the Feingold Association website. When you go to the Home Page at http://www.feingold.org, hover your cursor over the button at top (3rd from the right) that says “Scientific Studies” and you will have a choice to see:
    - Scientific studies (broken down into groups by relevant symptom)
    - Scientific reviews
    - Studies on dyes (organized by the color)
    - Dr. Feingold’s published papers
    - The 5% notion (a bit of history)
    - The Feingold presentation at the FDA
    - Taylor’s mice – a double blind study performed by a child with results similar to the Shaywitz study

    I haven’t counted all the studies referred to on the above pages, but I do have a page of full text studies totalling well over 1,000 studies – most, but not all, of them dealing with ADHD or other symptoms and diet. This list is password protected, but you may write me to get the password to see any (or all) of the studies.

    The Millichap study you refer to is unfortunate in that while he promised (twice) in his abstract that he would stress the recent research and provide a “comprehensive review” it was anything but comprehensive.

    Every student writing a critical review in college is told to use only studies less than 10 years old. Millichap must have missed that course altogether; while he dredges up the 30-year-old studies (some designed and paid for by the food additive industry), he omits almost all the recent research, including the most significant study on the topic — the McCann study published in The Lancet in 2007. This is the study that resulted in the British government calling for the banning of dyes in England, and led to the European Parliament’s requirement that manufacturers put warning labels on most foods that contain the dyes.

    This is the study that led the American Academy of Pediatrics to say, in their 2008 Grand Rounds article, “Thus, the overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of children, admit we might have been wrong.”

    But apparently, this study wasn’t important enough for Millichap to include in his “comprehensive review.”

    Astoundingly, Millichap says that in the past 20 years, until 2010, only two scientific articles on additive-free diets can be found in PubMed.

    Those, of course, would be the two he lists in his references:

    1. Egger 1992
    2. Carter 1993
    3. Boris 1994
    4. Schulte-Körne 1996
    5. Uhlig 1997
    6. Pelsser 2002
    7. Pelsser 2009
    8. Connolly 2010
    9. and Stevenson 2010.

    Looks like 9 to me – not two. Does he have a problem counting? However, I wonder why he missed the following papers on additives and ADHD published which were also published as peer review studies in those same two decades:

    1. Pollock & Warner, 1990
    2. Ward, 1990
    3. Schoenthaler et al, 1991
    4. Breakey, 1992
    5. Egger et al, 1992(a)
    6. Novembre et al, 1992
    7. Rowe & Rowe, 1994
    8. Weiss, 1994
    9. McFadden, 1996
    10. Reyes et al, 1996
    11. Breakey, 1997
    12. Schmidt et al, 1997 (used few-foods diet)
    13. Ward, 1997
    14. Arnold, 1999
    15. Stubberfield & Parry, 1999
    16. Kidd, 2000
    17. Arnold, 2001
    18. Berdonces, 2001
    19. Dengate & Ruben, 2002
    20. Schnoll et al, 2003
    21. Breakey, 2004
    22. Bateman et al, 2004
    23. Schab & Trinh, 2004
    24. Lien et al, 2006
    25. Lau et al, 2006
    26. McCann et al, 2007
    27. Banerjee et al, 2007
    28. Curtis & Patel, 2008
    29. Sinn, 2008
    30. Pelsser et al, 2009
    31. Schoenthaler, 2009
    32. Kiddie et al, 2010
    33. Kamel & El-lethey, 2011
    34. Pelsser et al, 2010

    The authors speak favorably about a “healthy diet pattern and lifestyle to prevent and control ADHD.” But it’s hard to understand why they don’t accept a diet removing petrochemical, cancer-causing additives as a healthy diet pattern, or why children on such a diet would need “frequent evaluation by an understanding physician and dietician” as though they might develop deficiencies … deficiencies of what? petrochemicals?

    The Feingold Diet is described as “time consuming and disruptive to the household” but they are not clear about why they believe this and do not cite any research studies to support their conclusion. While we accept the concept that a dietary change can be difficult at the beginning (which is why there is a parent support group) the authors seem to not realize that the most “time consuming and disruptive” factor in a household is a hyperactive child!

    Sure there are medical treatments available. Yes they have been proven to work – in the short term at least. Numerous recent studies have been indicating, however, that children put on stimulant drugs do not do better in the long run than children not treated at all. That is frightening. There are also studies on the effects of the stimulants themselves … for example, Henderson in 1995 showed that the lowest dose of Ritalin tested for the shortest time on rats and mice still caused damage to the muscle of the heart wall. In humans, unfortunately, such damage is not readily observed – until autopsy. Ritalin and other stimulants are also known to raise blood pressure and heart rate. Seems a mighty high price to pay just to have an “easy” treatment by taking a pill instead of (gasp) eating “real food.”

    Is the Feingold diet difficult? Sure … you have to learn which brands are okay to buy. That is what the Feingold Association is here for. We do the research for you, compiling Foodlist books of over 300 pages now, including many thousands of acceptable products — including ice cream, hot dogs, chewing gum, and candy. We have come a long way from 1975, when we really were told to go home and cook everything from scratch. Too bad Millichap and his ilk are still stuck in their decades-old mind-set. It is not really known if he was simply taken in by the food industry propaganda, or if he himself has a part in producing it.

    Please don’t brush the above off as “everybody can have an opinion” … nothing above is an opinion. Every word can be backed up with published studies in the mainstream medical literature. That’s my job – I’ve been reading this research for 20 years now.

    Shula Edelkind
    Research Information Director
    Feingold Association
    http://www.feingold.org

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