Feingold diet

The Feingold diet is a food elimination program developed by Ben F. Feingold, MD. following research in the 1970s which appeared to link food additives with hyperactivity; by eliminating these additives the diet was supposed to alleviate the condition.

Popular in its day, the diet has since been referred to as an "outmoded treatment"; there is no good evidence that it is effective.

Technique

The diet was originally based on the elimination from the diet of butylated hydroxyanisole, butylated hydroxytoluene, TBHQ, aspirin and salicylate; additionally a number of drugs were advised against alongside everyday products including toothpaste and perfume. More recent versions of the diet prohibit only articificial food coloring and additives.

Feingold stressed that the diet must be followed strictly and for an entire lifetime, and that whole families – not just the subject being "treated" – must observe the diet's rules.

Effectiveness

Further information: Diet and attention deficit hyperactivity disorder

Although the diet had a certain popular appeal, a 1983 meta-analysis found research on it to be of poor quality, and that overall there was no good evidence that is was effective in fulfilling its claims.

In general, as of 2014 there is no evidence to support broad claims that food coloring causes food intolerance and ADHD-like behavior in children. It is possible that certain food coloring may act as a trigger in those who are genetically predisposed, but the evidence is weak.

Reception

The Feingold Program requires a significant change in family lifestyle and eating patterns because families are limited to a narrow selection of foods, and that such foods are often expensive, and must be prepared "from scratch", greatly increasing the amount of time and effort a family must put into preparing a meal.

Nutritionally, the Feingold Program is little different from a normal diet. While some fruits and a few vegetables are eliminated in the first weeks of the Program, they are replaced by others. Often, some or all of these items can be returned to the diet, once the level of tolerance is determined.

History

Feingold was a pediatrician and allergist. He served as Chief of Pediatrics, Cedars of Lebanon Hospital, Los Angeles, CA; later he established a number of allergy centers for Kaiser Permanente of Northern California, and served as Chief of Allergy at the Kaiser Permanente Medical Center in San Francisco.

Since the 1940s, researchers worldwide had discussed cross-reactions of aspirin (a common salicylate) and Tartrazine (FD&C Yellow #5). Dr. Stephen Lockey at the Mayo Clinic and later Feingold at Kaiser, hypothesized that eliminating both salicylates and synthetic food additives from patients' diets not only eliminated allergic-type reactions such as asthma, eczema and hives, but also induced behavioral changes in some of their patients.

Feingold presented his findings at the annual conference of the American Medical Association in June 1973. This led to the first controlled double-blind crossover study; its favorable results were published in the August 1976 issue of Pediatrics, the official publication of the American Academy of Pediatrics.

According to Feingold in 1974 the food industry became involved via its industry-supported organization the "Nutrition Foundation of New York." A two-week-long conference, by invitation only, was arranged in January, 1975, in Glen Cove, Long Island. There, the attendees created what they called the National Advisory Committee. The committee widely published its preliminary report concluding that "no controlled studies have demonstrated that hyperkinesis is related to the ingestion of food additives."

Over the next few years, the Nutrition Foundation funded and designed several small studies, each concluding that the diet produced little effect. Although the studies were conducted at universities, which would normally have lent them credibility, Congressman Ben Rosenthal of New York complained, "Despite the compelling need for experts who can examine the food industry with a critical eye, nutrition and food science communities have fallen under the $200 billion industry's influence. At our more prominent universities, eminent nutritionists have traded their independence for food companies' favors."

Further reading

• Psychopharmacological and Other Treatments in Preschool Children with ADHD: Current Evidence and Practice J.K. Ghuman et al., J of Child & Adolescent Psychopharmacology, Vol.18, No.5, 2008

External links

• The Feingold Association website