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===Discussion===
===Discussion===

== Using Quackwatch as a source ==

Quackwatch is used extensively as a source for this article. Quackwatch is a one man effort, run by an old man, a long-retired doctor, with an axe to grind (IMO), who is out of touch with modern medicine. For example, I had an argument by email with him years ago when he was still insisting that [[Chronic Fatigue Syndrome]] was a scam (I was a sufferer). It has since gained wide acceptance amongst doctors as a valid condition. So since when has it become allowable, or in any way sensible, to use low quality personal sites (essentially blogs) like Quackwatch as sources for medically-oriented articles? [[User:MLPainless|MLPainless]] ([[User talk:MLPainless|talk]]) 13:03, 8 December 2014 (UTC)

Revision as of 13:05, 8 December 2014

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Unsubstantiated Statement

The last sentence of the first paragraph,

The medical community rejects it, as it is an "outmoded approach" lacking evidence and efficacy

is based upon a one page, non-refereed editorial [read here], which per se has only took up "Feingold diet" as one of examples of the so-called outmoded approaches. There is no evidence in this editorial to support the statement "the medical community rejects it."

Thus I deleted that sentence. Any reversal of this deletion is improper unless strong evidence is provided. Minimeme (talk) 19:18, 26 April 2014 (UTC)[reply]

Actually, the focus should be on WP:MEDRS. Seems like it is an attempt at WP:ASSERT. Perhaps a bad one? --Ronz (talk) 15:30, 27 April 2014 (UTC)[reply]
So what's your point to reverse it? As the cited reference has barely anything to support the statement and you didn't provide any better source, may I consider your reverse as vandalism?
The preceding sentence, there has been much debate about the efficacy of this program, is in direct contradiction to this statement. The main text of this entry supports this argument of "there has been much debate," instead of outright rejection of Feingold diet.
Thus I reverse it back. Minimeme (talk) 18:27, 27 April 2014 (UTC)[reply]
Do you understand MEDRS? ASSERT? --Ronz (talk) 00:48, 28 April 2014 (UTC)[reply]

"Research findings" section?

This "Research findings" section, tagged as being possible OR since 2007 (!), seems composed almost entirely of primary sources and, whre it isn't, out of sources which do not explictly mention the Feingold diet. All of our health content should now be sourced to WP:MEDRS sources. I am moving this content here for possible discussion, in case anything is salvagable:

Content moved from article

Research findings

Many studies show that 70% or more of hyperactive children respond positively to the removal of synthetic additives, especially when salicylates or allergens are removed.[1][2] There is controversy, however, over what happens when researchers take children whose behavior has improved on a diet that eliminates several thousand additives, and then challenge them with one or a few additives, usually synthetic colors.

Especially in the early studies, if such a challenge did not produce a change in behavior, researchers often concluded that the diet had not directly caused the initial improvement in behavior. Rather, the assumption was that the improvement had been due to a placebo effect.

There are other possible reasons for the failure of a challenge to evoke a response, however. For example, the amount of additive used as a challenge might have been too small to cause an effect.[3] Rowe & Rowe in 1994 found a dose-related effect; the higher the amount of coloring used in the double-blind challenge, the stronger (and longer) the reaction of the children.[1] The following chart lists the amount of coloring used in various studies along with the rate of response:

Name of Researcher

and Year Published

Amount of Food Dye

Challenge Used in Study

Percent of Children w/Behavioral

Reactions to Food Dye Challenge

Levy 1978[4] 4 cookies

1 mg dye in each

0% of 8 children (Note, 1 child was dropped from study when behavior deteriorated on challenge.)
Levy 1978[4] 5 cookies

1 mg dye in each

0% of 12 children. (Note, the testing was done the day AFTER the challenge.)
Wilson 1989[5] 17 mg 5% of 19 children
Weiss 1980[6] 35.26 mg 9% of 22 children (Note, the children in this study were not diagnosed with ADHD.)
Williams 1978[7] 26 mg 11% of 26 children
Goyette 1978 (a)[8] 26 mg 19% of 16 children showed visual tracking problem (Note, the behavior of all the children was reported to be worse after eating food dye, but not significantly so.)
Goyette 1978 (b)[8] 26 mg, using younger children 100% of 8 children were impaired by food dye. (Note, 26 mg is a higher dose for a younger child.)
Rowe 1988[9] 50 mg 25% of 8 children
Rowe 1994[1] 50 mg 64.7% of 34 children
Boris 1994[2] 100 mg or 5 g other provoking food 81% of 16 children
Swanson 1980[10] 100 & 150 mg 85% of 20 children
Pollock 1989[11] 125 mg 89.5% of 19 children
Egger 1985[12] 150 mg 79% of 34 children

Considering that in 1976 an FDA scientist estimated that children may be consuming up to 315 mg food dye per day,[13] all the above studies appear to be overly conservative in their choice of challenge amounts. In addition, the effect of an additive might only be seen in synergy with other additives or foods,[14] [15] or the additive used for the challenge may simply not be among those causing the original effect.[13]

Early studies

As with many new developments, the first reports of improvement of behavior via diet were anecdotal. This was followed by clinical trials and eventually by larger, double-blind placebo-controlled studies.

Conners, Williams, & Swanson studies ...

In 1976, a double-blind crossover diet trial found that both parents and teachers saw fewer hyperkinetic symptoms on the K-P diet as compared to the pretreatment baseline.[16] A 1978 double-blind crossover study using cookies with 13 mg food dye each combined with either medication or placebo found, "The results of this study offer data that a diet free of artificial flavors and colors results in a reduction of symptoms in some hyperactive children."[17] In 1980, forty children were put on a diet free of artificial food dyes and other additives for five days. They then performed the usual double-blind placebo-controlled test but used 100 mg or 150 mg of the food dye mix. They found that the food dyes impaired the performance of the 20 hyperactive children on paired-associate learning tests. The dyes did not hurt the performance of the 20 non-hyperactive children. The study states: "Our data suggest that a large dose of food dye blend decreases attention span in hyperactive children as reflected by performance on the learning test."[18]

Nuttition Foundation studies ...

In 1980, the Nutrition Foundation [19] reported on the seven small studies they had funded, adding up to a total of 190 children. Some of them were elaborate double-blind diet studies using a Feingold-type diet for which they provided all the food. Others simply took the children off additives and then challenged them with a small amount of food dye. In some studies, the children were taken off their medication, while in others they continued on stimulant medications including artificial colorants during the duration of the study.

One of the studies in 1978,[20] for example, used 36 children between 6 and 12, and 10 children between 3 and 5. The teachers of the school-aged children did not record any improvement, but 63% of the mothers reported improved behavior, as well as 100% of the mothers of the preschoolers; however, since the improvement was reported by the parents of the children rather than teachers, and locomotor activity tests were unaffected, it was reported that there was "no diet effect."

In 1980 the Nutrition Foundation set up a review team to review studies related to the Feingold diet.[21] They published a report that stated that there was no response at all to the diet. In 1983, the review team's co-chairman and a colleague reviewed a variety of studies and concluded that no more than 2% of children respond adversely to dye additives.[22]

Gross et al summer camp study ...

An influential comparative diet study was conducted in 1987 by Gross et al.[23] This was a study of 39 children, of whom 18 were hyperactive, and the balance had other learning disorders. Of those 18, all but one were on behavior-modifying medications during the entire study. The researchers provided a Feingold-type diet for a single week that was, by their own description, unpalatable. They particularly noted that the children missed mustard and ketchup; mustard, however, is not eliminated by the Feingold diet, and no reason was given for its exclusion.

This diet week was followed by an additive-rich diet the next week. Although the study reported that the camp director and all teachers felt that the children were noisier and more active during the second, additive-rich week, they discounted these observations in favor of filmed 4-minute sequences made during meals. These films were intended to measure reaction to additives in the meals in spite of the fact that any such reaction would not be expected to occur for some time after eating.

During the course of the study, three children were dropped: one who was not on stimulant medication, whose behavior became worse during the second week; one who refused to behave altogether; and one whose dose of Cylert became "inadequate" and whose behavior worsened when additives were allowed during the second week.

They concluded that the "Feingold diet has no beneficial effect on most children with learning disorders" and moreover that the diet was "distasteful to the typical American child."

Later studies

A number of studies conducted since 1980 using diets similar to the Feingold Program report greater than 70% of children responding positively to the diets. Others that eliminated synthetic colors and flavors, but included salicylates still reported greater than 50% positive response.[1][2][9][10] [12][24][25][26][27]

In the biggest such study ever performed, published in 1986, the performance of over a million children in 803 New York City public schools was studied for seven years. The children's average standardized test scores rose 8.1% when levels of sucrose (normal table sugar) were restricted to 11 percent along with the removal of two synthetic food colors; when the remaining food colors and all artificial flavors were removed the next academic year, performance rose another 3.8%; when no further changes were made the following academic year, test performance also remained stable; finally, when the petroleum-based preservatives BHT and BHA were removed from the menu in the next academic year, performance improved another 3.7% for an overall improvement of 15.7% in mean national percentile rankings (from 39.2% to 54.9%).[28] Although it appears that improvement increases as the diet approaches the guidelines of the Feingold Program, the researchers suggest that by removing sugar and additives - thereby removing empty calories and processed foods - malnutrition is reduced. It is not clear what portion of the effects can be contributed to limiting sugar intake or the foods containing BHT and BHA (the related preservative TBHQ did not exist at that time) and what portion can be attributed to the removal of the artificial colorants themselves.

A most important and often overlooked detail in this study is that all the children did not improve equally. There was a dramatic decline in learning disabled and repeat-failure children. In 1979, 12.4% of the million children were performing two or more grades below their proper level. By the end of the study in 1983, the percent of children two or more grades below proper level had dropped to 4.9%. Moreover, before the dietary changes, the more school food that was consumed, the worse the children did academically. After the changes, however, the more school food the children ate, the better they did academically.[29]

In 1997, an association between brain electrical activity and intake of provoking foods was shown in children with food-induced ADHD. (Picture) [30] Another study showed that an oligoantigenic diet can work as well as Ritalin for conduct-disordered children.[31] Other research demonstrated the positive effect of treating young criminals with dietary intervention and correction of mineral imbalances,[32][33] and that toddlers show both significant reductions in hyperactive behaviour when additives are removed from their diet, as well as increased hyperactivity when exposed to a very small (20 mg) amount of food coloring and a benzoate preservative. This effect was observed by parents whether or not the child was hyperactive or atopic.[34]

A 2007 British study at the University of Southampton[35] has pointed to food additives as a health hazard for all children, whether they have ADHD or not. The study concluded that artificial colors or a sodium benzoate preservative (or both) in the diet result in increased hyperactivity in 3-year-old and 8/9-year-old children in the general population. In response to this study and a massive media and grass-roots campaign, the major supermarket chains in the UK have removed additives from their house brands. Several American-based candy companies have done the same with the candies they sell in the UK.

In response to that study, which had been financed by Britain’s Food Standards Agency and published online by the British medical journal The Lancet, the American Academy of Pediatrics concluded that a low-additive diet is a valid intervention for children with ADHD. It released the following statement in the February 2008 issue of its publication, AAP Grand Rounds:

“Although quite complicated, this was a carefully conducted study in which the investigators went to great lengths to eliminate bias and to rigorously measure outcomes. The results are hard to follow and somewhat inconsistent. For many of the assessments there were small but statistically significant differences of measured behaviors in children who consumed the food additives compared with those who did not. In each case increased hyperactive behaviors were associated with consuming the additives. For those comparisons in which no statistically significant differences were found, there was a trend for more hyperactive behaviors associated with the food additive drink in virtually every assessment. 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 their children, admit we might have been wrong.”

Anne Swain, of the Allergy Unit at Royal Prince Alfred Hospital in Sydney Australia, measured amounts (but not type) of salicylate in 333 foods in 1985,[36] and has done other research based on the Feingold Diet.[37]

References

  1. ^ a b c d Rowe KS, Rowe KJ (1994). "Synthetic food coloring and behavior: A dose response effect in a double-blind, placebo-controlled, repeated-measures study". Journal of Pediatrics. 125: 691–698. doi:10.1016/S0022-3476(06)80164-2. PMID 7965420. Cite error: The named reference "Rowe94" was defined multiple times with different content (see the help page).
  2. ^ a b c Boris M., Mandel F.S. (1994). "Foods and additives are common causes of the attention deficit hyperactive disorder in children". Annals of Allergy. 72 (5): 462–468. PMID 8179235.
  3. ^ Cite error: The named reference Rimland83 was invoked but never defined (see the help page).
  4. ^ a b Levy F, Dumbrell S, Hobbes G, Ryan M, Wilton N, Woodhill JM (January 1978). "Hyperkinesis and diet: a double-blind crossover trial with a tartrazine challenge". Medical Journal of Australia. 1 (2): 61–4. PMID 349320.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Wilson N, Scott A. (May 1989). "A double-blind assessment of additive intolerance in children using a 12-day challenge period at home". Clinical & Experimental Allergy. 19 (3): 267–272. doi:10.1111/j.1365-2222.1989.tb02382.x. PMID 2736427.
  6. ^ Weiss, B. and Williams, J.H. and Margen, S. and Abrams, B. and Caan, B. and Citron, L.J. and Cox, C. and McKibben, J. and Ogar, D. and Schultz, S (March 1980). "Behavioral responses to artificial food colors". Science. 207 (4438): 1487–1489. doi:10.1126/science.7361103. PMID 7361103.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ^ Williams, J.I. and Cram, D.M. and Tausig, F.T. and Webster, E. (June 1978). "Relative effects of drugs and diet on hyperactive behaviors: an experimental study". Pediatrics. 61 (6): 811–817. PMID 353680.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ a b Goyette, G.H. and Connors, C.K. and Petti, T.A. and Curtis, L.E. (April 1978). "Effects of artificial colors on hyperkinetic children: a double-blind challenge study". Psychopharmacol Bull. 14 (2): 39–40. PMID 652927.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ a b Rowe KS (1988). "Synthetic food colourings and "hyperactivity': A double-blind crossover study". Australian Pediatrics. 24 (2): 143–147. doi:10.1111/j.1440-1754.1988.tb00307.x. PMID 3395307. Cite error: The named reference "Rowe88" was defined multiple times with different content (see the help page).
  10. ^ a b Swanson, J. and Kinsbourne, M. (March 1980). "Food Dyes Impair Performance of Hyperactive Children on a Laboratory Learning Test". Science. 207 (4438): 1485–1487. doi:10.1126/science.7361102. PMID 7361102.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ Pollock, I. and Warner, J.O. (January 1990). "Effect of artificial food colours on childhood behaviour". Arch Dis Child. 65 (1): 74–77. doi:10.1136/adc.65.1.74. PMC 1792406. PMID 2301986.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ a b Egger, J. and Carter, C.M. and Soothill, J.F. and Wilson, J. (January 1989). "Oligoantigenic diet treatment of children with epilepsy and migraine". Journal of Pediatrics. 114 (1): 51–58. doi:10.1016/S0022-3476(89)80600-6. PMID 2909707.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  13. ^ a b Center for Science in the Public Interest, Quarter-Century Review, pg.11
  14. ^ Cite error: The named reference Lau06 was invoked but never defined (see the help page).
  15. ^ Maffini, M. V. and Neltner, T. G. (2014). "Brain drain: the cost of neglected responsibilities in evaluating cumulative effects of environmental chemicals". Journal of Epidemiology and Community Health. doi:10.1136/jech-2014-203980.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  16. ^ Conners CK, Goyette CH, Southwick DA, Lees JM, Andrulonis PA. (August 1976). "Food additives and hyperkinesis: a controlled double-blind experiment". Pediatrics. 58 (2): 154–66. PMID 781610.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ Williams JI, Cram DM, Tausig FT, Webster E. (June 1978). "Relative effects of drugs and diet on hyperactive behaviors: an experimental study". Pediatrics. 61 (6): 811–7. PMID 353680.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  18. ^ Swanson JM, Kinsbourne M. (March 1980). "Food dyes impair performance of hyperactive children on a laboratory learning test". Science. 207 (4438): 1485–7. doi:10.1126/science.7361102. PMID 7361102.
  19. ^ Cite error: The named reference nf was invoked but never defined (see the help page).
  20. ^ Harley, J.P. and Ray, R.S. and Tomasi, L. and Eichman, P.L. and Matthews, C.G. and Chun, R. and Cleeland, C.S. and Traisman, E. (June 1978). "Hyperkinesis and food additives: testing the Feingold hypothesis". Pediatrics. 61 (6): 818–828. PMID 353681.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ^ Wender EH, Lipton MA. The National Advisory Committee Report on Hyperkinesis and Food Additives -- Final Report to the Nutrition Foundation. Washington D.C: The Nutrition Foundation, 1980.
  22. ^ Cite error: The named reference Lipton83 was invoked but never defined (see the help page).
  23. ^ Gross, M.D. and Tofanelli, R.A. and Butzirus, S.M. and Snodgrass, E.W. (January 1987). "The effect of diets rich in and free from additives on the behavior of children with hyperkinetic and learning disorders" (PDF). Journal of the American Academy of Child and Adolescent Psychiatry. 26 (1): 53–55. doi:10.1097/00004583-198701000-00011. PMID 3584001.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  24. ^ Egger J, Carter CM, Graham PJ, Gumley D, Soothill JF (1985). "Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome". Lancet. 1 (8428): 540–5. doi:10.1016/S0140-6736(85)91206-1. PMID 2857900.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  25. ^ Kaplan BJ, McNicol J, Conte RA, Moghadam HK (1989). "Dietary replacement in preschool-aged hyperactive boys". Pediatrics. 83 (1): 7–17. PMID 2909977.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  26. ^ Egger J, Carter CH, Soothill JF, Wilson J. (1992). "Effect of diet treatment on enuresis in children with migraine or hyperkinetic behavior". Clinical Pediatrics. 31 (5): 302–7. doi:10.1177/000992289203100508. PMID 1582098.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  27. ^ Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ, Taylor E. (1993). "Effects of a few food diet in attention deficit disorder". Archives of Disease in Childhood. 69 (5): 564–8. doi:10.1136/adc.69.5.564. PMC 1029619. PMID 8257176.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ^ Schoenthaler SJ, Doraz WE, Wakefield JA. (1986). "The Impact of a Low Food Additive and Sucrose Diet on Academic Performance in 803 New York City Public Schools". International Journal of Biosocial Research. 8 (2): 185–195.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  29. ^ Schoenthaler SJ, Doraz WE, Wakefield J. (1986). "The Testing of Various Hypothesis as Explanations for the Gains in National Standardized Academic Test Scores in the 1978-1983 New York City Nutrition Policy Modification Project". The International Journal of Biosocial Research. 8 (2): 196–203.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  30. ^ Uhlig T, Merkenschlager A, Brandmaier R, Egger J. (1997). "Topographic mapping of brain electrical activity in children with food-induced attention deficit hyperkinetic disorder". European Journal of Pediatrics. 156 (7): 557–61. doi:10.1007/s004310050662. PMID 9243241.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. ^ Schmidt MH, Mocks P, Lay B, Eisert HG, Fojkar R, Fritz-Sigmund D, Marcus A, Musaeus B. (1997). "Does oligoantigenic diet influence hyperactive/conduct-disordered children--a controlled trial". European Child & Adolescent Psychiatry. 6 (2): 88–95. doi:10.1007/bf00566671. PMID 9257090.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  32. ^ Peter C, Bennett W, Brostoff J. (1997). "The Health of Criminals Related to Behaviour, Food, Allergy and Nutrition: A Controlled Study of 100 Persistent Young Offenders" (PDF). Journal of Nutritional & Environmental Medicine. 7 (4): 359–366. doi:10.1080/13590849762493.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  33. ^ Peter C, Bennett W, McEwen, LM, McEwen HC, ROSE, EL. (1997). "The Shipley project: Treating food allergy to prevent criminal behavior in community settings" (PDF). Journal of Nutritional & Environmental Medicine. 8 (1): 77–8. doi:10.1080/13590849862311.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  34. ^ Bateman B, Warner JO, Hutchinson E, Dean T, Rowlandson P, Gant C, Grundy J, Fitzgerald C, Stevenson J. (2004). "The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children". Archives of Disease in Childhood. 89 (6): 506–11. doi:10.1136/adc.2003.031435. PMC 1719942. PMID 15155391.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  35. ^ McCann D, Barrett A, Cooper A; et al. (November 2007). "Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial". Lancet. 370 (9598): 1560–7. doi:10.1016/S0140-6736(07)61306-3. PMID 17825405. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  36. ^ Swain AR, Dutton SP, Truswell AS (August 1985). "Salicylates in foods". Journal of the American Dietetic Association. 85 (8): 950–60. PMID 4019987.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  37. ^ "Food Intolerance Network" (PDF). Retrieved 2008-03-31.

Discussion

Using Quackwatch as a source

Quackwatch is used extensively as a source for this article. Quackwatch is a one man effort, run by an old man, a long-retired doctor, with an axe to grind (IMO), who is out of touch with modern medicine. For example, I had an argument by email with him years ago when he was still insisting that Chronic Fatigue Syndrome was a scam (I was a sufferer). It has since gained wide acceptance amongst doctors as a valid condition. So since when has it become allowable, or in any way sensible, to use low quality personal sites (essentially blogs) like Quackwatch as sources for medically-oriented articles? MLPainless (talk) 13:03, 8 December 2014 (UTC)[reply]

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