Talk:Feingold diet

"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. 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. 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. 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 cookies 1 mg dye in each 0% of 8 children (Note, 1 child was dropped from study when behavior deteriorated on challenge.) Levy 1978 5 cookies 1 mg dye in each 0% of 12 children. (Note, the testing was done the day AFTER the challenge.) Wilson 1989 17 mg 5% of 19 children Weiss 1980 35.26 mg 9% of 22 children (Note, the children in this study were not diagnosed with ADHD.) Williams 1978 26 mg 11% of 26 children Goyette 1978 (a) 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) 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 50 mg 25% of 8 children Rowe 1994 50 mg 64.7% of 34 children Boris 1994 100 mg or 5 g other provoking food 81% of 16 children Swanson 1980 100 & 150 mg 85% of 20 children Pollock 1989 125 mg 89.5% of 19 children Egger 1985 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, 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, or the additive used for the challenge may simply not be among those causing the original effect. 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. 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." 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." Nuttition Foundation studies ... In 1980, the Nutrition Foundation 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, 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. 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. Gross et al summer camp study ... An influential comparative diet study was conducted in 1987 by Gross et al. 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. 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%). 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. In 1997, an association between brain electrical activity and intake of provoking foods was shown in children with food-induced ADHD. (Picture) Another study showed that an oligoantigenic diet can work as well as Ritalin for conduct-disordered children. Other research demonstrated the positive effect of treating young criminals with dietary intervention and correction of mineral imbalances, 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. A 2007 British study at the University of Southampton 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, and has done other research based on the Feingold Diet. References

THIS PAGE HAS BEEN CHANGED -- BUT NOT IMPROVED

Somebody has made major and inappropriate changes to this page .... for starters, quoting the Kavale meta analysis from 1983 as evidence of ANYTHING ...... for heavens sake, 1983 is more than 30 years out of date!!!

I have not worked on this page for a long time, and my wikipedia skills may be rusty. Please give me any suggested guidelines for how to begin and whether I need to work with somebody within Wikipedia editing staff.

I should be ready to begin updating the page piece by piece in a week or so, but I don't want to start a war -- I want to do it right. Shulae (talk) 20:31, 27 April 2015 (UTC)

The age of a source only matters if there are newer, equally reliable sources that contradict that source due to newer evidence. Yobol (talk) 20:44, 27 April 2015 (UTC)

Indeed this is true. And yes indeed, there are MANY newer reviews and newer meta analyses. Besides, there really has been some research done on this subject in the past 30 years. I don't care if the Kavale review is gold-plated ... it is OLD and leaves out dozens and dozens of good studies. And even back then, not everybody agreed that Kavale had the last word. See Dr. Bernard Rimland's comment about it: GIGO or "Garbage In, Garbage Out" ... http://www.feingold.org/Research/rimland.html Personally, I prefer looking at the original studies and not reviews which can include the reviewer's bias. But if you want some reviews, there is a whole list of them (Kavale included) at http://www.feingold.org/Research/reviews.php -- this page was last updated 2012, so there are even more now.Shulae (talk) 12:20, 29 April 2015 (UTC)

In your introductory paragraph, your writer supports the contention that the Feingold Diet is "outmosed" with the 1983 Kavale & Forness review (30 years outdated) and the one-page Turka & Caplan 2011 "evidence for standards of care" which contains no more than an opinion, including the diet in a list of items they consider "outmoded" without any supporting evidence at all.

I have been reading the research on the connection of diet to various behavioral and physical symptoms for the past 30 years, and will shortly receive a masters in psychology. I am a volunteer with the Feingold Association, paid a small amount as their webmaster, for which I have been accused of bias "as an employee." I would not waste my time doing this if I did not find the research credible. I would like to know what I need to do in order to be considered an "expert" before I put in some hundreds of hours again editing the Feingold Diet page for Wikipedia.

I notice that Dr. Paul Offit has his very own page at https://en.wikipedia.org/wiki/Paul_Offit in which he is billed as an "expert on vaccines" and nobody seems to be complaining of bias in spite of the fact that he makes a huge income from promoting them. ```` — Preceding unsigned comment added by Shulae (talk • contribs) 11:06, 25 November 2015 (UTC)

The only "expertise" required here is in finding the best sources and reflecting them accurately in our articles according to the WP:PAGs. Alexbrn (talk) 11:50, 25 November 2015 (UTC)

Thank you for your clarification. I did not realize I must not modify or correct my own comment on a talk page.Shulae (talk) —Preceding undated comment added 16:59, 2 August 2016 (UTC)

Requesting to update the Feingold Diet page

On advice of one of the editors, I will try to present my reasons here to show that the old Kavale & Forness 1983 meta analysis is out of date and inappropriate as a major authority on the effectiveness of the Feingold Diet. Furthermore, I hope to show that the statement citing it -- "there is no good evidence that it (the Feingold Diet) is effective" -- is no longer valid.

However well done the Kavale & Forness analysis may have been in its day, and no matter how high the status of Kavale and Forness in the research community, they were reviewing 23 studies published four decades ago.

Since then, more than 300 newer studies on the subject have been published in MedLine, based on a search for "ADHD Diet." In addition to studies on children, there have been animal studies, immunological studies, epidemiological studies, and even in vitro studies testing neurites exposed to combinations of additives. There is ample new material on the connection of Feingold-type diets and behavior for more modern reviewers to review.
Below are three recent reviews:

(1) Research Review: The role of diet in the treatment of attention-deficit/hyperactivity disorder - an appraisal of the evidence on efficacy and recommendations on the design of future studies.

Stevenson J, Buitelaar J, Cortese S, Ferrin M, Konofal E, Lecendreux M, Simonoff E, Wong IC, & Sonuga-Barke E.

Journal of Child Psychology and Psychiatry, 2014 May;55(5):416-27. doi: 10.1111/jcpp.12215

• Stevenson said "no one meta-analysis can be considered definitive." (Page 419).
• In his review, he found that even when excluding two studies with very high effect sizes, the data "suggest that food colour elimination is a potentially valuable treatment approach for ADHD." (Page 423).
• He explained that studies of food dye elimination were sometimes part of a larger trial of the Feingold Diet, while oligoantigenic or restricted elimination diets (REDs) exclude not only all items excluded by Feingold but also several allergenic foods. In a meta analysis of REDs, Stevenson concluded that such a diet "may be beneficial for children with ADHD with a history of adverse reactions to food" (page 423). He commented that all the RED studies evaluated had positive effects, although he wished for larger, newer studies with more modern controls and incorporating recent changes in dietary habits.
• Note: The 1983 Kavale-Forness meta analysis was not even included in Stevenson's reference list.

(2) Restriction and Elimination Diets in ADHD Treatment

Nigg JT & Holton K. (See full text)

Child and Adolescent Psychiatric Clinics of North America 2014 Oct;23(4):937-53. doi: 10.1016/j.chc.2014.05.010

• Nigg referred to the old Kavale-Forness meta analysis (Page 3), as follows: "An initial meta-analysis … including 23 studies of varying quality regarding the efficacy of the Feingold diet; the authors concluded that the composite effect size (d = 0.11) was too small to be important, setting the tone for 2 decades of professional skepticism as to the value of elimination diets."
• On page 17, Nigg says that a "consensus has emerged among most reviewers that an elimination diet produces a small aggregate effect but may have greater benefit among some children."

(3) Diet in the treatment of ADHD in children - a systematic review of the literature

Heilskov Rytter MJ, Andersen LB, Houmann T, Bilenberg N, Hvolby A, Mølgaard C, Michaelsen KF, & Lauritzen L.

Nordic Journal of Psychiatry, 2015 Jan;69(1):1-18. doi: 10.3109/08039488.2014.921933

• After reviewing the usual studies, Heilskov-Rytter specified two large studies (McCann et al 2007 and Bateman et al 2004) which found that children from the general population (e.g., without a specific ADHD diagnosis) showed an increase in adhd-like behavior after ingesting food dyes and benzoates (a preservative). The effect "seemed linked to genetic polymorphisms in the metabolism of histamine." (page 5)
• Of the four meta-analyses considered - including Kavale & Forness (1983) - Heilskov-Rytter said that they "all conclude that artificial food colorants have small, but statistically significant adverse effects on ADHD symptoms in some children."

Another thing to consider is that far more food dyes are consumed today - 500% more, per person per day - than in 1950. See Vojdani 2013 and Stevens 2014. When the "average child" eats more than 60 mg food dyes per day (Stevens 2014a, page 3), the studies on children being "challenged" with 1 mg (Rose 1978), 5 mg (Levy 1978), 13 mg (Mattes 1978), 26 mg (Goyette 1978, Williams 1978), 27 mg (Harley 1978, Williams 1978) or 35 mg (Weiss 1980) of food dyes are no longer really relevant.

Taking the above into consideration, may I proceed to update the page? Shulae (talk) 05:19, 3 August 2016 (UTC)

A rather cherry-picked presentation there. So far as I can see from the totality of these (much better!) sources, none of them say the Feingold diet is effective in delivered its claims. The most I think we can take from this is that our statement of the current state of knowledge needs to be tweaked so that we say there is disagreement among the sources whether there is "no evidence to support broad claims that food coloring causes food intolerance and ADHD-like behavior in children" or whether there is some tentative evidence. Alexbrn (talk) 06:55, 3 August 2016 (UTC)

Cherry-picked? Perhaps this is a Wikipedia term I am not familiar with, but if I understand correctly, you are saying I have chosen only those reviews that support my own view while ignoring others. You could be right. So I went looking for them, and did a search of Pubmed for "ADHD Diet Review" and studied all those I could find published in the past several years (2013-2016). Below are all of them that I can find, and a relevant quote or summary from each:

Lachance 2015 - "Dietary patterns high in processed foods, or a “western dietary pattern”, are strongly correlated with an increased risk of developing depression, mild cognitive impairment, and ADHD."

Nigg 2014 - "The literature clearly demonstrates that a minority of children with ADHD will benefit from an elimination diet."

Heilskov Rytter 2015 - "Elimination diets and fish oil supplementation seem to be the most promising dietary interventions for a reduction in ADHD symptoms in children"

Stevenson 2014 - "Restricted elimination diets may be beneficial, but large-scale studies are needed on unselected children, using blind assessment and including assessment of long-term outcome. Artificial food colour elimination is a potentially valuable treatment but its effect size remains uncertain, as does the type of child for whom it is likely to be efficacious."

Verlaet 2014 - "Though results have been inconsistent, a meta-analysis of double-blind placebo-controlled trials concluded that there is evidence to support the theory that AFC (artificial food color) promote hyperactivity in hyperactive children" ... "a behavioral response to food often occurs in ADHD children"

Esparham 2014 - "RED (restricted elimination diet) has been shown to benefit children with ADHD."

De Thieje 2014 - "These findings suggest that ingested foods can affect behavior in a subset of children with ADHD through a mechanism that involves a non-IgE-mediated, cell-mediated, or non-allergic response."

Gray 2013 - Finally, one that doesn't support my opinion. Gray says salicylate elimination diets are harmful. He is referring to the most restrictive form of Feingold-type diet -- the Failsafe diet used in Australia. In his clinic, he saw only those who were not happy with the Failsafe diet. After all, those who were satisfied and benefitted didn't need him. This led to a very skewed population, several of whom actually had developed eating disorders.

Arnold 2013 - "In summary, food and additive sensitivity is not a major cause of diagnosable ADHD but may occasionally be a significant factor. Two weeks of a severely restricted diet should not be exceeded without obvious benefit."

Note: I agree -- when considering the oligoantigenic or few foods diet he is discussing. The much less restrictive Feingold diet itself, however, can be used life-long without any such limitation because it is a perfectly adequate diet -- the way people USED to eat before all the additives were incorporated into foods. Two studies fueled by concerns raised about the nutritional adequacy of the Feingold diet both concluded that children on the diet were not only meeting all nutritional daily requirements, but were doing it better than those on the "regular" diet.

Kaplan 2013 -- the abstract doesn't say anything about diet although it came up in the search for reviews on diet and adhd. I have not yet acquired the full text.

Akhondzadeh 2013 - Does not mention foods at all because he is concentrating on vitamin deficiencies and nutrients. Although not part of the Feingold diet, per se, the Feingold Association (FAUS) provides this sort of information to members as it becomes available.

Sonuga-Barke 2013 - In the Abstract, it says: "Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities" ... In the Results: "when the best probably blinded assessment was employed, effects remained significant for free fatty acid supplementation .. and artificial food color exclusion"

Note: It is true that those who think their child may be sensitive to foods are more likely to try the diet -- in which case one might say if you have an inkling that your child is sensitive, then try it. So? (BTW, I had no idea whatsoever that my child was sensitive; I only tried the diet for him because all else had already failed.)

Goodman 2013 - "Artificial food colour exclusion, and to a lesser extent free fatty acid supplementation, significantly reduce symptom severity in ADHD, although the clinical significance of these results has not been determined."

Zell 2012 - This review came up on the search but appears to be about supplements, not diet. Full text not acquired yet.

Pulgaron 2013 - This review came up on the search but appears to be about obesity. Full text not acquired yet.

Ghanizadeh 2013 - This review is about zinc deficiency. FAUS routinely advises members about such research. Ward (1990) found that when kids with ADHD were exposed to yellow dyes they lost zinc -- and he was using only a HALF a mg -- so some deficiency may be normalized simply by avoiding the colorings, although in many cases a supplement of zinc is helpful, especially at the start. FAUS suggests members concerned about zinc should first ask their doctor how much is safe to use.

FDA - In preparation for its 2011 hearing on food dyes, the FDA certainly appeared to do its best to skew the evidence by accepting without question any study that found no effect of food dyes on children's behavior while picking holes in any study that did find such an effect. After all their effort, however, they couldn't quite make it go away. In their Background document (2011), they wrote: "For certain susceptible children with Attention Deficit/Hyperactivity Disorder and other problem behaviors, however, the data suggest that their condition may be exacerbated by exposure to a number of substances in food, including, but not limited to, synthetic color additives"

As you wrote, the food dyes are only part of the "Feingold Diet." But this is research - one piece of the puzzle may be studied at a time. If you want to get very picky about such things, you will come to the conclusion (and some have) that no study of the actual Feingold Diet as it is used today has ever been done. But that's not very helpful, so let's live with what we have.

Yes, there are a few older reviews that say there has been no research supporting diet for ADHD, but they each were older than 2013, and seemed to discuss only the old studies from the 1970s and 1980s while ignoring all the newer ones. Unfortunately, not all the newer studies are so great either. You have the Ward study in 1990, for example, which found that children with ADHD lost zinc (and had increased symptoms) when exposed to Yellow 5 and Yellow 6. Ward's study has been criticized because his results, while statistically significant, were not very dramatic ... but take another look. He used one HALF a mg of the coloring in his "challenge" study. I am surprised he got any measurable result at all. What would have happened if he had used 50 mg instead of .05 mg? Nobody has ever tried it, although the Rowe & Rowe 1994 study did identify a dose response in children exposed to a range of Yellow 5 challenges from 1 mg to 50 mg. As you know, when you have a dose response, that is a pretty good indication that you are looking at something real. Now Rowe, of course, has been criticized because he used symptoms such as irritability and sleep problems rather than just the core ADHD symptoms .... yep. So what? Show me a kid with an ADHD diagnosis and ask his mom if he is irritable and has trouble falling asleep; she will say yes, which is why Rowe added those symptoms to his questionnaire. Not to mention that if diet can cure even just those symptoms in your kid, wouldn't that be worth it?

In light of all the above, it would not be correct to say that there is only tentative evidence that food additives can affect ADHD. In fact, there is now general acceptance that the food dyes affect behavior. Salicylates and preservatives have yet to be studied; each has had only one or two studies devoted to it over all these decades. Not whether, but how big a piece of the ADHD puzzle this diet will prove to be is the question now; with the expansion of studies on environmental toxins, neonatal and perinatal exposures, vitamin/mineral deficiencies, hormonal variations, genetic deviations, and interactions of all of the above, there is much room for more research. However, if you wait until all the chips have fallen, today's babies will be grown up already. A parent looking for help can benefit from knowing that a diet such as Feingold is not harmful and that it can be a place to begin the journey to find help for their child. Use of the diet does not prevent other needed treatments, including the use of meds, if still needed. Shulae (talk) 03:02, 5 August 2016 (UTC)

You obviously have a strong opinion, but it seems out-of-step with the science wrt Feingold. Much of what you write might be better discussed at our Diet and attention deficit hyperactivity disorder article, but this article is about the Feingold diet, and we need sources on that. So far as I can see it was an elimination diet with some whacky ideas that came and went and has now fallen into obscurity source-wise. Any current debate on the topic of diet and ADHD doesn't frame it in terms of the Feingold diet but mentions it - at most - in passing. Alexbrn (talk) 05:22, 5 August 2016 (UTC)

This is rather like saying that research on cholesterol has nothing to do with heart disease treatment. Okay. Forget the "reviews" ... I challenge you to a duel of studies. Suggest any study you believe disproves the Feingold diet. Such a duel only works if we both have the full text - I have most of them, and will be happy to provide you with the one you want if I have it. I assume you will do the same. Since, as you say, there are really no modern studies of the diet as a whole, you will have to go back and look at the old ones, but you seem quite knowledgeable, so go ahead.

If you don't want to do that, then pray take a look at a modern study not yet included in any of the reviews, so by Wikipedia rules it can't be mentioned in Wikipedia, I guess. Eagle (2014) studied the effect of artificial food colors and salicylate-containing foods (the basic Feingold diet, whether he used the name or not). Both affect an enzyme variously named PST (Phenol SulfoTransferase-P) or SULT1A. He not only describes the process of enzyme inhibition, but also the "U" shaped effect that explains for the first time why some kids actually get worse for a few weeks on the diet before they get better. It also explains, he says, some of the studies that showed little effects from their "active" challenges - because the placebo vehicle used contained the same kind of chemicals as the experimental item. The study I have is under password protection and not open to the public, but I can send it to you via email. It is published in the peer reviewed journal Physiology & Behavior and is indexed in MedLine.Shulae (talk) 16:47, 5 August 2016 (UTC)

Not interested in a duel, sorry. It seems sources (even ones concerned with additives and ADHD) have left the "Feingold diet" to history, and it would be WP:SYNTH for us to connect any dots we think there might be. Simply put, we just reflect what good sources say about the Feingold diet. As I say, some of the recent work on additives may be useful for informing our Diet and attention deficit hyperactivity disorder article. Alexbrn (talk) 16:53, 5 August 2016 (UTC)

Actually, not. If you look again, you will see that Dr. Feingold himself recommended studying the food dyes first .... not because they were more important, but he figured that it would be easier to study 7 dyes than thousands of flavorings or dozens of salicylates. There have been very few "diet" studies since they are expensive ... and those studies were of varying quality. And very old. Then there were the many studies in which children were put on an additive-free diet (a Feingold-type diet, in full or in part) followed by a challenge of one or more food dyes for those who responded to the diet. Those are the studies Kavale & Forness reviewed. Today's studies on food dyes are done exactly the same way, whether they say the name "Feingold" or not. One reason many do not use the "F" name may well be the campaign mounted by the food additive industry to make "Feingold" practically a dirty word. This was done in a way similar to that mounted by Big Tobacco against the "wacky notion" that smoking could cause lung cancer.

Obviously, I have been wasting my time since instead of any kind of compromise suggestion you have resorted to name-calling. You have stated that the Feingold Association (teaching the diet since 1976) should be "shunned." That Dr. Feingold (Chief of Allergy of Kaiser Permanente, not just some fly-by-night quack) had "wacky ideas." If I show you new reviews, then I am "cherry picking." Something from 1983 is "ending the debate" while conclusions by others in 1999, 2010, etc. are "too old." There was more, but these come to mind as being certainly way beyond the pale of a NPOV. Shulae (talk) 20:02, 5 August 2016 (UTC)

Sorry, but I have to agree that it is original research to further a WP:POV if we have to assume sources are related to the Feingold diet in some manner. --Ronz (talk) 20:53, 5 August 2016 (UTC)

Hi Ronz, I am glad to see a new name on here, but can you clarify what you wrote? How could a study on food dyes and behavior not be related to the Feingold diet? From the beginning, food dyes alone were the usual challenges, no matter what else was eliminated (or not) before challenge. Shulae (talk) 20:57, 6 August 2016 (UTC)

Assuming they are related is original research. We might be able to avoid OR if Feingold had made a list of all the dyes he studied, and then later studies were done on all those specific dyes. --Ronz (talk) 17:44, 8 August 2016 (UTC)

Ronz, all the certified (FD&C and D&C) dyes were eliminated by Dr. Feingold. He specified all of them - therefore, a study on any of them is relevant. He himself didn't do any dye-related research; he was a clinician interested in patients. He called for researchers and biochemists to do the research and predicted it would take 30 years.

Therefore, any study on food dye and behavior ... or flavorings and behavior ... or BHT and behavior ... would be relevant because they are components of the Feingold diet used for behavior.

A study on food dye and cancer, on the other hand, would not be related to the Feingold Diet because the Feingold Diet is not concerned with treatment or prevention of cancer.

It is true that more and better studies are needed, but that doesn't mean those already done are not relevant. Shulae (talk) 01:15, 9 August 2016 (UTC)

And even then it would be difficult, I think, since AIUI the Feingold diet also stipulated things about family behaviour and perfume-wearing, e.g. Alexbrn (talk) 17:46, 8 August 2016 (UTC)

He specified all of them - therefore, a study on any of them is relevant. Then it's OR. --Ronz (talk) 17:50, 9 August 2016 (UTC)

Alexbrn, no change in "family behavior" is now, or ever was, required in order to properly do the Feingold diet. I know Barrett at Quackwatch says so, but he is simply making that up.

Nothing is wrong with perfume, either -- if it is natural and not a petrochemical. FAUS helps parents find natural products, including perfumes. But what does any of this have to do with the research?Shulae (talk) 01:15, 9 August 2016 (UTC)

• Third opinion request: A request was filed for a third opinion on this dispute. Since there are already three participants, the 3O process does not really apply. I will say in passing, though, that the reliability of a reference is quite different from its relevance, and that it is not our job to extrapolate from the findings of a scientific study (unlike in academia, where such extrapolation would be quite acceptable). Whether or not these particular studies are relevant, I will leave it to you folks to determine. Vanamonde (talk) 12:52, 6 August 2016 (UTC)

Compromise?

Would you accept this as a second paragraph for this page? (citations to be added properly of course)

Although popular with parents, much of the research on the Feingold diet has been disappointing. The scientific panel convened by the National Institutes of Health in 1982 reviewed all of the research then available and concluded that "these controlled challenge studies do not appear to have addressed adequately the role of diet in hyperactivity." [NIH pg. 163] Even today, although the scientific consensus is that the eliminated food dyes do affect behavior [Nigg 2014, Stevenson 2014], research on salicylates and preservatives is still lacking. Shulae (talk) 01:25, 9 August 2016 (UTC)

WP:LEDEs are meant to summarize what is discussed in more detail in the article body, so getting body content would be a first step. But we'd need sources relating the research to the Feingold Diet. Alexbrn (talk) 02:30, 9 August 2016 (UTC)

Do you mean I should edit the body of the article first? Be happy to. As for relating the sources TO the Feingold Diet, please clarify. Shulae (talk) 03:29, 9 August 2016 (UTC)

Yes, I mean that is what would need to happen. However, I'm still not convinced: I mean text we insert needs to be backed firmly by a source and not imply things about the diet that cannot be found in good sources. Alexbrn (talk) 06:34, 9 August 2016 (UTC)

I agree that good sources must always be used to back up statements. As I understand it, a "good source" is considered one published in a peer reviewed journal. Not all, however, are equally good. Am I allowed to comment on a source? I don't mean an opinion, but pointing out something factual, like whether their numbers add up correctly? Shulae (talk) 16:06, 9 August 2016 (UTC)

Of course (on Talk anyway). Alexbrn (talk) 16:08, 9 August 2016 (UTC)

Page edits

Under "History" - I have clarified Dr. Feingold's actual professional history, since he was far more than "just" a pediatrician/allergist. I can cite his biography page in Wikipedia or the Feingold Association's biographical page at http://feingold.org/about-the-program/dr-feingold/bio/, but if you prefer a history book, I will get the citation. I am writing while on a trip across country, and I didn't bring all those books with me.

Also, I might as well ask in advance: Is it okay to quote from his own books or papers to describe the original Feingold Program, or do I have to quote only what somebody else said about it? In a similar vein, may I quote the Feingold Program Handbook if describing some detail of the actual Program? Shulae (talk) 07:09, 12 August 2016 (UTC)

Question re procedure: I noticed that the citation of the National Health Museum (Footnote #10) just goes to the website http://www.accessexcellence.org/HHQ/qow/qow05/qow051031.html and one would be on their own to find the information referred to. The information is correct, but is such a general source considered sufficient or should I actually find some better or more specific citation for the statement? Shulae (talk) 07:20, 12 August 2016 (UTC)

WP:PSTS. Primary sources can be used, but with care since articles should be based on secondary sources. This is usually decided case-by-case but I'd say any quotation from a primary source must be unexceptional and hung off something in a secondary source to establish that it's WP:DUE. Alexbrn (talk) 07:33, 12 August 2016 (UTC)

Barrett citation

There is a notation "Check date values in: |access-date= (help)" in the Quackwatch (Barrett) citation in reference #3. I have looked at the cited page and the date (2004) is correct. The page on Quackwatch has not been updated since then. IMO there are a lot of problems with that document, but the date is not one of them, so I will fix the problem with the citation date if somebody can explain the question. Thanks. Shulae (talk) 01:56, 16 August 2016 (UTC)

Alexbrn, please explain what your comment in your revision means: Re-accurify to source

I am unfamiliar with the word "re-accurify" and it is not in my dictionary.

Do you feel that what the parents did to help each other with this "difficult" diet is not a bona fide part of a section called "Reception?" Or was there something wrong with my presentation of that information? Shulae (talk) 05:40, 16 August 2016 (UTC)

Where is the stuff about the Seventies sourced? Alexbrn (talk) 05:43, 16 August 2016 (UTC)

I'm sorry -- which stuff are you asking about? If you mean about how hard the diet is, that information was there before. The source listed is Barrett of Quackwatch which in my opinion is an awful source which I would never use for anything, but I didn't want to delete it since it has been on there for years. I can find other sources for you if you like. Or if you mean the development of support groups in the 1970s ... well the Feingold Association was incorporated in 1976 as an umbrella for all the little "kitchen-table" support groups. If the history on the Feingold website is not okay as a source, I can find others. Smith talks about it in his history book. It is mentioned in various other places, and I actually have the IRS letter granting FAUS exemption from Federal income tax. This is history, not my personal opinion. Possibly it belongs under the History heading rather than under here. I await your explanation of what you need. Shulae (talk) 06:32, 16 August 2016 (UTC)

We can't relate the development of the food industry to the FD unless we have sources that explicitly do so. Do we? Alexbrn (talk) 06:45, 16 August 2016 (UTC)

The section claims that the diet is too hard because there are few foods without additives available resulting in a narrow selection of foods etc. It is written in the present tense, indicating it is a claim true today. Certainly, Barrett has no current source whatsoever to support his assertion of this being true today. In fact, he never did have any real source beyond quoting someone else's opinion. And surely that paragraph looks ludicrous to anyone who knows that they can walk into a Walmart and buy organic ketchup (no additives or corn syrup) to go with their Hormel Natural Choice deli meat or all natural hot dogs ... or that they can get a Foodlist at the Feingold website which has thousands and thousands of brand name processed acceptable additive-free foods. That Foodlist, by the way, would be a perfect source showing the change in foods related to the Feingold diet... in particular because the Foodlist has grown from 2 pages in the early 1980s to over 400 pages now. Would that be an acceptable document as a source? Or, how about just taking out that whole paragraph and leave the second paragraph only? Shulae (talk) 07:16, 16 August 2016 (UTC)

If a source doesn't mention the the Feingold diet, it's hard to see a legitimate use for it. If tense is a problem, change the tense. Alexbrn (talk) 07:30, 16 August 2016 (UTC)

My question is: Can I use the Feingold Foodlist expansion from 2 pages to 400+ pages as an indication that more additive-free processed foods are available today for families wishing to use the Feingold Diet? This was not covered in any reviews or studies, but I do have the actual physical books. It's simply a fact. What you would call original research. I have done a search of Matthew Smith's history of the Feingold Diet (gotta love Kindle books) and indeed a search for "supermarkets" brings up the information that after the Southampton studies showed that kids were more hyper after eating food dyes, the food industry began changing their products ... to remove the additives, in particular the food dyes ... because people didn't want them. This is a history book, and the whole book is about the Feingold Diet, the history, the research, etc. -- is that enough of a connection for you? I cannot give you a page number because it is a Kindle, but I can copy the section if you need to see it. Shulae (talk) 07:53, 16 August 2016 (UTC)

Looks a useful source, so long as any of Smith's arguments are attributed to him. That would probably be the best way of presenting it. Alexbrn (talk) 08:26, 16 August 2016 (UTC)

Thanks. Shulae (talk) 23:14, 16 August 2016 (UTC)

How about chapter # and a brief, relevant quote for verification?

I modified it slightly, making some assumptions about the source and trying to be more precise and encyclopedic. --Ronz (talk) 16:54, 17 August 2016 (UTC)

Will be out this afternoon -- will do as soon as am backShulae (talk) 20:27, 17 August 2016 (UTC)

I am assuming that you meant the Smith book, not the Barrett document. The following is the section about additive-free food being increasingly available in supermarkets. Although the book was published in 2011, if you live in the US, you have surely noticed that by now almost every supermarket has either a "health food" section of its own or has incorporated many additive-free and/or organic options in its offerings. I hope this is the info you wanted.

Chapter 9, Conclusion.

In addition, many large companies in the British food industry decided to preempt legislative action and changed the production and packaging of their products to accord with nutrition concerns. . . . Marks and Spencer, for example, removed 99 percent of the artificial colors and flavors found in their foods, and other supermarkets followed suit.(40) . . . Other food manufacturers and supermarkets, often responding to pressure from parents, began to use natural dyes such as beetroot instead of those made from petrochemicals and emphasized on the packaging of certain products that they were free of artificial additives. (42) . . . a number of organic supermarkets, such as Trader Joes and Whole Foods Market, have become more visible in the United States, providing American consumers with additive-free products. Many of the Feingold families reported relying almost exclusively on these supermarkets for their groceries...(43)

Matthew Smith. An Alternative History of Hyperactivity (Critical Issues in Health and Medicine) (Kindle Locations 2305-2314).

Much appreciated. The corresponding article content seems a bit too much OR, even after my changes. --Ronz (talk) 17:04, 18 August 2016 (UTC)

I am a little confused. by "corresponding article" do you mean the history book excerpt above? Or do you mean the Feingold Diet page? If so, which part are you referring to as too OR? Perhaps I can fix it. Shulae (talk) 23:20, 18 August 2016 (UTC)

The corresponding content in this article seems to require original research with just this source as verification. --Ronz (talk) 17:50, 19 August 2016 (UTC)

Perhaps I am being dense ... but is this a problem? All reviews require original research - that is what they review, isn't it? That doesn't mean that they all come to the same conclusion. Unfortunately, some of these reviewers have ties to the food industry, and so do some of the original researchers. For example, when the Nutrition Foundation funded Harley back in 1970s to do a study of 10 preschoolers using the Feingold and a "control" diet, 100% of the kids did better on the Feingold diet by parent reports --- yet he managed to report that there was no support for the Feingold diet because there weren't any teachers involved (didn't he know they were PRE-schoolers when he started?).

Ah - maybe what you mean is that I need more than one supportive review? How many reviews would even talk about supermarkets related to the Feingold diet? There are no studies on "availability of foods to use." But I will see what I can find. Shulae (talk) 13:23, 20 August 2016 (UTC)

All reviews require original research What are you referring to re "reviews"? --Ronz (talk) 15:47, 20 August 2016 (UTC)

There are critical reviews, meta analyses, and various other kinds of reviews of the science. There are also textbooks and history books. What they are all discussing is original research (except that some meta analyses actual review a collection of other reviews). The reviews can come to different conclusions based on the research they choose to include (Millichap & Yee, for example, left out almost all studies done after 1990 even though they wrote their review in 2012). The result is that no review is itself without a POV ... but some have better scientific support than others. I can't understand why you have this question - surely you know what a review is?Shulae (talk) 18:03, 20 August 2016 (UTC)

Kanarek

Although the Kanarek review is quite good overall as a review, the actual two sentences that are using it as a citation are Kanarek's own opinion and not really part of his review. For example, he is quoted as saying "More recent versions of the diet eliminate only artificial food additives and/or dyes." Indeed, he does say that. But he cites no source, and no study exists that mentions such a thing. It is his own opinion -- and it is wrong. There are no "versions" of the Feingold Diet. There are (and always were) two stages of the diet; in the second stage tolerance to salicylates is explored. There are other diets, of course ... Failsafe, Paleo, gfcf, etc., but they are not the Feingold Diet. I am not saying that there are no people out there who eliminated Red 40 and claimed they had tried the Feingold Diet .... but that is like eliminating only potato chips and saying you are on Weight Watchers. The Feingold Diet has changed very little over the years, and such changes involved adding more items to eliminate, not dropping them. So although Kanarek is certainly a fine resource in general, what do I do about the sentence? Doesn't the author inserting his own opinion make it OR? Can I just remove it or correct it using another resource? Shulae (talk) 23:20, 18 August 2016 (UTC)

I'd rather stick to the sources to avoid OR and POV problems. --Ronz (talk) 17:56, 19 August 2016 (UTC)

I thought about it some more and removed the sentence about "modern versions" by Kanarek. Not only is it his own POV, but in any case such "versions" of the diet are not the Feingold Diet. Sure, people make up their own diets using bits and pieces of this and that ... and some may think they are doing Feingold ... but I don't want to sanction the practice by naming it a "modern version." There is simply no such thing. The only "Feingold Diet" is the one taught by the Feingold Association. Other groups may eliminate dyes or other additives, but they are not Feingold -- it is a registered name.Shulae (talk) 13:51, 20 August 2016 (UTC)

We should report what the source says: it's a good one. Quite a lot of our article is about how the diet has changed so it seems there are different "versions" of it as a result. Alexbrn (talk) 14:01, 20 August 2016 (UTC)

Quite a lot of our article is about how the diet has changed Which brings up a number of red flags: WP:SOAP/POV and No true Scotsman arguments in sources and from editors. --Ronz (talk) 15:50, 20 August 2016 (UTC)

I do not see this. The article describes

(1) The Technique. This section was done sloppily, and so I have been making corrections. There have essentially been no changes in the diet and there is only one "version" which is why that sentence should be removed.

(2) Effectiveness. This section may need corrections but they are not involving any changes in the diet itself.

(3) Reception. This section complained that the diet was hard - the only "change" discussed here is the change in the general food supply, making the diet easier to do, not any change in the diet itself.

(4)History. History obviously has progressed over a half century. This discusses what happened, not involving any dietary changes.

Well, you said "Quite a lot of our article is about how the diet has changed" .... where is it? The DIET simply hasn't changed except to address changes in the food supply to determine whether specific things should be excluded or included. Shulae (talk) 17:42, 20 August 2016 (UTC)

If the food list keeps getting revised surely there are new versions all the time. This seems to be how independent commentators see it. Alexbrn (talk) 17:49, 20 August 2016 (UTC)

Let me explain.

--> When a company fills out a form for the Feingold Association, and their candy (or whatever product) meets the requirements of the Product Information Center (PIC) of the Feingold Association, that product is included -- first in the monthly newsletter and then in the next printing of the Foodlist.

--> When a product's ingredients are changed by its manufacturer and now includes a prohibited additive, a PIC Alert is sent to members, and that product is removed from the next printing of the Foodlist.

In neither case does this create a new VERSION of the diet. It simply gives the members updated information about which products meet the (same) requirements to be listed.Shulae (talk) 18:12, 20 August 2016 (UTC)

One more thing. About insisting that there are other versions, and Kanarek's statement about "recent versions." This is getting into territory that is likely illegal. It borders on trademark infringement. The "Feingold" name is registered. NO OTHER DIET can call itself the Feingold Diet. There is NO OTHER VERSION of this diet except the one that the Feingold Association provides. Just because Kanarek said it and somebody quoted it doesn't make it right for this encyclopedic article. The Feingold Association does NOT provide any "version" of the diet ignoring salicylates ... although they recognize there will always be people who try it that way. If there is any official diet avoiding additives and allowing all salicylates, it better be called something else -- not "FEINGOLD" -- and it is not appropriate for this article. Please remove Kanarek's sentence again. Shulae (talk) 18:22, 20 August 2016 (UTC)

Editing Technique section

The corrections I have made so far are to bring the text in line with Barrett's actual document, so I haven't changed the citation. As he said, the original diet only eliminated the 3 items; the others were added later as it developed. TBHQ was eliminated later on, as it didn't exist in the 1970s (will get to all that tomorrow so please don't revert this)Shulae (talk) 00:28, 17 August 2016 (UTC)