Dr. Ben Feingold, a pediatrician and allergist working for Kaiser Permanente in San Francisco, noticed some of his patients with aspirin sensitivity also reacted to certain food additives. When these and natural sources of chemicals were eliminated, surprising behavior improvements occurred. Feingold started treating hyperactive children with an elimination diet, which came to be known as the Feingold diet. At first, about half of the children with attention deficit hyperactivity disorder in Feingold's care responded to dietary changes. Over time, the diet has evolved, and the Feingold Association claims a much higher success rate.
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Artificial Colors, Flavorings and Preservatives
Petroleum-based synthetic food colorings, artificial flavors and preservatives, such as BHA, BHT and TBHQ, are not allowed on the Feingold diet. Other food additives that children may be sensitive to include MSG, sodium benzoate, nitrites and sulfites. Food labels can be misleading; the Feingold association publishes a food list and updates it monthly to help parents with shopping. A review of studies published in the October 2009 "Prescrire International" reports 15 double-blind clinical studies of children with ADHD showed increased hyperactivity associated with ingestion of food coloring. In addition, a placebo-controlled study of 297 children in the general population showed higher scores of hyperactive behavior after consumption of artificially colored drinks.
The widespread belief that sugar causes hyperactivity is not supported by data from Feingold's practice, but many sugary treats contain artificial colors. The Feingold diet allows sugar and stevia, but eliminates artificial sweeteners such as aspartame, sucralose, saccharine and neotame. B. Christian and colleagues at East Carolina University put aspartame in the drinking water of rats. After three to four months, the rats could not remember how to find a reward in a T-maze they had previously mastered. In this study, long-term aspartame consumption altered receptor cells and enzymes in the brain. The results were published in the May 2004 issue of "Pharmacology, Biochemistry and Behavior."
Foods that Contain Salicylates
Aspirin and food additives contain salicylates, which also occur naturally in fruits and vegetables. Salicylates may be elevated in produce that is picked early and shipped long distances and in concentrated foods such as tomato sauce, ketchup or fruit juices. Foods high in salicylates include almonds, apples, apricots, avocados, berries, broccoli, cherries, citrus fruits, cloves, coffee, cucumbers, dried fruits, grapes, kiwis, nectarines, olive oil, peaches, peppers, pickles, pineapple, plums, prunes, raisins, rose hips, strawberries, tea and tomatoes. Sue Dengate, author of "Fed Up," reminds parents the effects of natural salicylates are dose-dependent. If food additives have been eliminated, the child may be able to enjoy a piece of fruit without triggering behavior problems. Healthy foods may be gradually added back into the diet while monitoring effects. Dengate states larger bodies react less to natural salicylates, therefore children often outgrow food intolerances.