Some of the Research
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A sensible guide to a
risk-benefit analysis:
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= Double blind controlled study
The following excerpts are in alphabetical order by first author.
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A sensible guide to a
risk-benefit analysis:
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"... an elimination diet is effective in most cases. ... If they have had help with finding alternative foods, most parents find it surprisingly easy to keep the child to the diet most of the time after the first few weeks because the child usually prefers to feel well. ... If the diet is effective, behaviour often reverts to normal, to the great relief of all concerned. In view of the potential toxicity of medication in children and its limited effectiveness, all families with hyperactive children should be offered help in detecting offending foods. It is more appropriate to reserve medication for those who fail. "Full Text || Get Password || Comment on article by Hill 1998 (Full Text) ||
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The food dye erythrosine (Erythrosin B; FD&C No. 3) was applied to isolated neuromuscular synapses in the frog ... At concentrations of 10 muM or greater this anionic dye produced an irreversible, dose-dependent increase in neurotransmitter release.... These results suggest that erythrosine might prove a useful pharmacological tool for studying the process of transmitter release, but that its use as a food additive should be reexamined.
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20 children who responded to the Feingold diet, and 14 who did not were tested for copper and zinc levels in their blood. There was a significantly higher level of copper in the children who did respond to the diet. Possible reasons are discussed.
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Red #3 at concentrations of 10 micrograms or more, produced time and dose dependent increases in transmitter release from presynaptic nerve terminals and swollen mitochondria.
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. . . These results indicate that Erythrosin B is not acting solely by altering the ionic permeability of the presynaptic nerve terminal to calcium, magnesium, or sodium ions, or by altering the calcium metabolism of the terminal. The enhanced effect of the dye in calcium-free saline suggests that it may be competing with calcium at a common site, while the enhancement of its effect in elevated external calcium suggests that the dye may also increase the permeability of the nerve terminal to calcium ions.
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"AIMS: To determine whether artificial food colourings and a preservative in the diet of 3 year old children in the general population influence hyperactive behaviour. . . .RESULTS: There were significant reductions in hyperactive behaviour during the withdrawal phase. Furthermore, there were significantly greater increases in hyperactive behaviour during the active than the placebo period based on parental reports. . . .CONCLUSIONS: There is a general adverse effect of artificial food colouring and benzoate preservatives on the behaviour of 3 year old children . . . "
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This questionnaire-based research addressed the young offender population in order to estimate the proportion likely to have food allergic and other nutritionally related disorders such as hyperactivity. A controlled health and dietary survey was conducted with 100 young offenders and 100 matched non-offenders. The offender group reported significantly higher rates of ill health than the non-offender group. It is suggested that the nutritional health of young offenders could be investigated as part of present statutory requirements to consider the physical and mental health of young criminals. There was no real difference between the diets of the two groups. Further research is justified into the association between nutrition, health and behaviour problems. From this study, the proportion of the persistent young offender population with maladaptive behaviours linked to food allergy, food intolerance and nutritional problems is cautiously estimated to be 75% whereas 18% of the young non-offender population is similarly affected."
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Nine children with persistent anti-social, disruptive and/or criminal behaviours were assessed and treated for food intolerance and allergy. All were found to have a number of food allergies or intolerances and mineral imbalances, particularly in zinc. Three showed marginally raised cadmium while one had considerably raised cadmium. . . .The health and behaviour of all nine subjects improved both physically and psychologically. However, three children abandoned the dietary regime, two of whom re-offended and were placed in care while the third moved home and accepted enzyme-potentiated desensitization (EPD) treatment. He and the other six continued to improve in health, behaviour and school performance over 6 months. . . After 2 years, five of the nine had not re-offended. The feasibility of applying nutritional and biochemical assessment and treatment in the community to divert young offenders and disruptive schoolchildren from criminal behaviour was demonstrated. Criminal justice, education and health agencies could incorporate and develop this approach in furtherance of their statutory objectives. "
73% of 26 children with ADHD responded favorably to a diet eliminating reactive foods and artificial colors. 16 of the improved children were given a double blind challenge with 100 mg of mixed food dyes or a food chosen by the parent. ALL of them reacted to the challenge. Placebo effect was ruled out, as the children were as good on placebo days as at baseline (on the diet). "This study demonstrated a beneficial effect of eliminating reactive foods and artificial colors in children with ADHD. Dietary factors may play a significant role in the etiology of the majority of children with ADHD."
"... the startling
changes seen in patients who had been followed for years with other forms of therapy suggest strongly that this
improvement was genuine. "
Abstract [not included on MedLine]: "The Feingold hypothesis associating the hyperkinetic syndrome with ingestion of common food additives, artificial colors and flavors, and salicylate-containing foods has evoked considerable controversy. Since many children ingest these ubiquitous additives, and no differences in dietary habits have been noted between hyperkinetic and nonhyperkinetic children, it is possible that a biochemical difference may be present in children who appear to be affected by the additives."
A single subject ABAB design design was employed to determine the effectiveness of the Feingold Kaiser Permanente (K-P) diet in the treatment of a 6-year-old hyperkinetic male hypothesized to be diet-responsive. Secondary aims were to assess both the nutritional adequacy of the diet and the problems involved in implementing it. Diet effectiveness was measured by classroomobservations of attending-to-task, out-of-seat, and movement behaviors; and by teacher and foster-mother reports. It was concluded that the K-P diet was effective in controlling the subject's hyperkinesis. The diet was also shown to be nutritionally adequate and moderately difficult to implement.
59 of 78 children (75.6%) referred for "hyperactive
behavior" improved on an open trial of an elimination diet. 19
of them were studied in a placebo-controlled double-blind challenge protocol.
"A double-blind crossover trial involving a control diet and a diet eliminating artificial flavors, colors, and natural salicylates
as recommended by Feingold was conducted on 15 hyperkinetic children. ...Both parents and teachers reported fewer hyperkinetic
symptoms on the K-P diet as compared to the pretreatment baseline. ..."
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... Following Feingold's dietary prescription, an elimination diet relevant to the foods available in Sydney was developed. The treatment regime is described, and the results of its application to 15 hyperkinetic children are presented. The parents of 10 children are "quite certain" and those of three others "fairly certain" that their children's behaviour not only improved substantially with the diet, but also relapsed promptly when significant dietary infringements occurred. A possible ecological implication of these findings is briefly discussed.
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" OBJECTIVES: The purpose of this study was to concisely review the available literature of nutritional and environmental factors on autistic spectrum and attention deficit hyperactivity disorder (ADHD). DESIGN AND METHODS: Review of journal articles found on the PubMed database and from information from several conference proceedings. RESULTS: Many, but not all, studies link exposure to toxins such as mercury, lead, pesticides, and in utero smoking exposure to higher levels of autism and/or ADHD . . . CONCLUSIONS: Autistic spectrum disorders and ADHD are complicated conditions in which nutritional and environmental factors play major roles. Larger studies are needed to determine optimum multifactorial treatment plans involving nutrition, environmental control,medication, and behavioral/education/speech/physical therapies. "
" Double blind challenges with tartrazine and benzoic acid were performed in hospital in 24 children .. Twenty two patients returned to a normal diet without problems, but the parents of two children insisted on continuing the diet. While popular belief has it that additives may have harmful behavioural effects, objective verification is required to prevent overdiagnosis. "Note: David used a large dose of coloring -- 250 mg. However, he solicited children whose parents had come to him for help with their efforts at implementing a diet for their children; he treated the parents like neurotics, judging by the tone of the article. The challenges were administered to children in the throes of reaction; furthermore, they were not evaluated by any sort of testing or questionnaire, but by asking busy nurses in the ward to "observe" them. This study is included for your information, but should not be considered a valid test of either the Feingold diet or food dyes.
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Note: See Ward studies re children with ADHD who are exposed to synthetic food coloring lose zinc.
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Note: This is EPD, in use in England for 30 years. The FDA, responding to a ruling by the Medical Board of California, prevented new patients from being accepted under the then-existing national IRB treatment program. EPD is now effectively illegal in the U.S. See more information.
See also a similar article in News for the Practitioner.
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...Twenty-seven children, whose behaviour improved significantly on the Royal Prince Alfred Hospital diet, which excludes food additives, natural salicylates, amines and glutamates, were challenged with calcium propionate (preservative code 282) or placebo through daily bread in a double-blind placebo-controlled crossover trial. ... CONCLUSIONS: Irritability, restlessness, inattention and sleep disturbance in some children may be caused by a preservative in healthy foods consumed daily. Minimizing the concentrations added to processed foods would reduce adverse reactions. Testing for behavioural toxicity should be included in food additive safety evaluation.
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"Zinc is an essential cofactor of more than 100 enzymes ... Dopamine is one of the most important factors in the pathophysiology of hyperactivity disorder, and the hormone melatonin has an important role in the regulation of dopamine. Because zinc is necessary in the metabolism of melatonin, it can be assumed that zinc is a very important factor in the treatment of attention deficit and hyperactivity disorder (ADHD). ... Preliminary investigations in humans show that many children with ADHD have lower zinc concentration in relation to healthy children. ... There are many theories about the possible origin of hyperactive disorder, and one of the most widely studied is the theory of the role of dopamine, which is supported by the results of treatment in these children with dopamine agonists like methylphenidate and amphetamines. Recent studies do not neglect the influence of maternal intake of food and drink additives, alcohol consumption and smoking during pregnancy, soil contamination, and low birth weight. Zinc is a coenzyme of the enzyme delta-6 desaturase, which is important in the anabolism of polyunsaturated long chain fatty acids, linolic and linolenic acids that constitute neuronal membrane. ... A study of ADHD treatment with zinc sulfate as a supplement to methylphenidate [Ritalin] showed beneficial effects of zinc supplementation in the treatment of children with ADHD. The dose of zinc sulfate used was 55 mg/day, which is equivalent to 15 mg zinc. The improvement achieved in ADHD children with the use of zinc sulfate appears to confirm the role of zinc deficiency in the etiopathogenesis of ADHD. ..."
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"... The nutritional quality, in terms of the level and
balance of nutrients in the elimination test diet, was superior to that of the normal diet. With proper dietary counselling,
the elimination test diet is safe for use in the treatment of children with hyperkinesis."
"93% of 88 children with severe frequent migraine recovered on oligoantigenic diets; ... the role of the foods provoking migraine was
established by a double-blind controlled trial in 40 of the children. ... Associated symptoms which improved in addition to headache included abdominal pain, behaviour disorder, fits, asthma, and eczema. In most of the patients in whom migraine was provoked by non-specific factors, such as blows to the head, exercise, and flashing lights, this provocation no longer occurred while they were on the diet."
62 of 76 selected overactive children (81.6%) improved;
other symptoms such as headaches, abdominal pain, and fits, also improved.
Of 45 children with epilepsy and recurrent headaches, abdominal symptoms, or hyperkinetic behavior, 36 [80%] improved on an oligoantigenic diet; 25 [55%] ceased to have seizures and 11 had fewer seizures during diet therapy. "Headaches, abdominal pains, and hyperkinetic behavior ceased in all those whose seizures ceased, and in some of those whose seizures did not cease." ..."Of 24 children with generalized epilepsy, 18 [75%] recovered or improved (including 4 of 7 with myoclonic seizures and all with petit mal), as did 18 of 21 [85%] children with partial epilepsy. In double-blind, placebo-controlled provocation studies, symptoms recurred in 15 of 16 children, including seizures in eight; none recurred when placebo was given. Eighteen other children, who had epilepsy alone, were similarly treated with an oligoantigenic diet; none improved."
"Twenty-one children with migraine and/or hyperkinetic behavior disorder which was successfully
treated with an oligoantigenic (few-foods) diet also suffered from nocturnal and/or diurnal enuresis. [daytime or nighttime bed wetting]
On diet, the enuresis stopped in 12 of these children and improved in an additional four. [76%] ... Enuresis in
food-induced migraine and/or behavior disorder seems to respond, in some patients, to avoidance of
provoking foods."
A trial of enzyme-potentiated desensitisation, expected
to be useful for those who have problems with foods that are difficult
to avoid, or who cannot comply with dietary restrictions.
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"... It is important to recognize that this entire behavioral pattern is beyond the child's voluntary control. He does not choose to be a failure nor does he want to be bad. It is as though something within is driving him. He is like a revved up motor with the throttle stuck. Discipline achieves nothing but invites rebellion and further frustration, precipitating displays of temper and tantrums."
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"Truancy, vandalism, violence and assault among school children coupled with a persistent drop in scholastic achievement is a universal problem affecting the school population of every so-called developed country. Every procedure for the control of behavioural disorders has not been successful; every technique for the improvement of learning has not been productive, while every modality for the rehabilitation of delinquents has failed us. Since all these procedures have been structured upon psychosocial concepts, it becomes necessary to look elsewhere for the answers, which is to the biosciences, including genetics, molecular genetics, pharmacogenetics, behavioural toxicology, behavioural teratology, immunochemistry, immunology, allergy and endocrinology, with a focus upon nutrition, which encompasses all these disciplines.
Dr. Feingold finalized this paper in the few days before his death. He had not had time to list his references, and the editors noted that they had decided to publish it without them.
Note: The "challenge" dose of food dyes is not specified, but implied to be 13 mg. This tiny amount still resulted in a trend of performance deficits on a visual motor tracking task after challenge but not after placebo. The deficits were more pronounced in younger children. This is not surprising because 13 mg is a larger "dose" per body weight for a smaller child.
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They were studying a diet recommended for children with ADHD, which usually takes more than one week to "show" an effect, and longer when a child is on medication. However,
Note: This study was funded by the "Nutrition Foundation," a food additive and chemical industry organization. Harley claimed he found "no support" for the diet. Nevertheless, 100% of preschoolers and 63% of the group of older children who had done the "control" diet first improved on the Feingold diet in this study. Harley discounted the 63%, claiming an "order effect."
Upon reading the analysis of the Harley study by Dr. Bernard Weiss, Professor of Toxicology at University of Rochester School of Medicine and Dentistry, it becomes clear that there was no actual "order effect" for the older children.
Without arguing the point, suffice it to say that the two groups of older children were not equal. The ones who were put on the Feingold diet after the control diet where off their medications several weeks longer than the ones put on the Feingold diet first. Since it was already known that stimulant medications increase the time necessary before an effect of diet is seen, we wonder why they were surprised to find this happening in this study (where those on the "control" diet first would have been off the meds several weeks more than the ones doing the Feingold diet first).
You can see another detailed analysis of the Harley study (and others).
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Conclusion: A Western-style diet may be associated with ADHD. (J. of Att. Dis. 2010; XX(X) 1-XX)."
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Material and Methods - In our large observational study we monitored 810 children from 5 to 12 years of age referred for medical help and recommended for consuming polyunsaturated fatty acids (PUFA) in combination with zinc and magnesium by a physician over a period of at least 3 months. The food supplement ESPRICO® ... containing a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc. ...
Results - After 12 weeks ... most subjects showed a considerable reduction in symptoms of attention deficit and hyperactivity/impulsivity assessed by SNAP-IV. Further, the assessment by SDQ revealed fewer emotional problems at the end of the study period compared to baseline and also [fewer] sleeping disorders. ... Regarding safety, no serious adverse events occurred. ... only 5.2% of the children discontinued the study due to acceptance problems. Continuation of consumption of the food supplement was recommended by the paediatricians for 61.1% of the children.
Conclusion - Our results suggest a beneficial effect of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc consumption on attentional, behavioural, and emotional problems of children and adolescents. Thus, considering the behavioural benefit in combination with the low risk due to a good safety profile, the dietary supplementation with PUFA in combination with zinc and magnesium can be recommended."
Note: The Feingold Association has always recommended beginning the diet before adding supplements - this lets you know what effects are due to the diet alone and whether supplements are actually needed (they can be quite expensive). Over time, we have begun encouraging new members to begin using fish oil (if no fish allergy is involved) as soon as possible since virtually all Americans are deficient in omega 3 essential fatty acids. For fish oil - and for zinc and magnesium if desired - ask your doctor how much is safe and appropriate for your child, and make sure to acquire a brand without salicylates or artificial additives.
The supplement used in the study is made in Denmark and contains orange flavoring (natural? salicylate?) and an artificial sweetener. You can see the amounts of supplements used, however, here and cross-check with your Feingold Supplements Guide (shortly to be incorporated into the Foodlist).
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The historical background of hyperkinesis and learning disabilities is reviewed briefly and followed by a discussion of food additives. Focus on artificial food colors and flavors as important etiologic agents is explained and supported ..."
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Recognizing that any compound under the appropriate conditions can induce adverse reactions, including behavioral disturbances, it becomes necessary to evaluate each compound or class of compounds on the basis of benefit compared with risk. ... colors and flavors have no nutritional value whatsoever. If they were removed from our food supply, nothing nutritionally would be lost. Therefore, on balance, the risk outweighs the benefit."
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The presence of food additives in products used in dental procedures may have serious consequences for many patients. Hyperactivity and learning disabilities as well as buccal, gingival and oral cankers have occurred following the use of diagnostic aids. Furthermore, hyperkinetic patients, whose symptoms have been controlled by withdrawal of all artificial colors and flavors from their diets, have suffered relapses following a dental visit. These problems should be recognized by practitioners because only by the concerted efforts of professionals in the field will diagnostic aids free of artificial color and flavor become available."
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This disenchantment with present-day rehabilitation techniques prompted the Ford Foundation in its annual report for 1977 to recommend that the role in delinquency of biochemical and organic factors, with a focus on nutrition be investigated.
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We have now managed approximately 600 children with the diet. Initially, our successes for control of observed behavior ranged between 30 and 50 percent; however, since we are emphasizing the elimination of BHT (butylated hydroxtoluene) and BHA (butylated hydroxyanisole) our successes for control of behavior average between 60 to 70 percent of our samples."
"The behavioural disorders, frequently labelled hyperkinesis, hyperkinetic impulse disorder, hyperactivity, Minimal Brain Dysfunction (MBD) and Attentional Deficit Disorder (ADD), are among the most critical problems of our contemporary culture.
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The increase in behavioural disorders accompanied by a persistent drop in scholastic performance coupled with the continuing rise in the prevalence of delinquency is undoubtedly one of the most important expressions of the disruption of nature by the rising concentration of pollutants in the ecosystem. The prospect for controlling and eliminating the major contaninants of the environment is not too promising for the immediate future; however, an informed public, which should lead to greater commitment and involvement, would be followed by the containment and then reversal and resolution of this critical and important present-day situation involving the health and behaviour of both our contemporary population and also future generations. Public recognition and participation in the problem are mandatory to correct the insidious downgrading of the human race, which is already evident.
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Twelve children, aged six to 13 years, whose parents reported an improvement in behavioural problems with use of the
Feingold (K-P) diet for an average period of 12 months, were challenge-tested with 40 mg of acetylsalicylic acid in a
double-blind, cross-over trial with ascorbic acid as a placebo. ... significance was reached in tests of general cognitive capacity, line walking and the "finger-to-nose" tests, as well as
increased disturbance in sleep patterns in these children.
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The effects of sulfanilic acid, a major azo food dye metabolite, were studied in normal developing rat pups and pups treated with 6-hydroxydopamine (60HDA). Chronic daily intraperitoneal injection of sulfanilic acid during the first postnatal month elicited hyperactivity and impaired shock escape performance in vehicle pups. ... These findings, which are similar to the results of our study of chronic administration of a food dye mix, suggest that sulfanilic acid may be one of the causative agents in food dye-induced behavioral changes in developing rats. ... "
"Summary: ... In the first trial there was suggestive evidence that performance on a visual-motor tracking task may be impaired following ingestion of challenge material. Three "dye-sensitive" children retested in the laboratory gave results consistent with an impairment of attention and visual motor tracking 1 hour after cookie ingestion... A second study showed significant effects on parent ratings when these were limited to a 3-hour period immediately following ingestion of the cookies, suggesting that artificial food dyes do indeed impair and disrupt the behavior of the children..."
". . . A few industrial chemicals (eg, lead, methylmercury, polychlorinated biphenyls [PCBs], arsenic, and toluene) are recognised causes of neurodevelopmental disorders and subclinical brain dysfunction. Exposure to these chemicals during early fetal development can cause brain injury at doses much lower than those affecting adult brain function. . . . Despite an absence of systematic testing, many additional chemicals have been shown to be neurotoxic in laboratory models. The toxic effects of such chemicals in the developing human brain are not known and they are not regulated to protect children. The two main impediments to prevention of neurodevelopmental deficits of chemical origin are the great gaps in testing chemicals for developmental neurotoxicity and the high level of proof required for regulation. New, precautionary approaches that recognise the unique vulnerability of the developing brain are needed for testing and control of chemicals."
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Thirty-nine children in a summer camp were given the Feingold Diet, which eliminates artificial additives and salicylate-containing foods, for 1 week, followed by administration for 1 week of food containing those ingredients. The behavior of all children was monitored by videotape for 4-minute intervals at mealtime. All children were classified by public school psychologists as having moderate to severe learning disorder; 18 were also hyperkinetic, and 17 were taking medication for the latter condition. Three raters blind to the respective diets the children were on rated the children's behavior for motor restlessness, disorganized behavior, and misbehavior. No significant differences were found in behaviors during weeks 1 and 2. The authors conclude that the Feingold Diet has no beneficial effect on most children with learning disorders, or on hyperkinetic children taking medication."
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Twenty children with attention deficit/hyperactivity disorder (AD/HD) were treated with either Ritalin (10 children) or dietary supplements (10 children) . . . Subjects in both groups showed significant gains . . . . . .Numerous studies suggest that biochemical heterogeneous etiologies for AD/HD cluster around at least eight risk factors: food and additive allergies, heavy metal toxicity and other environmental toxins, low-protein/high-carbohydrate diets, mineral imbalances, essential fatty acid and phospholipid deficiencies, amino acid deficiencies, thyroid disorders, and B-vitamin deficiencies. . . . These findings support the effectiveness of food supplement treatment in improving attention and self-control in children with AD/HD and suggest food supplement treatment of AD/HD may be of equal efficacy to Ritalin treatment.
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Teacher ratings, objective classroom and laboratory observational data, attention-concentration, and other psychological measures obtained on 36 school-age, hyperactive boys under experimental and control diet conditions yielded no support for the Feingold hypothesis. Parental ratings revealed positive behavioral changes for the experimental diet; however, they seemed primarily attributable to one diet sequence. Parents' behavioral ratings on ten hyperactive, preschool boys indicated a positive response to the experimental diet; again, laboratory observations showed no diet effect.
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"The nutrient intakes of fifty-four hyperactive children during a baseline period and while following the hyperkinesis diet
were calculated. During both periods, mean dietary intakes compared favorably with the Recommended Dietary
Allowances. ..."
"... Ten hyperkinetic children have been treated with the diet, five of whom improved dramatically and are now off all other therapy. Their response to accidental and deliberate challenge supports the hypothesis that the dietary regime described has been responsible for their improvement."
"Approximately 300 children in seven primary (elementary) schools used the Feingold diet for two weeks. Ratings were made by teachers before and after use of the diet on questionnaires developed from Conners' long teacher questionnaire. The questionnaire incorporated Conners' hyperactivity factor items, but related to the normal or average child, by referring to most children. Of the total sample, 8.5% improved by five points or more. The mean before diet scores of children who improved were below the cut off value for hyperactivity, indicating hyperactivity itself is not a necessary condition for improvement. Item by item analysis of the response showed that the behavior problems mostly likely to show improvement were distractability, attention span, fiddling, and demands for attention. Parents provided information on the additive foods being ingested by their children. Those children who were reported to be taking a great deal of additive were found to rate significantly higher in behavioral problems compared with children receiving little additive."
"Objective: To examine the relationship between dietary patterns and ADHD in a population-based cohort of adolescents. Method: The Raine Study is a prospective study following 2,868 live births. At the 14-year follow-up, the authors collected detailed adolescent dietary data, allowing for the determination of major dietary patterns using factor analysis. ADHD diagnoses were recorded according to International Classification of Deiseases, 9th Revision coding conventions. Logistic regression was used to assess the relationship between scores for major dietary pattern and ADHD diagnoses. Results: Data were available for 1,799 adolescents, and a total of 115 adolescents had an ADHD diagnosis. Two major dietary patterns were identified: "Western" and "Healthy." A higher score for the Western dietary pattern was associated with ADHD diagnosis (odds ratio = 2.21, 95% confidence interval = 1.18, 4.13) after adjusting for known confounding factors from pregnancy to 14 years. ADHD diagnosis was not associated with the "Healthy" dietary pattern.
"To assess the intake of artificial food colour additives by 5-14-year-old children in the State of Kuwait, a 24-h dietary recall was conducted twice on 3141 male and female Kuwaiti and non-Kuwaiti children from 58 schools. ... The results indicated that out of nine permitted colours, four exceeded their ADIs (acceptable daily intake) by factors of 2-8: tartrazine (E102/Yellow #5), sunset yellow (E110/Yellow #6), carmoisine (E122/not used in USA) and allura red (E129/Red #40). ... Further, follow-up studies to provide insight into potential adverse health effects associated with the high intakes of these artificial colour additives on the test population are warranted."
"ABSTRACT: Background Polyunsaturated fatty acids are essential nutrients for humans. ... Recent discoveries have shown that the long-chained omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) also play an important role in the central nervous system. They are essential for normal brain functioning including attention and other neuropsychological skills.
" The current research aimed to determine the influence of different doses of exposure to tartrazine on levels of hyperactivity, anxiety, depression and anti-social behaviours in rats. . . Tartrazine-treated rats showed hyperactivity in open field test presented by increased horizontal locomotion. Anxiogenic effect of tartrazine was evidently observed during open field, elevated plus-maze and dark-light transition tests. Furthermore, tartrazine intake significantly promoted depression as expressed by prolonged immobilization during forced swim test. Impairment in social interaction test was also detected signifying the relevance of administered dose especially on numbers of bouts of social contacts. This study provides sufficient scientific evidence that a causal link truly exists between tartrazine and inflection of hyperactivity, anxiety and depression-like behaviours in rats and points to the hazardous impact of tartrazine on public health. ".
"...concluded that nutrition-behavior interactions are more likely a function of idiosyncratic sensitivities, rather than a general tendency for ADDH children to eat differently..."
"More than half the subjects exhibited reliable improvement in behavior and negligible placebo effects. In addition, several nonbehavioral variables tended to improve ... particularly halitosis, night awakenings, and latency to sleep onset."Full Text || Get Password || TOP
" Objective. This is a pilot study of the dietary intake and nutrient status of children with Attention Deficit Hyperactivity Disorder (ADHD). Method. Nutritional assessment of 43 children aged 6-12 with ADHD was performed using a 3-day food record, 24-hour recall, and serum assessors. Results. Macronutrient intake and consumption of Low-Nutrient Foods were comparable to population norms; however, 66% were found to be deficient in zinc and 23% in copper. Conclusions. This pilot study reports the food intake and nutrient status of children with ADHD and shows a predisposition for low zinc and copper status in ADHD. "Note: They are deficient in spite of adequate intake.
" . . . We found that erythrosin B inhibits dopamine uptake in rat caudate synaptosomes "uncompetitively" in the 10- to 800-micromolar range. . . . Erythrosin B also decreased nonsaturable binding of dopamine to the synaptosome membrane. The inhibitory action of erythrosin B on dopamine uptake is consistent with the hypothesis that erythrosin B can act as a central excitatory agent able to induce hyperkinetic behavior. "Full Text || Get Password || TOP
" Exposure to non-nutritional food additives during the critical development window has been implicated in the induction and severity of behavioural disorders such as attention deficit hyperactivity disorder (ADHD). . . We therefore examined the neurotoxic effects of four common food additives in combinations of two (Brilliant Blue and L-glutamic acid, Quinoline Yellow and aspartame) to assess potential interactions. . . Neurotoxicity was measured as an inhibition of neurite outgrowth. . . . Theoretical exposure to additives was calculated based on analysis of content in foodstuff, and estimated percentage absorption from the gut. Inhibition of neurite outgrowth was found at concentrations of additives theoretically achievable in plasma by ingestion of a typical snack and drink. . . both combinations had a straightforward additive effect on cytotoxicity. These data have implications for the cellular effects of common chemical entities ingested individually and in combination. "Full Text || Get Password || TOP
"...The rating scales and objective tests for the full sample did not show a statistically significant deterioration in the children's behaviour when they were challenged under double-blind test conditions with the Yellow Dye No. 5, tartrazine, and the tests were conducted the day after a two-week challenge period. ... a subgroup of the children... indicated a significant challenge effect, with mothers reporting more symptoms during the challenge period."
NOTE: tests were conducted the day after challenge, not during challenge, and results of all children were averaged. Moreover, the "challenge" was 5 biscuits per day, each containing ONE mg of Tartrazine — a total per day of about ONE SWALLOW of Koolaid -- a very tiny dose indeed!
Nevertheless, astonishingly, some of the children still reacted to this dye challenge!
See also the Full Text of a second similar study by Levy, using only 8 children (one, who reacted strongly to the challenge was dropped from the study). In spite of again using only ONE mg Tartrazine per biscuit for the challenge, the results "just missed" significance statistically.
" ... A cross-sectional population-based survey was conducted with 10th-grade students in Oslo, Norway (n = 5498). ... The relationship was linear for hyperactivity. ... the association between soft drink consumption and mental health problems remained significant after adjustment for behavioral, social, and food-related variables. The highest adjusted odds ratios were observed for conduct problems among boys and girls who consumed 4 or more glasses of sugar-containing soft drinks per day. CONCLUSIONS: High consumption levels of sugar-containing soft drinks were associated with mental health problems among adolescents even after adjustment for possible confounders."Note: It has been concluded by some reporters that the cause of the behavioral deterioration is the high fructose corn syrup in these sodas, but there are many chemicals besides sugar or corn syrup included in sodas. Consider the combination of synthetic coloring, flavoring, and sodium benzoate, as suggested culprits.
" ... the children with malnutrition signs at age 3 years (N=353) were more aggressive or hyperactive at age 8 years, had more externalizing problems at age 11, and had greater conduct disorder and excessive motor activity at age 17. . . . The findings suggest that reducing early malnutrition may help reduce later antisocial and aggressive behavior."Full Text || Get Password || TOP
" ... Externalizing behavior (aggression, hyperactivity, and conduct disorder) is associated with both macromalnutrition (e.g. protein) and micromalnutrition (e.g. iron and zinc). Both prenatal and postnatal malnutrition is implicated. . . . The effects of docosahexaenoic acid/omega-3 long-chain essential fatty acid on externalizing behavior are more mixed. From animal and human findings, it is hypothesized that malnutrition impairs neurocognitive functioning by reducing neurons, alternating neurotransmitter functioning, and increasing neurotoxicity, and that such neurocognitive impairments predispose to externalizing behavior. "
" ... We sought to maximize the likelihood of demonstrating behavioral effects of artificial food colorings by (1) studying only children who were already on the Feingold diet and who were reported by their parents to respond markedly to artificial food colorings, (2) attempting to exclude placebo responders, and (3) administering high dosages of coloring. ... Evaluations by parents, teachers, and psychiatrists and psychological testing yielded no evidence of a food coloring effect."Full Text || Get Password || See review by Bernard Rimland, PhD
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- Their "high dose" of coloring did not even change the color of the cookies from identical cookies without coloring.
- Many of the children could not eat all the cookies, so they did not receive the expected dose of coloring.
- Evaluations were not always done 1 1/2 hours after eating a cookie - we have a report from one parent that she was unable to give her child the cookie and then drive to the meeting place.
- This same parent reports her child's reactions were so severe that the after-school dance teachers could not keep her in class, and she missed school because reactions included ear infections. You can read an excerpt of her letter here.
"The Feingold diet, eliminating artificial colorings, artificial flavorings, and salicylates, has been claimed, based on anecdotal evidence, to improve the learning and behavior of hyperactive children. A review of all published, completed controlled studies, however, indicates that the Feingold diet is probably not effective, except perhaps in a very small percentage of children. The positive results in a few studies have been inconsistent between studies and greatly outnumbered by negative results. Even among children whose parents feel the diet has helped them greatly, the improvement seems more often a placebo effect, e.g., due to the increased attention the child is receiving, than a true effect of artificial colorings or flavorings."Note: This is the source of the often-heard mantra of "anecdotal evidence," "weight of the evidence," and "increased attention" ... These statements were not actually true at that time - but even had they been true, they were made back in 1983, and much double-blind ("gold standard") research has been done since then.
"Artificial colours 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."Full Text || Get Password || TOP
" . . . A number of case studies are presented which suggest that the difficulties encountered by a significant number of these children have much to do with idiosyncratic responses to foods and additives. This hypothesis requires careful research study at an early date for if validated it will have far reaching implications for the assessment and management of disturbed, delinquent and learning disordered children. Perhaps not enough attention has been paid to the role of biological and environmental factors in the development of children's problems. Certainly recent research has begun to provide support for the concept of environmental (ecologic) illness. "
" Individuals with epilepsy also often exhibit symptoms of attention deficit hyperactivity disorder (ADHD). The ketogenic diet, which is a high fat, low protein, and low carbohydrate diet used in the treatment of intractable epilepsy, also appears to improve symptoms of ADHD in individuals with both disorders. Previous research suggests that the diet decreases the activity level of rats. ... adult male Long-Evans rats were placed on either a ketogenic diet or a control diet. The results of the first experiment show that the ketogenic diet can cause a decrease in activity level within 24 h and that the results are reversible. The results of Experiment 2 show that the decrease in activity level is not linked to a change in anxiety level. The ketogenic diet may be of use in the treatment of ADHD."Note: A word of caution is needed here. Every dietary manipulation which involves removing all or most "processed" foods approaches the Feingold diet by inadvertently eliminating all the many additives used in such products. We are therefore not surprised to see that removal of "only" milk, wheat, sugar, or protein/fats from the diet will "work," at least somewhat, in relieving hyperactive behavior.
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"Several studies report a possible association of celiac disease (CD) with psychiatric and psychological disturbances, such as ADHD. METHOD: The authors assess 132 participants from 3 to 57 years of age ... affected by CD for the possibility of an associated ADHD-like symptomatology ... before their gluten-free diet was started and 6 months later. RESULTS: The overall score improves significantly as well as most of the ADHD-like symptomatology ... CONCLUSION: The data indicate that ADHD-like symptomatology is markedly overrepresented among untreated CD patients and that a gluten-free diet may improve symptoms significantly within a short period of time. "Notes:
- A gluten-free diet would eliminate many processed foods, thereby automatically reducing the ingestion of additives.
- Some people with ADHD, even on the Feingold Program, do better when they eliminate gluten and/or casein. Since Celiac Disease can also be present without frank symptoms of GI disturbance, this connection is very interesting.
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The diet group followed a 5-week elimination diet; the control group adhered to their normal diet. Parents of both groups had to keep an extended diary and had to monitor the behaviour and the physical and sleep complaints of their child conscientiously. . . The number of physical and sleep complaints was significantly decreased in the diet group compared to the control group . . . Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints. . . An elimination diet may be an effective instrument to reduce physical complaints in children with ADHD, but more research is needed to determine the effects of food on (functional) somatic symptoms in children with and without ADHD."
"The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder (ADHD). Dietary studies have already shown evidence of efficacy in selected subgroups. Twenty-seven children (mean age 6.2) who all met the DSM-IV criteria for ADHD, were assigned randomly to either an intervention group (15/27) or a waiting-list control group (12/27). Primary endpoint was the clinical response, i.e. a decrease in the symptom scores by 50% or more, at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale. The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [parent ratings 11/15 (73%) versus 0/12 (0%); teacher ratings, 7/10 (70%) versus 0/7 (0%)]. The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 (cohen's d) and a scale reduction of 69.4%. Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group (cohens's d 1.1, scale reduction 45.3%). A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children's behaviour."
They used a diet which eliminates milk, wheat, eggs, chicken, and beef as well as additives. This would pick up allergies or intolerance to any of these items. Otherwise, the diet is basically an extreme version of the standard Feingold diet.
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Note: This study was done in Holland where a Feingold Foodlist is not available. Their diet was very much more limited than the usual Feingold diet. Since 9 children dropped out, the number of children who completed the 2-weeks trial of the diet was only 31. Thus, 25 children improving would be 80.6% of them. This is in line with the results we see of those who try the Feingold diet, in spite of the fact that two weeks is a very short trial for any diet.
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"...In this study, we report two cases of unusual reactions to food additives (tartrazine and benzoates) involving mainly the central nervous system (headache, migraine, overactivity, concentration and learning difficulties, depression) and joints (arthralgias), confirmed with diet and
double blind challenge. The possible pathogenetic mechanisms are also discussed."
"... 100 children were enrolled and randomly assigned to the control group (n=50) or the diet group (n=50). Between baseline and the end of the first phase, the difference between the diet group and the control group in the mean ARS [ADHD Rating Scale] total score was 23·7 according to the masked ratings. ... In the challenge phase, after challenges with either high-IgG or low-IgG foods, relapse of ADHD symptoms occurred in 19 of 30 (63%) children, independent of the IgG blood levels...INTERPRETATION: A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food. The prescription of diets on the basis of IgG blood tests should be discouraged."
Several letters to the editor of Lancet, and author's reply
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"Attention deficit/hyperactivity disorder (ADHD), a common behavioural disorder in children, may be associated with comorbid physical and sleep complaints. Dietary intervention studies have shown convincing evidence of efficacy in reducing ADHD symptoms in children. In this pilot study, we investigated the effects of an elimination diet on physical and sleep complaints in children with ADHD. A group of 27 children . . . were assigned randomly to either a diet group (15/27) or a control group (12/27).
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.. children, 36 boys and 4 girls, aged 3-7 (average 4.8 years), who met the DSM-IV-criteria for ADHD, followed their usual diet for two weeks and thereafter for two weeks an elimination diet, based on the few foods diet (rice, turkey, pear and lettuce). ... 25 children (62%) showed an improvement in behaviour of at least 50% on both the Conners list and the ADHD Rating Scale at the end of the elimination diet. Nine children (23%) withdrew from the study because the parents were unable to stick to the diet or because the child fell ill. Among the 15 children with both parent and teacher ratings, 10 [66%] responded both at home and in school. CONCLUSION: In young children with ADHD an elimination diet can lead to a statistically significant decrease in symptoms.
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"... 19 children completed a double blind placebo controlled challenge study with artificial food colours. In these children food colours were shown to have an adverse effect on a daily Conners' rating of behaviour, but most parents could not detect these changes. A pharmacological mechanism of food additive intolerance is proposed to explain these effects."
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"... This study assessed the effects of an early nutritional, educational, and physical exercise enrichment program on adult outcome for schizotypal personality, conduct disorder, and criminal behavior. . .Subjects who participated in the
enrichment program at ages 3–5 years
had lower scores for schizotypal personality
and antisocial behavior at age 17 years
and for criminal behavior at age 23 years,
compared with the control subjects."
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150 of 200 children [75%] improved on an open trial of a diet free of synthetic food coloring, and deteriorated upon introduction of foods containing synthetic colorings.
34 other "clear" or "suspected" reactors plus 20 "controls" were studied in a separate double blind study. 82.5% of the "suspected reactors,", 27% of the "uncertain reactors," and 10% of the "controls" reacted to a mild single-item challenge of tartrazine (Yellow #5). Kind of reaction and length of time the children were affected depended on the dose. Rowe reported that a dose response effect was observed.
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Note: Many people who don't "test positive" on such tests still respond well to the diet. Allergy testing may be useful if positive, but does not rule out response to diet management if negative.
Note: They used 10 mg Yellow 5 or Yellow 6. No matter how beautifully designed the study, when you use only a tiny amount of food dye as your "challenge" you won't get dramatic results.
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NOTE: These were children with conduct-disorder as well as ADHD. 44% responded to Ritalin while 24% responded equally well to a Feingold-type diet.
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Note: 2.0 mg/kg is about the same as 60 mg food dye for a 30 kg child - or the same as a single red-frosted cupcake.
Note: They want a "moratorium on further public advocacy" ... this means that they wanted Dr. Feingold to shut up. Note the date: 1976. It is interesting that quite a few publications more than 10 years later are still citing this article as though it would be relevant, in spite of all the research done since that time.
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Note: Dr. Swanson used 100 mg and 150 mg of mixed food dye in his study. In a phone conversation with this author, he said he had been told that his use of a "toxic dose" had devalued his study. When informed of the amount of food dye per tablespoon in solid bright-colored candies and frosting, green ketchup, and powdered drinks, as measured by students at an Atlanta college, he was astonished. According to his math, students at a birthday party can easily consume 500-600 mg of food dye. If 150 mg is really a "toxic dose," then we need to seriously reconsider what we are allowing in the food sold for children, and we also need to rethink the fact that manufacturers refuse to reveal just how much coloring is actually in any of their products.
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Note:
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Note: Exposure of rats to neurotoxic substances commonly results in hyperactivity, as though the "brakes" are the neurons first suffering damage. Toluene is a solvent made from petroleum or coal tar. Its chemical formula is C6H5CH3
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... The compounds tested were: Erythrosine, Ponceau 4R, Allura Red, Sunset yellow, Tartrazine, Amaranth, Brilliant Blue, Blue, Fast Red E, Orange GGN and Scarlet GN. All food colours tested inhibited mitochondrial respiration ...This inhibition varied largely, e.g. from 100% to 16% for Erythrosine and Tartrazine respectively, ...This effect was dose related ....
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Food Additives and Hyperactive Children (Conners, 1980) is the first book-length attempt to evaluate Feingold's additive and salicylate-free Kaiser-Permenente diet for the treatment of hyperactive children, and as such it requires critical scrutiny. . .It is argued that the studies as
reported do not constitute a methodologically adequate test of Feingold's hypothesis . . . and that it is thus premature to reject the hypothesis on the grounds presented here. . . "
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. . .Two eight-year-old females, who had been on the Feingold K-P diet for a minimum of 11 months, were the subjects studied. The experimental design was a variation of the BAB design, with double-blind conditions. This design allowed an experimental analysis of the placebo phases as well as challenge phases. Data were obtained by trained observers on Out of Seat, On Task, and Physically Aggressive behaviors, as they occurred in the subjects' regular class setting. Results indicated (a) the existence of a functional relationship between the ingestion of artificial food colors and an increase in both the duration and frequency of hyperactive behaviors, (b) the absence of a placebo effect, and (c) differential sensitivity of the dependent variables to the challenge effects.
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40 of 55 children (72.7%) put on a 6-week trial of the
Feingold Diet "... demonstrated improved behaviour." 26
of them (47.3%) remained improved following "liberalization"
of the diet over a 3-6 month period.
"... The physiological measures [EEG and heart rate] were obtained prior to and following the ingestion of drinks containing food additives or placebos, which were administered in a double-blind, randomized, crossover procedure. ... the magnitude of physiological changes in the hyperactive children were greater in response to ingestion of the additives than to placebo. These physiological findings are consistent with behavioural data indicating that some hyperactive children are adversely affected by food additives.
Thirty-one children with behavioural problems and learning difficulties were allergy tested ... 15 of these were given the Australian Version
of the Feingold K.P. diet. Ninety-three per cent responded with improved behaviour in the areas of overactivity,
distractability, impulsiveness and excitability. Sleep and enuresis problems were resolved partially or completely. This
study demonstrates that the aforementioned elimination diet significantly affects behaviour.
"As part of their overall management, a diet excluding synthetic food colourings may be of benefit in modifying the behaviour of a small number of children with attention deficit disorder."
"These findings suggest a strong relationship between
childhood ADD and later arrests for delinquent behavior." "...our study is consistent with other follow-up studies of drug-treated children that have found an absence of long-term beneficial effect ..."
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... We searched ten electronic databases for double-blind placebo-controlled trials evaluating the effects of AFCs [artificial food colors]. ... Despite indications of publication bias and other limitations, this study is consistent with accumulating evidence that neurobehavioral toxicity may characterize a variety of widely distributed chemicals.
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"Effects of diet were compared with those yielded by stimulant medication (methylphenidate). ... Twelve children (24%) showed significant behavioral improvement in two behavior ratings during diet relative to control diet conditions ... The amount of positive changes in behavior in those who received both treatments was about the same... dietary treatment cannot be neglected as a possible access to treating hyperactive/disruptive children ..."
Review of studies at California State University; implementation of "nutrient dense diets" in 813 state facilities "resulted in significantly improved conduct, intelligence, and/or academic performance..."
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The introduction of a diet policy which lowered sucrose, synthetic food color/flavors, and two preservatives (BHA and BHT) over 4 years in 803 public schools was followed by a 15.7% increase in mean academic percentile ranking above the rest of the nation's schools who used the same standardized tests. Prior to the 15.7% gain, the standard deviation of the annual change in nation percentile rating had been less than 1% . . ., after the policy transitions, the percent of students who ate school lunches and breakfasts within each school became positively correlated with that school's rate of gain (r = .28, p < .0001)."
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... At every age the highest dose of food dye (2.0 mg/kg) produced the greatest activity. This dose also resulted in significant effects on habituation of activity. Pups who did not receive food dye decreased their activity by 32.1% over the first 30 minutes of observation while in groups who received 2.0 mg/kg of food dye a reduction in activity of only 7.25% was noted over the same time period. ..."
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This article evaluates evidence relevant to Feingold's hypothesis that synthetic food colors and flavors cause hyperactivity. Feingold's opinion that a recent “epidemic” of hyperkinesis is due to an increase in the use of synthetic colors and flavors is examined. The authors conclude that there are no reliable data to support the belief that there has been an epidemic of hyperkinesis. Results from clinical tests and uncontrolled studies of an elimination diet are reviewed, and the contaminating effect of placebo responses is discussed. Finally, results from two recent controlled studies of the diet are examined. The authors agree with the investigators that these controlled studies show equivocal results which should be interpreted with caution. A moratorium on further public advocacy is recommended until the efficacy of the diet for a defined population is firmly established by controlled research. "
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. . .accumulated evidence suggests that a subgroup shows significant symptom improvement when consuming an AFC-free diet and reacts with ADHD-type symptoms on challenge with AFCs [artificial food colors]. Of children with suspected sensitivities, 65% to 89% reacted when challenged with at least 100 mg of AFC. . . . A trial elimination diet is appropriate for children who have not responded satisfactorily to conventional treatment or whose parents wish to pursue a dietary investigation.
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Objective: Food additives can exacerbate ADHD symptoms and cause non-immunoglobulin E-dependent histamine release from circulating basophils. However, children vary in the extent to which their ADHD symptoms are exacerbated by the ingestion of food additives. The authors hypothesized that genetic polymorphisms affecting histamine degradation would explain the diversity of responses to additives. Method: In a double-blind, placebo-controlled crossover trial, challenges involving two food color additive and sodium benzoate (preservative) mixtures in a fruit drink were administered to a general community sample of 3-year-old children (N=153) and 8/9-year-old children (N=144). ... Results: The adverse effect of food additives on ADHD symptoms was moderated by histamine degradation gene polymorphisms HNMT T939C and HNMT Thr105Ile in 3- and 8/9-year-old children and by a DAT1 polymorphism (short versus long) in 8/9-year-old children only. ... Conclusions: Histamine may mediate the effects of food additives on ADHD symptoms, and variations in genes influencing the action of histamine may explain the inconsistency between previous studies. Genes influencing a range of neurotransmitter systems and their interplay with environmental factors, such as diet, need to be examined to understand genetic influences on ADHD symptoms."
"...A mailed questionnaire survey was undertaken in June 1993, of the use of
various therapies by families of 381 children with ADHD. The respondent rate was 76%.... Diet therapies were the most commonly used alternative
therapy (60%). ... Physicians were commonly involved in the suggestion to try a modified diet. ..."
"The performance of the hyperactive children on paired-associate
learning tests on the day they received the dye blend was impaired relative
to their performance after they received the placebo, but the performance
of the non-hyperactive group was not affected by the challenge..."
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"... During consumption of provoking foods there was a significant increase in betal activity in the frontotemporal
areas of the brain. This investigation is the first one to show an association between brain electrical activity and intake of
provoking foods in children with food-induced attention deficit hyperactivity disorder. ..."
"...Tartrazine induces a reduction in serum and saliva zinc
concentrations and an increase in urinary zinc content with a corresponding deterioration in behaviour/emotional responses of the hyperactive children but not the controls."
"...Only hyperactive children showed a significant reduction in blood
serum zinc levels and an increase in urinary zinc output following the
consumption of E102 [tartrazine] and E110 [sunset yellow]. . . For the 23 children who consumed a tartrazine beverage there were increased levels of overactivity (n = 18 children), aggressive (n = 16) and/or violent (n = 4) activity, poor speech (n = 2), poor coordination (n = 12), and the development of asthma and/or eczema (n = 8). Most of these were severe or moderate changes. Only one control child showed minor behavioural responses to tartrazine."
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Twenty-two young children, maintained on a diet that excluded certain foods, were challenged intermittently with a blend of seven artificial colors in a double-blind trial. Parents' observations provided the criteria of response. One child that responded mildly to the challenge and one that responded dramatically were detected. The latter, a 34-month-old female, showed a significant increase in aversive behaviors. These results further confirm previous controlled studies.
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"In a test of Feingold's hypothesis that food additives trigger the hyperactive response, 26 hyperactive children were randomly assigned to treatment conditions whereby they were given active or placebo medications in combination with challenge cookies with artificial food colors or control cookies without the additives. . . when the children were receiving placebos, their hyperactive behaviors in the classroom were greater when eating cookies with artificial colors than when eating cookies without artificial colors. According to the ratings, approximately seven children were no longer hyperactive. There is evidence to suggest that the behavior of three to eight children was diet-responsive, depending on the criteria used. There is evidence, particularly in teacher ratings, in support of Feingold's hypothesis if it is modified. . . .
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"...The inhaling of toluene vapor (0.7% in air, for 15 min) induced the increase in spontaneous locomotor activity.
This locomotor accelerating effect lasted about 60 min after the end of toluene exposure. ... These results suggest that toluene may raise dopaminergic neuron activity."
