Literature Review Notes

When you click on a numbered link which looks like [#1], the appropriate paragraph will appear in this window.

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[1]
The clinical diagnosis of participants should be appropriate. A study designed to research the connection between ADHD and diet should use participants who actually have ADHD and not something else. It may be worthwhile doing research on the connection between irritability or depression or asthma and diet, but participants must be diagnosed accordingly.

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[2]
Tests should be defined and agreed upon which measure not only attention and activity, but the actual symptoms such as irritability, tantrums, and sleep habits that parents observe as improved.

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[3]
Observation or recording of the child's behavior by parents or teachers should be done daily, at least, since daily recording is a much more sensitive barometer than weekly recording.

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[4]
Group data averages are fine as far as they go, but individual data must be presented and compared since it has been postulated many times that only a small number of ADHD children "really" respond to dietary intervention. Therefore, each child should be compared in the different states to himself, and the responders should also be compared to the nonresponders, not averaged in with them. If you want to weigh the needles in a haystack, you must first find a magnet that can pull the needles out of the stack, rather than weigh the whole stack and divide by number of straws + needles.

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[5]
Since the Feingold hypothesis involves the elimination of multiple items, then the multiple items need to be eliminated to test it. The Feingold membership materials and Foodlists should be used since the test would then be of the Feingold diet as it currently exists. Testing a 3-food diet is a valid test of a 3-food diet, but it is not a test of the Feingold diet.

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[6]
Since the Feingold hypothesis involves the elimination of multiple items, then the multiple items need to be used in the challenge materials to try to provoke a behavioral response in the double blind portions of the study. If a single-item challenge does not provoke symptoms, it means little, since the interactions of several items may be needed to do so.

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[7]
When administering challenge materials, behavior should be monitored periodically beginning one-half hour after ingestion, and ending four to six or more hours later. A single evaluation four hours after ingestion may totally miss the reaction, especially with food dyes (Adams, 1981; Swanson, 1980).

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[8]
When administering challenge materials, the level of such materials should be reasonably large, not to miss the "Halloween effect," or what happens during other periods of excessive consumption during birthday parties and holidays.

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[9]
When administering challenge materials, the time period of administration should be long enough to overcome what FAUS calls the "washout effect," where a child established on the diet does not react to a single infraction and can "get away with" cheating if not done frequently. Several days in a row should be adequate.

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[10]
Arrange to avoid cheating. Cheating twice a week may be enough to prevent improvement (has the alcoholic recovered if he only gets drunk twice a week?)

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[11]
Since the Feingold diet is administered and adjusted individually, some provision for doing that should be included in the study. It is not a one-size-fits-all program.

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[12]
The researcher must be vigilant against confounds like coloring in non-food items such as for skin care, finger paint or play dough, environmental toxins such as pesticides, fresh paint, or fragrances, etc., as outlined in the Feingold Handbooks (1982, 1996, 1998).

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[13]
The researcher should be aware that children recently on psychoactive medication may take up to six weeks to respond to diet therapy (Feingold Assoc, 1982, 1996, 1998). The reason for this is not known. They should either be given an extended washout period or not be used in the research.