Dear Commission Members,
It is my distinct honor and privilege to speak as President of the Feingold Associaiton of the United States on behalf of the hundreds of thousands of families we have assisted over the past 25 years in addressing behavior, learning and health problems through dietary intervention. The service we provide remains unique and unduplicated, in our mission to generate public awareness of the potential role of foods and synthetic additives in behavior, learning and health problems, and to support our members in the implementation of the Feingold Program.
The Feingold Program should be properly recognized as the "cornerstone" of care it can be in providing a baseline to allow for a clear diagnostic picture to be assessed. Those who may be affected by dietary factors can be identified thorugh a simple trial which poses no risk, and then the most appropriate treament can be determined. The use of the Feingold Program does not exclude the use of any other treatment modality, and can be used as part of a multimodal approach to address the problems associated with, for example, ADHD and autism -- issues commanding current national attention. This understanding is partiuclarly important in light of the concerns being expressed regarding the use of drugs in addressing the needs of children under the age of six.
When used appropriately, drugs can offer many benefits, but they are not always used properly for children with behavior, learning or health problems. We would like to insure that children receive careful screening to rule out the many things that can trigger attention/behavior problems. We believe that inadequate attention is given to ruling out underlying medical conditions, and initiating stimulant or other medications without considering such conditions may only mask their symptoms and make them harder to identify.
Access to information regarding the use of dietary intervention must be assured, and health care providers must be able and responsible to present accurate information about all available treatment options based on experience and research without fear of reprisal. In this way, there is opportunity for informed choice and participation as a full partner in care decision-making. The case brought by the California Medical Board against Dr. Robert Sinaiko raises grave concerns about jeopardizing such access through supportive physicians.
Compelling evidence on the use of diet as a non-drug therapy for ADHD was presented by Dr. L. Eugene Arnold at the National Institutes of Health (NIH) Consensus Development Conference on ADHD in 1998. The final statement noted "Some of the dietary elimination strategies showed intriguing results suggesting the need for further research." Despite this comment, there was no follow-through in the listed research suggestions, no further mention of the need to resolve concerns by continuing to search for underlying causes.
Additionally, often repeated but erroneous information abounds from even respected sources. Some of this misinformation is found in government sources such as the National Institute of Mental Health web site stating, "restricted diets have not been scientifically shown to be effective." Such inconsistency undermines credibility.
Update, 2006: It has been noticed that the information on their website has changed. Apparently they have progressed all the way up to the 1982 information, in that they now say: "It was found that diet restrictions helped about 5 percent of children with ADHD, mostly young children who had food allergies."
Update #2 (August 27, 2012) - The original link to the NIMH page is broken and has been removed. On their page about causes of ADHD, they now say:
"Food additives. Recent British research indicates a possible link between consumption of certain food additives like artificial colors or preservatives, and an increase in activity. Research is under way to confirm the findings and to learn more about how food additives may affect hyperactivity.
The Assistant Surgeon General, Dr. Marilyn Gaston, sent a designated speaker to be our keynote presenter at our 25th Annual Conference which addressed the relationship of diet to behavior, learning and health. It specifically focused on ADHD and autism, issues of public health concern about which we were able to express our desired goals for participation in the ongoing search for answers.
I have come forward in good faith to present conerns to the NIH, the Assistant Surgeon General, and to you today. In light of its long-standing, unique contributions and commitment to the future, the Feingold Association would deeply appreciate consideraiton in the following areas:
Thank you for your consideraiton of these issues about which we share concern, and we are grateful for the opportunity to provide any additional insight.
Utilization as a resource providing a simple, cost-effective, first-line approach to facilitate diagnosis and determination of the most appropriate intervention in behavior, learning and health problems such as ADHD and autism.
Inclusion in any current and future efforts to address public health concerns related to diet and behavior, learning and health.
Assistance in mandating and funding further research needed to address unresolved issues related to diet, such as those documented in the NIH Consensus Development Statement on ADHD.
Kathleen Bratby, MSN, RN
Feingold Association of the United States
Clinical Assistant Professor
SUNY at Stony Brook
School of Nursing