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Diet > Diet and Behaviour Information provided by; Open Forum on Health Australian dietician researcher, Joan Breakey MAppSc, reviews the literature to show the link between diet and hyperactivity. "The often quoted position that the relationship between diet and hyperactivity has not been proven was based on research in the 1970s," she says in a recent edition of Journal of Paediatrics and Child Health (33, 190-194,1997). "It is now time to consider the useful studies of the 1980s and 90s that clearly show a relationship." The focus in the early 1970s was on artificial flavourings, colourings and natural salicylates. BF Feingold pioneered the study of these chemicals. In 1975 he made the work public in his book, Why Your Child is Hyperactive, His "Feingold Diet" was then used world-wide by parents to deal with learning difficulties and behavioural problems. "The diet eliminates foods that contain the naturally occurring chemical, salicylate, found in apples, oranges, stone and berry fruits, tomatoes, cucumbers and so on. It also eliminates artificial colours and flavours and some preservatives, notably BHT (butylated hydroxytoluene) and BHA (butylated hydroxy anisole), common preservatives for fats. This diet is unusual when compared with modern alternative approaches which look for allergies or nutritional factors." (Let the genius flower, Patricia Holborow.) Breakey's review reported that the 1970s' research showed that small amounts of colouring did cause a reaction in some children. 1980s By the 1980s research was focusing on specific chemicals, food allergens and combinations. Widespread interest in the area led to a growing body of knowledge about diet and behaviour. Most importantly, there was now clear statistical evidence that diet affected behaviour. Some of the most influential research of the 1980s was done by BJ Kaplan. This research and other studies showed that the effects of diet on behaviour vary between individuals. It was realised that there were degrees of reactions rather than an all-or-nothing response. The focus of research then expanded beyond flavourings and colourings. Researchers found that whole foods can impact as adversely on behaviour as artificial chemicals. Whole foods that cause a behavioural reaction are usually the same foods that cause an allergic reaction, e.g. eggs, milk, peanuts, wheat, soy or fish. Unless a child or a close relative has demonstrated an allergic reaction to these food types it is unlikely that they will suffer behavioural problems due to these foods. 1990s Much recent research suggests that mood changes are the most frequent result of dietary intolerance. Breakey reports that the commonest in children is irritability. A study of 300 normal children showed that lack of attention (ADD) is the comonest diet reaction. (Holborow, Jnl Learning Disabilities, 1978). These findings are relevant to the growing body of evidence that links criminal or anti-social behaviour with chemical imbalance in the brain. The physical roots of mood and behaviour are now widely discussed. An article in the British Journal of Psychiatry (June 1997) suggested that up to 50% of factors that contribute to ADD may be genetic. This reinforces the link between body chemistry and behaviour. Of concern is their finding that if the cause of ADD is not found it will persist into adult life in 25% of cases. Many children were found to have had little proper socialisation by age 23yr. Summary Health professionals should be aware of dietary treatment as an option for some children. Breakey suggests a 'diet detective process' to see if dietary intolerance has a role to play in a childs problems. The NZ Dietetic Association advocates diagnosis of food intolerance only when the provoking foods or food constituents have been clearly identified. This can be done by checking the patients clinical history and through the use of skin RAST, and through test diets and food challenges. They stress that it is first desirable to eliminate other causes that may be responsible for a problem. In contrast Holborow states that diet trials can contribute to the diagnosis. Dietary related problems are usually of four types: 1. Nutritional deficiency, especially zinc or copper. 2. Salicylates, so check the consumption of fruit, juice and artificial flavourings and colourings 3. Allergies to foods or environmental chemicals 4. Toxic minerals or other chemicals. Problem Substances: natural and medicinal salicylates, colour, flavour and preservatives, BHT, EHA, monosodium glutamate, perfumes, amines, toothpaste. The historical development of concepts in the role of diet and Hyperactivity from mid 1970s to mid 1980s - Joan Breakey reviews some of the literature. Jrnl of Paediatrics and Child Health (33, 190-194, 1997). USA 1973 - Feingold first linked the ingestion of artificial colours, flavours and salicylates with hyperkinesis and earning difficulties (salicylate data from 1932). 1975 - The book Why Your Child is Hyperactive was published. 1976-78 - Three studies which refuted Feingold's claim published. Order effect found; parent and teacher ratings did not agree. Reported hyperactivity reduced in only a small number with pre-schoolers rated better on diet. Researchers challenged with 26 mg dye, the estimated daily dye intake. Chocolate was often used as a mask in test and control foods. 1977 and 1980 - National Advisory Committee reports: no data suggests changes in food manufacture needed; effects asserted by Feingold not found. Clinical report findings: Families vary in preference for dietary treatment; some diet responders still need medication as well; poor school work continued in some; chocolate reported as another aggravating Substance; brain-damaged children did not improve. The Clinical Ecology movement influenced public opinion. Australasia 1976 Stricter diet used with some 1974 Salicylate data. Clinical findings: Individual variation in additives tolerated; some take days to reach threshold; petrol fumes and felt pens could trigger reactions. Food craving involved: relief by repeated ingestion. First trial of artificial flavour [nature identical mango] conducted; not tolerated. Is dose important? Artificial flavours in foods are used in 10 times the dose of colours (Hulacher, pers. comm 1988). Moulds, mites and aromatic trees considered. Diet affected symptoms in parents and siblings; foods, as well as additives, implicated in some; concomitant reactions (bed-wetting, 'neurotic' and physical allergic symptoms) decreased; different expression in susceptible females. 1978 - New Zealand report: reaction tc additives and salicylates differed; fevt responders tolerated salicylate Infections, stress, inhalants increase severity of food allergic symptoms Double-blind dye challenge studies found short duration effect. A report stated 26 mg dye as only 40% of daily intake. 1980. 100 mg dye effect on learning tasks peaked by 1.5 h,lasted 3 h. Sugar connected to delinquent behaviour in popular press, but not implicated in research - 1981. Allergic exposure may provoke both physical and psychological symptoms. 1986. Symposium on diet and behaviour, good overview. Expectations if mechanisms were pharmacological. 1987. An overview reference on food allergy and intolerance. Footnote: All foods, or ingested products including fragrances, have a unique chemistry which when mixed with the unique chemistry of an individual will always have some effect. natural whole foods generally have a beneficial, positive effect in that the person feels that they are healthy, strong and able to not only cope, with life, but will excell at all levels of life.
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