Feingold diet

The Feingold diet is a food elimination program developed by Ben F. Feingold, MD. following research in the 1970s which appeared to link food additives with hyperactivity; by eliminating these additives the diet was supposed to alleviate the condition.

Popular in its day, the diet has since been referred to as an "outmoded treatment"; there is no good evidence that it is effective.[1][2]

Technique

The diet was originally based on the elimination from the diet of butylated hydroxyanisole, butylated hydroxytoluene, TBHQ, aspirin and salicylate; additionally a number of drugs were advised against alongside everyday products including toothpaste and perfume.[3] More recent versions of the diet prohibit only artificial food coloring and additives.[4]

Feingold stressed that the diet must be followed strictly and for an entire lifetime, and that whole families – not just the subject being "treated" – must observe the diet's rules.[4]

Effectiveness

Although the diet had a certain popular appeal, a 1983 meta-analysis found research on it to be of poor quality, and that overall there was no good evidence that it was effective in fulfilling its claims.[2]

In general, as of 2014 there is no evidence to support broad claims that food coloring causes food intolerance and ADHD-like behavior in children.[5] It is possible that certain food coloring may act as a trigger in those who are genetically predisposed, but the evidence is weak.[6][7][8]

Reception

The Feingold Program requires a significant change in family lifestyle and eating patterns because families are limited to a narrow selection of foods, and that such foods are often expensive, and must be prepared "from scratch", greatly increasing the amount of time and effort a family must put into preparing a meal.[3]

Nutritionally, the Feingold Program is little different from a normal diet. While some fruits and a few vegetables are eliminated in the first weeks of the Program, they are replaced by others. Often, some or all of these items can be returned to the diet, once the level of tolerance is determined.[9]

History

Feingold was a pediatrician and allergist. He served as Chief of Pediatrics, Cedars of Lebanon Hospital, Los Angeles, CA; later he established a number of allergy centers for Kaiser Permanente of Northern California, and served as Chief of Allergy at the Kaiser Permanente Medical Center in San Francisco.

Since the 1940s, researchers worldwide had discussed cross-reactions of aspirin (a common salicylate) and Tartrazine (FD&C Yellow #5).[10] Dr. Stephen Lockey[11] at the Mayo Clinic and later Feingold at Kaiser, hypothesized that eliminating both salicylates and synthetic food additives from patients' diets not only eliminated allergic-type reactions such as asthma, eczema and hives,[12] but also induced behavioral changes in some of their patients.

Feingold presented his findings at the annual conference of the American Medical Association in June 1973.[13][14] This led to the first controlled double-blind crossover study; its favorable results were published in the August 1976 issue of Pediatrics, the official publication of the American Academy of Pediatrics.[15]

According to Feingold in 1974 the food industry became involved via its industry-supported organization the "Nutrition Foundation of New York."[14] A two-week-long conference, by invitation only, was arranged in January, 1975, in Glen Cove, Long Island. There, the attendees created what they called the National Advisory Committee. The committee widely published its preliminary report concluding that "no controlled studies have demonstrated that hyperkinesis is related to the ingestion of food additives."[14]

Over the next few years, the Nutrition Foundation funded and designed several small studies, each concluding that the diet produced little effect.[16][17] Although the studies were conducted at universities, which would normally have lent them credibility, Congressman Ben Rosenthal of New York complained, "Despite the compelling need for experts who can examine the food industry with a critical eye, nutrition and food science communities have fallen under the $200 billion industry's influence. At our more prominent universities, eminent nutritionists have traded their independence for food companies' favors."[14]

References

  1. ↑ Turka LA, Caplan A (July 2011). "What is the evidence for our standards of care?". J. Clin. Invest. 121 (7): 2530. doi:10.1172/JCI59185. PMC 3127439. PMID 21737884.
  2. 1 2 Kavale KA, Forness SR (1983). "Hyperactivity and Diet Treatment: A Meta-Analysis of the Feingold Hypothesis". Journal of Learning Disabilities 16 (6): 324–330. doi:10.1177/002221948301600604. ISSN 0022-2194.
  3. 1 2 Barrett S (15 March 2004). "The Feingold Diet: Dubious Benefits, Subtle Risks". Quackwatch. Retrieved December 2014.
  4. 1 2 Kanarek RB (July 2011). "Artificial food dyes and attention deficit hyperactivity disorder". Nutr. Rev. 69 (7): 385–91. doi:10.1111/j.1753-4887.2011.00385.x. PMID 21729092.
  5. ↑ Tomaska LD and Brooke-Taylor, S. Food Additives - General pp 449-454 in Encyclopedia of Food Safety, Vol 2: Hazards and Diseases. Eds, Motarjemi Y et al. Academic Press, 2013. p. 452. ISBN 9780123786135
  6. ↑ Millichap JG, Yee MM (February 2012). "The diet factor in attention-deficit/hyperactivity disorder". Pediatrics 129 (2): 330–337. doi:10.1542/peds.2011-2199. PMID 22232312.
  7. ↑ FDA. Background Document for the Food Advisory Committee: Certified Color Additives in Food and Possible Association with Attention Deficit Hyperactivity Disorder in Children: March 30-31, 2011
  8. ↑ EFSA Panel on Food Additives and Nutrient Sources added to food (ANS) Scientific Opinion on the re-evaluation of Sunset Yellow FCF (E 110) as a food additive. EFSA Journal 2009; 7(11):1330 doi:10.2903/j.efsa.2009.1330
  9. ↑ Dumbrell, S. and Woodhill, J.M. and Mackie, L. and Leelarthaepin, B. (December 1978). "Is the Australian version of the Feingold diet safe?". The Medical Journal of Australia 2 (12): 569–570. PMID 364258.
  10. ↑ "National Health Museum". Retrieved 2008-03-31.
  11. ↑ Lockey, SD (September–October 1959). "Allergic reactions due to F D and C Yellow No. 5, tartrazine, an aniline dye used as a coloring and identifying agent in various steroids". Annals of Allergy 17: 719–21. PMID 14417794.
  12. ↑ Lockey, SD Sr. (1977). "Hypersensitivity to tartrazine (FD&C Yellow No. 5) and other dyes and additives present in foods and pharmaceutical products.". Annals of Allergy 38 (3): 206–210. PMID 842907.
  13. ↑ Feingold, Ben F. (1982). "The Role of Diet in Behavior" (PDF). Ecology of Disease 2 (2/3): 153–165. PMID 6090095.
  14. 1 2 3 4 Feingold, Ben F. (June 8, 1977). "A View of the Press From the Other Side" (PDF). Newspaper Food Editors & Writers Association.
  15. ↑ Conners CK, Goyette CH, Southwick DA, Lees JM, Andrulonis PA. (August 1976). "Food additives and hyperkinesis: a controlled double-blind experiment". Pediatrics 58 (2): 154–66. PMID 781610.
  16. ↑ Weiss, Bernard (March 1982). "Food Additives and Environmental Chemicals as Sources of Childhood Behavior Disorders". Journal of the American Academy of Child Psychiatry. 21 (2): 144–52. doi:10.1016/S0002-7138(09)60913-4. PMID 7069080.
  17. ↑ Rimland, Bernard (June–July 1983). "The Feingold Diet: An Assessment of the Reviews by Mattes, by Kavale and Forness and Others". Journal of Learning Disabilities. 16 (6): 331–3. doi:10.1177/002221948301600605. PMID 6886554.

Further reading

External links

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