Talk:Feingold diet

Page contents not supported in other languages.
From Wikipedia, the free encyclopedia

"Research findings" section?[edit]

This "Research findings" section, tagged as being possible OR since 2007 (!), seems composed almost entirely of primary sources and, whre it isn't, out of sources which do not explictly mention the Feingold diet. All of our health content should now be sourced to WP:MEDRS sources. I am moving this content here for possible discussion, in case anything is salvagable:

Content moved from article

Research findings[edit]

Many studies show that 70% or more of hyperactive children respond positively to the removal of synthetic additives, especially when salicylates or allergens are removed.[1][2] There is controversy, however, over what happens when researchers take children whose behavior has improved on a diet that eliminates several thousand additives, and then challenge them with one or a few additives, usually synthetic colors.

Especially in the early studies, if such a challenge did not produce a change in behavior, researchers often concluded that the diet had not directly caused the initial improvement in behavior. Rather, the assumption was that the improvement had been due to a placebo effect.

There are other possible reasons for the failure of a challenge to evoke a response, however. For example, the amount of additive used as a challenge might have been too small to cause an effect.[3] Rowe & Rowe in 1994 found a dose-related effect; the higher the amount of coloring used in the double-blind challenge, the stronger (and longer) the reaction of the children.[1] The following chart lists the amount of coloring used in various studies along with the rate of response:

Name of Researcher

and Year Published

Amount of Food Dye

Challenge Used in Study

Percent of Children w/Behavioral

Reactions to Food Dye Challenge

Levy 1978[4] 4 cookies

1 mg dye in each

0% of 8 children (Note, 1 child was dropped from study when behavior deteriorated on challenge.)
Levy 1978[4] 5 cookies

1 mg dye in each

0% of 12 children. (Note, the testing was done the day AFTER the challenge.)
Wilson 1989[5] 17 mg 5% of 19 children
Weiss 1980[6] 35.26 mg 9% of 22 children (Note, the children in this study were not diagnosed with ADHD.)
Williams 1978[7] 26 mg 11% of 26 children
Goyette 1978 (a)[8] 26 mg 19% of 16 children showed visual tracking problem (Note, the behavior of all the children was reported to be worse after eating food dye, but not significantly so.)
Goyette 1978 (b)[8] 26 mg, using younger children 100% of 8 children were impaired by food dye. (Note, 26 mg is a higher dose for a younger child.)
Rowe 1988[9] 50 mg 25% of 8 children
Rowe 1994[1] 50 mg 64.7% of 34 children
Boris 1994[2] 100 mg or 5 g other provoking food 81% of 16 children
Swanson 1980[10] 100 & 150 mg 85% of 20 children
Pollock 1989[11] 125 mg 89.5% of 19 children
Egger 1985[12] 150 mg 79% of 34 children

Considering that in 1976 an FDA scientist estimated that children may be consuming up to 315 mg food dye per day,[13] all the above studies appear to be overly conservative in their choice of challenge amounts. In addition, the effect of an additive might only be seen in synergy with other additives or foods,[14] [15] or the additive used for the challenge may simply not be among those causing the original effect.[13]

Early studies[edit]

As with many new developments, the first reports of improvement of behavior via diet were anecdotal. This was followed by clinical trials and eventually by larger, double-blind placebo-controlled studies.

Conners, Williams, & Swanson studies ...[edit]

In 1976, a double-blind crossover diet trial found that both parents and teachers saw fewer hyperkinetic symptoms on the K-P diet as compared to the pretreatment baseline.[16] A 1978 double-blind crossover study using cookies with 13 mg food dye each combined with either medication or placebo found, "The results of this study offer data that a diet free of artificial flavors and colors results in a reduction of symptoms in some hyperactive children."[17] In 1980, forty children were put on a diet free of artificial food dyes and other additives for five days. They then performed the usual double-blind placebo-controlled test but used 100 mg or 150 mg of the food dye mix. They found that the food dyes impaired the performance of the 20 hyperactive children on paired-associate learning tests. The dyes did not hurt the performance of the 20 non-hyperactive children. The study states: "Our data suggest that a large dose of food dye blend decreases attention span in hyperactive children as reflected by performance on the learning test."[18]

Nuttition Foundation studies ...[edit]

In 1980, the Nutrition Foundation [19] reported on the seven small studies they had funded, adding up to a total of 190 children. Some of them were elaborate double-blind diet studies using a Feingold-type diet for which they provided all the food. Others simply took the children off additives and then challenged them with a small amount of food dye. In some studies, the children were taken off their medication, while in others they continued on stimulant medications including artificial colorants during the duration of the study.

One of the studies in 1978,[20] for example, used 36 children between 6 and 12, and 10 children between 3 and 5. The teachers of the school-aged children did not record any improvement, but 63% of the mothers reported improved behavior, as well as 100% of the mothers of the preschoolers; however, since the improvement was reported by the parents of the children rather than teachers, and locomotor activity tests were unaffected, it was reported that there was "no diet effect."

In 1980 the Nutrition Foundation set up a review team to review studies related to the Feingold diet.[21] They published a report that stated that there was no response at all to the diet. In 1983, the review team's co-chairman and a colleague reviewed a variety of studies and concluded that no more than 2% of children respond adversely to dye additives.[22]

Gross et al summer camp study ...[edit]

An influential comparative diet study was conducted in 1987 by Gross et al.[23] This was a study of 39 children, of whom 18 were hyperactive, and the balance had other learning disorders. Of those 18, all but one were on behavior-modifying medications during the entire study. The researchers provided a Feingold-type diet for a single week that was, by their own description, unpalatable. They particularly noted that the children missed mustard and ketchup; mustard, however, is not eliminated by the Feingold diet, and no reason was given for its exclusion.

This diet week was followed by an additive-rich diet the next week. Although the study reported that the camp director and all teachers felt that the children were noisier and more active during the second, additive-rich week, they discounted these observations in favor of filmed 4-minute sequences made during meals. These films were intended to measure reaction to additives in the meals in spite of the fact that any such reaction would not be expected to occur for some time after eating.

During the course of the study, three children were dropped: one who was not on stimulant medication, whose behavior became worse during the second week; one who refused to behave altogether; and one whose dose of Cylert became "inadequate" and whose behavior worsened when additives were allowed during the second week.

They concluded that the "Feingold diet has no beneficial effect on most children with learning disorders" and moreover that the diet was "distasteful to the typical American child."

Later studies[edit]

A number of studies conducted since 1980 using diets similar to the Feingold Program report greater than 70% of children responding positively to the diets. Others that eliminated synthetic colors and flavors, but included salicylates still reported greater than 50% positive response.[1][2][9][10] [12][24][25][26][27]

In the biggest such study ever performed, published in 1986, the performance of over a million children in 803 New York City public schools was studied for seven years. The children's average standardized test scores rose 8.1% when levels of sucrose (normal table sugar) were restricted to 11 percent along with the removal of two synthetic food colors; when the remaining food colors and all artificial flavors were removed the next academic year, performance rose another 3.8%; when no further changes were made the following academic year, test performance also remained stable; finally, when the petroleum-based preservatives BHT and BHA were removed from the menu in the next academic year, performance improved another 3.7% for an overall improvement of 15.7% in mean national percentile rankings (from 39.2% to 54.9%).[28] Although it appears that improvement increases as the diet approaches the guidelines of the Feingold Program, the researchers suggest that by removing sugar and additives - thereby removing empty calories and processed foods - malnutrition is reduced. It is not clear what portion of the effects can be contributed to limiting sugar intake or the foods containing BHT and BHA (the related preservative TBHQ did not exist at that time) and what portion can be attributed to the removal of the artificial colorants themselves.

A most important and often overlooked detail in this study is that all the children did not improve equally. There was a dramatic decline in learning disabled and repeat-failure children. In 1979, 12.4% of the million children were performing two or more grades below their proper level. By the end of the study in 1983, the percent of children two or more grades below proper level had dropped to 4.9%. Moreover, before the dietary changes, the more school food that was consumed, the worse the children did academically. After the changes, however, the more school food the children ate, the better they did academically.[29]

In 1997, an association between brain electrical activity and intake of provoking foods was shown in children with food-induced ADHD. (Picture) [30] Another study showed that an oligoantigenic diet can work as well as Ritalin for conduct-disordered children.[31] Other research demonstrated the positive effect of treating young criminals with dietary intervention and correction of mineral imbalances,[32][33] and that toddlers show both significant reductions in hyperactive behaviour when additives are removed from their diet, as well as increased hyperactivity when exposed to a very small (20 mg) amount of food coloring and a benzoate preservative. This effect was observed by parents whether or not the child was hyperactive or atopic.[34]

A 2007 British study at the University of Southampton[35] has pointed to food additives as a health hazard for all children, whether they have ADHD or not. The study concluded that artificial colors 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. In response to this study and a massive media and grass-roots campaign, the major supermarket chains in the UK have removed additives from their house brands. Several American-based candy companies have done the same with the candies they sell in the UK.

In response to that study, which had been financed by Britain’s Food Standards Agency and published online by the British medical journal The Lancet, the American Academy of Pediatrics concluded that a low-additive diet is a valid intervention for children with ADHD. It released the following statement in the February 2008 issue of its publication, AAP Grand Rounds:

“Although quite complicated, this was a carefully conducted study in which the investigators went to great lengths to eliminate bias and to rigorously measure outcomes. The results are hard to follow and somewhat inconsistent. For many of the assessments there were small but statistically significant differences of measured behaviors in children who consumed the food additives compared with those who did not. In each case increased hyperactive behaviors were associated with consuming the additives. For those comparisons in which no statistically significant differences were found, there was a trend for more hyperactive behaviors associated with the food additive drink in virtually every assessment. Thus, the overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong.”

Anne Swain, of the Allergy Unit at Royal Prince Alfred Hospital in Sydney Australia, measured amounts (but not type) of salicylate in 333 foods in 1985,[36] and has done other research based on the Feingold Diet.[37]

References

  1. ^ a b c d Rowe KS, Rowe KJ (1994). "Synthetic food coloring and behavior: A dose response effect in a double-blind, placebo-controlled, repeated-measures study". Journal of Pediatrics. 125: 691–698. doi:10.1016/S0022-3476(06)80164-2. PMID 7965420. Cite error: The named reference "Rowe94" was defined multiple times with different content (see the help page).
  2. ^ a b c Boris M., Mandel F.S. (1994). "Foods and additives are common causes of the attention deficit hyperactive disorder in children". Annals of Allergy. 72 (5): 462–468. PMID 8179235.
  3. ^ Cite error: The named reference Rimland83 was invoked but never defined (see the help page).
  4. ^ a b Levy F, Dumbrell S, Hobbes G, Ryan M, Wilton N, Woodhill JM (January 1978). "Hyperkinesis and diet: a double-blind crossover trial with a tartrazine challenge". Medical Journal of Australia. 1 (2): 61–4. PMID 349320.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ^ Wilson N, Scott A. (May 1989). "A double-blind assessment of additive intolerance in children using a 12-day challenge period at home". Clinical & Experimental Allergy. 19 (3): 267–272. doi:10.1111/j.1365-2222.1989.tb02382.x. PMID 2736427.
  6. ^ Weiss, B. and Williams, J.H. and Margen, S. and Abrams, B. and Caan, B. and Citron, L.J. and Cox, C. and McKibben, J. and Ogar, D. and Schultz, S (March 1980). "Behavioral responses to artificial food colors". Science. 207 (4438): 1487–1489. doi:10.1126/science.7361103. PMID 7361103.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ^ Williams, J.I. and Cram, D.M. and Tausig, F.T. and Webster, E. (June 1978). "Relative effects of drugs and diet on hyperactive behaviors: an experimental study". Pediatrics. 61 (6): 811–817. PMID 353680.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. ^ a b Goyette, G.H. and Connors, C.K. and Petti, T.A. and Curtis, L.E. (April 1978). "Effects of artificial colors on hyperkinetic children: a double-blind challenge study". Psychopharmacol Bull. 14 (2): 39–40. PMID 652927.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. ^ a b Rowe KS (1988). "Synthetic food colourings and "hyperactivity': A double-blind crossover study". Australian Pediatrics. 24 (2): 143–147. doi:10.1111/j.1440-1754.1988.tb00307.x. PMID 3395307. Cite error: The named reference "Rowe88" was defined multiple times with different content (see the help page).
  10. ^ a b Swanson, J. and Kinsbourne, M. (March 1980). "Food Dyes Impair Performance of Hyperactive Children on a Laboratory Learning Test". Science. 207 (4438): 1485–1487. doi:10.1126/science.7361102. PMID 7361102.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  11. ^ Pollock, I. and Warner, J.O. (January 1990). "Effect of artificial food colours on childhood behaviour". Arch Dis Child. 65 (1): 74–77. doi:10.1136/adc.65.1.74. PMC 1792406. PMID 2301986.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  12. ^ a b Egger, J. and Carter, C.M. and Soothill, J.F. and Wilson, J. (January 1989). "Oligoantigenic diet treatment of children with epilepsy and migraine". Journal of Pediatrics. 114 (1): 51–58. doi:10.1016/S0022-3476(89)80600-6. PMID 2909707.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  13. ^ a b Center for Science in the Public Interest, Quarter-Century Review, pg.11
  14. ^ Cite error: The named reference Lau06 was invoked but never defined (see the help page).
  15. ^ Maffini, M. V. and Neltner, T. G. (2014). "Brain drain: the cost of neglected responsibilities in evaluating cumulative effects of environmental chemicals". Journal of Epidemiology and Community Health. doi:10.1136/jech-2014-203980.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  16. ^ 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.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  17. ^ Williams JI, Cram DM, Tausig FT, Webster E. (June 1978). "Relative effects of drugs and diet on hyperactive behaviors: an experimental study". Pediatrics. 61 (6): 811–7. PMID 353680.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  18. ^ Swanson JM, Kinsbourne M. (March 1980). "Food dyes impair performance of hyperactive children on a laboratory learning test". Science. 207 (4438): 1485–7. doi:10.1126/science.7361102. PMID 7361102.
  19. ^ Cite error: The named reference nf was invoked but never defined (see the help page).
  20. ^ Harley, J.P. and Ray, R.S. and Tomasi, L. and Eichman, P.L. and Matthews, C.G. and Chun, R. and Cleeland, C.S. and Traisman, E. (June 1978). "Hyperkinesis and food additives: testing the Feingold hypothesis". Pediatrics. 61 (6): 818–828. PMID 353681.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  21. ^ Wender EH, Lipton MA. The National Advisory Committee Report on Hyperkinesis and Food Additives -- Final Report to the Nutrition Foundation. Washington D.C: The Nutrition Foundation, 1980.
  22. ^ Cite error: The named reference Lipton83 was invoked but never defined (see the help page).
  23. ^ Gross, M.D. and Tofanelli, R.A. and Butzirus, S.M. and Snodgrass, E.W. (January 1987). "The effect of diets rich in and free from additives on the behavior of children with hyperkinetic and learning disorders" (PDF). Journal of the American Academy of Child and Adolescent Psychiatry. 26 (1): 53–55. doi:10.1097/00004583-198701000-00011. PMID 3584001.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  24. ^ Egger J, Carter CM, Graham PJ, Gumley D, Soothill JF (1985). "Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome". Lancet. 1 (8428): 540–5. doi:10.1016/S0140-6736(85)91206-1. PMID 2857900.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  25. ^ Kaplan BJ, McNicol J, Conte RA, Moghadam HK (1989). "Dietary replacement in preschool-aged hyperactive boys". Pediatrics. 83 (1): 7–17. PMID 2909977.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  26. ^ Egger J, Carter CH, Soothill JF, Wilson J. (1992). "Effect of diet treatment on enuresis in children with migraine or hyperkinetic behavior". Clinical Pediatrics. 31 (5): 302–7. doi:10.1177/000992289203100508. PMID 1582098.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  27. ^ Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ, Taylor E. (1993). "Effects of a few food diet in attention deficit disorder". Archives of Disease in Childhood. 69 (5): 564–8. doi:10.1136/adc.69.5.564. PMC 1029619. PMID 8257176.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  28. ^ Schoenthaler SJ, Doraz WE, Wakefield JA. (1986). "The Impact of a Low Food Additive and Sucrose Diet on Academic Performance in 803 New York City Public Schools". International Journal of Biosocial Research. 8 (2): 185–195.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  29. ^ Schoenthaler SJ, Doraz WE, Wakefield J. (1986). "The Testing of Various Hypothesis as Explanations for the Gains in National Standardized Academic Test Scores in the 1978-1983 New York City Nutrition Policy Modification Project". The International Journal of Biosocial Research. 8 (2): 196–203.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  30. ^ Uhlig T, Merkenschlager A, Brandmaier R, Egger J. (1997). "Topographic mapping of brain electrical activity in children with food-induced attention deficit hyperkinetic disorder". European Journal of Pediatrics. 156 (7): 557–61. doi:10.1007/s004310050662. PMID 9243241.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  31. ^ Schmidt MH, Mocks P, Lay B, Eisert HG, Fojkar R, Fritz-Sigmund D, Marcus A, Musaeus B. (1997). "Does oligoantigenic diet influence hyperactive/conduct-disordered children--a controlled trial". European Child & Adolescent Psychiatry. 6 (2): 88–95. doi:10.1007/bf00566671. PMID 9257090.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  32. ^ Peter C, Bennett W, Brostoff J. (1997). "The Health of Criminals Related to Behaviour, Food, Allergy and Nutrition: A Controlled Study of 100 Persistent Young Offenders" (PDF). Journal of Nutritional & Environmental Medicine. 7 (4): 359–366. doi:10.1080/13590849762493.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  33. ^ Peter C, Bennett W, McEwen, LM, McEwen HC, ROSE, EL. (1997). "The Shipley project: Treating food allergy to prevent criminal behavior in community settings" (PDF). Journal of Nutritional & Environmental Medicine. 8 (1): 77–8. doi:10.1080/13590849862311.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  34. ^ Bateman B, Warner JO, Hutchinson E, Dean T, Rowlandson P, Gant C, Grundy J, Fitzgerald C, Stevenson J. (2004). "The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children". Archives of Disease in Childhood. 89 (6): 506–11. doi:10.1136/adc.2003.031435. PMC 1719942. PMID 15155391.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  35. ^ McCann D, Barrett A, Cooper A; et al. (November 2007). "Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial". Lancet. 370 (9598): 1560–7. doi:10.1016/S0140-6736(07)61306-3. PMID 17825405. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  36. ^ Swain AR, Dutton SP, Truswell AS (August 1985). "Salicylates in foods". Journal of the American Dietetic Association. 85 (8): 950–60. PMID 4019987.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  37. ^ "Food Intolerance Network" (PDF). Retrieved 2008-03-31.

Discussion[edit]

Requesting to update the Feingold Diet page[edit]

On advice of one of the editors, I will try to present my reasons here to show that the old Kavale & Forness 1983 meta analysis is out of date and inappropriate as a major authority on the effectiveness of the Feingold Diet. Furthermore, I hope to show that the statement citing it -- "there is no good evidence that it (the Feingold Diet) is effective" -- is no longer valid.

However well done the Kavale & Forness analysis may have been in its day, and no matter how high the status of Kavale and Forness in the research community, they were reviewing 23 studies published four decades ago.

Since then, more than 300 newer studies on the subject have been published in MedLine, based on a search for "ADHD Diet." In addition to studies on children, there have been animal studies, immunological studies, epidemiological studies, and even in vitro studies testing neurites exposed to combinations of additives. There is ample new material on the connection of Feingold-type diets and behavior for more modern reviewers to review.
Below are three recent reviews:

(1) Research Review: The role of diet in the treatment of attention-deficit/hyperactivity disorder - an appraisal of the evidence on efficacy and recommendations on the design of future studies.
Stevenson J, Buitelaar J, Cortese S, Ferrin M, Konofal E, Lecendreux M, Simonoff E, Wong IC, & Sonuga-Barke E.
Journal of Child Psychology and Psychiatry, 2014 May;55(5):416-27. doi: 10.1111/jcpp.12215
  • Stevenson said "no one meta-analysis can be considered definitive." (Page 419).
  • In his review, he found that even when excluding two studies with very high effect sizes, the data "suggest that food colour elimination is a potentially valuable treatment approach for ADHD." (Page 423).
  • He explained that studies of food dye elimination were sometimes part of a larger trial of the Feingold Diet, while oligoantigenic or restricted elimination diets (REDs) exclude not only all items excluded by Feingold but also several allergenic foods. In a meta analysis of REDs, Stevenson concluded that such a diet "may be beneficial for children with ADHD with a history of adverse reactions to food" (page 423). He commented that all the RED studies evaluated had positive effects, although he wished for larger, newer studies with more modern controls and incorporating recent changes in dietary habits.
  • Note: The 1983 Kavale-Forness meta analysis was not even included in Stevenson's reference list.
(2) Restriction and Elimination Diets in ADHD Treatment
Nigg JT & Holton K. (See full text)
Child and Adolescent Psychiatric Clinics of North America 2014 Oct;23(4):937-53. doi: 10.1016/j.chc.2014.05.010
  • Nigg referred to the old Kavale-Forness meta analysis (Page 3), as follows: "An initial meta-analysis … including 23 studies of varying quality regarding the efficacy of the Feingold diet; the authors concluded that the composite effect size (d = 0.11) was too small to be important, setting the tone for 2 decades of professional skepticism as to the value of elimination diets."
  • On page 17, Nigg says that a "consensus has emerged among most reviewers that an elimination diet produces a small aggregate effect but may have greater benefit among some children."
(3) Diet in the treatment of ADHD in children - a systematic review of the literature
Heilskov Rytter MJ, Andersen LB, Houmann T, Bilenberg N, Hvolby A, Mølgaard C, Michaelsen KF, & Lauritzen L.
Nordic Journal of Psychiatry, 2015 Jan;69(1):1-18. doi: 10.3109/08039488.2014.921933
  • After reviewing the usual studies, Heilskov-Rytter specified two large studies (McCann et al 2007 and Bateman et al 2004) which found that children from the general population (e.g., without a specific ADHD diagnosis) showed an increase in adhd-like behavior after ingesting food dyes and benzoates (a preservative). The effect "seemed linked to genetic polymorphisms in the metabolism of histamine." (page 5)
  • Of the four meta-analyses considered - including Kavale & Forness (1983) - Heilskov-Rytter said that they "all conclude that artificial food colorants have small, but statistically significant adverse effects on ADHD symptoms in some children."

Another thing to consider is that far more food dyes are consumed today - 500% more, per person per day - than in 1950. See Vojdani 2013 and Stevens 2014. When the "average child" eats more than 60 mg food dyes per day (Stevens 2014a, page 3), the studies on children being "challenged" with 1 mg (Rose 1978), 5 mg (Levy 1978), 13 mg (Mattes 1978), 26 mg (Goyette 1978, Williams 1978), 27 mg (Harley 1978, Williams 1978) or 35 mg (Weiss 1980) of food dyes are no longer really relevant.

Taking the above into consideration, may I proceed to update the page? Shulae (talk) 05:19, 3 August 2016 (UTC)[reply]

A rather cherry-picked presentation there. So far as I can see from the totality of these (much better!) sources, none of them say the Feingold diet is effective in delivered its claims. The most I think we can take from this is that our statement of the current state of knowledge needs to be tweaked so that we say there is disagreement among the sources whether there is "no evidence to support broad claims that food coloring causes food intolerance and ADHD-like behavior in children" or whether there is some tentative evidence. Alexbrn (talk) 06:55, 3 August 2016 (UTC)[reply]
Cherry-picked? Perhaps this is a Wikipedia term I am not familiar with, but if I understand correctly, you are saying I have chosen only those reviews that support my own view while ignoring others. You could be right. So I went looking for them, and did a search of Pubmed for "ADHD Diet Review" and studied all those I could find published in the past several years (2013-2016). Below are all of them that I can find, and a relevant quote or summary from each:
Lachance 2015 - "Dietary patterns high in processed foods, or a “western dietary pattern”, are strongly correlated with an increased risk of developing depression, mild cognitive impairment, and ADHD."
Nigg 2014 - "The literature clearly demonstrates that a minority of children with ADHD will benefit from an elimination diet."
Heilskov Rytter 2015 - "Elimination diets and fish oil supplementation seem to be the most promising dietary interventions for a reduction in ADHD symptoms in children"
Stevenson 2014 - "Restricted elimination diets may be beneficial, but large-scale studies are needed on unselected children, using blind assessment and including assessment of long-term outcome. Artificial food colour elimination is a potentially valuable treatment but its effect size remains uncertain, as does the type of child for whom it is likely to be efficacious."
Verlaet 2014 - "Though results have been inconsistent, a meta-analysis of double-blind placebo-controlled trials concluded that there is evidence to support the theory that AFC (artificial food color) promote hyperactivity in hyperactive children" ... "a behavioral response to food often occurs in ADHD children"
Esparham 2014 - "RED (restricted elimination diet) has been shown to benefit children with ADHD."
De Thieje 2014 - "These findings suggest that ingested foods can affect behavior in a subset of children with ADHD through a mechanism that involves a non-IgE-mediated, cell-mediated, or non-allergic response."
Gray 2013 - Finally, one that doesn't support my opinion. Gray says salicylate elimination diets are harmful. He is referring to the most restrictive form of Feingold-type diet -- the Failsafe diet used in Australia. In his clinic, he saw only those who were not happy with the Failsafe diet. After all, those who were satisfied and benefitted didn't need him. This led to a very skewed population, several of whom actually had developed eating disorders.
Arnold 2013 - "In summary, food and additive sensitivity is not a major cause of diagnosable ADHD but may occasionally be a significant factor. Two weeks of a severely restricted diet should not be exceeded without obvious benefit."
Note: I agree -- when considering the oligoantigenic or few foods diet he is discussing. The much less restrictive Feingold diet itself, however, can be used life-long without any such limitation because it is a perfectly adequate diet -- the way people USED to eat before all the additives were incorporated into foods. Two studies fueled by concerns raised about the nutritional adequacy of the Feingold diet both concluded that children on the diet were not only meeting all nutritional daily requirements, but were doing it better than those on the "regular" diet.
Kaplan 2013 -- the abstract doesn't say anything about diet although it came up in the search for reviews on diet and adhd. I have not yet acquired the full text.
Akhondzadeh 2013 - Does not mention foods at all because he is concentrating on vitamin deficiencies and nutrients. Although not part of the Feingold diet, per se, the Feingold Association (FAUS) provides this sort of information to members as it becomes available.
Sonuga-Barke 2013 - In the Abstract, it says: "Artificial food color exclusion produced larger effects but often in individuals selected for food sensitivities" ... In the Results: "when the best probably blinded assessment was employed, effects remained significant for free fatty acid supplementation .. and artificial food color exclusion"
Note: It is true that those who think their child may be sensitive to foods are more likely to try the diet -- in which case one might say if you have an inkling that your child is sensitive, then try it. So? (BTW, I had no idea whatsoever that my child was sensitive; I only tried the diet for him because all else had already failed.)
Goodman 2013 - "Artificial food colour exclusion, and to a lesser extent free fatty acid supplementation, significantly reduce symptom severity in ADHD, although the clinical significance of these results has not been determined."
Zell 2012 - This review came up on the search but appears to be about supplements, not diet. Full text not acquired yet.
Pulgaron 2013 - This review came up on the search but appears to be about obesity. Full text not acquired yet.
Ghanizadeh 2013 - This review is about zinc deficiency. FAUS routinely advises members about such research. Ward (1990) found that when kids with ADHD were exposed to yellow dyes they lost zinc -- and he was using only a HALF a mg -- so some deficiency may be normalized simply by avoiding the colorings, although in many cases a supplement of zinc is helpful, especially at the start. FAUS suggests members concerned about zinc should first ask their doctor how much is safe to use.
FDA - In preparation for its 2011 hearing on food dyes, the FDA certainly appeared to do its best to skew the evidence by accepting without question any study that found no effect of food dyes on children's behavior while picking holes in any study that did find such an effect. After all their effort, however, they couldn't quite make it go away. In their Background document (2011), they wrote: "For certain susceptible children with Attention Deficit/Hyperactivity Disorder and other problem behaviors, however, the data suggest that their condition may be exacerbated by exposure to a number of substances in food, including, but not limited to, synthetic color additives"
As you wrote, the food dyes are only part of the "Feingold Diet." But this is research - one piece of the puzzle may be studied at a time. If you want to get very picky about such things, you will come to the conclusion (and some have) that no study of the actual Feingold Diet as it is used today has ever been done. But that's not very helpful, so let's live with what we have.
Yes, there are a few older reviews that say there has been no research supporting diet for ADHD, but they each were older than 2013, and seemed to discuss only the old studies from the 1970s and 1980s while ignoring all the newer ones. Unfortunately, not all the newer studies are so great either. You have the Ward study in 1990, for example, which found that children with ADHD lost zinc (and had increased symptoms) when exposed to Yellow 5 and Yellow 6. Ward's study has been criticized because his results, while statistically significant, were not very dramatic ... but take another look. He used one HALF a mg of the coloring in his "challenge" study. I am surprised he got any measurable result at all. What would have happened if he had used 50 mg instead of .05 mg? Nobody has ever tried it, although the Rowe & Rowe 1994 study did identify a dose response in children exposed to a range of Yellow 5 challenges from 1 mg to 50 mg. As you know, when you have a dose response, that is a pretty good indication that you are looking at something real. Now Rowe, of course, has been criticized because he used symptoms such as irritability and sleep problems rather than just the core ADHD symptoms .... yep. So what? Show me a kid with an ADHD diagnosis and ask his mom if he is irritable and has trouble falling asleep; she will say yes, which is why Rowe added those symptoms to his questionnaire. Not to mention that if diet can cure even just those symptoms in your kid, wouldn't that be worth it?
In light of all the above, it would not be correct to say that there is only tentative evidence that food additives can affect ADHD. In fact, there is now general acceptance that the food dyes affect behavior. Salicylates and preservatives have yet to be studied; each has had only one or two studies devoted to it over all these decades. Not whether, but how big a piece of the ADHD puzzle this diet will prove to be is the question now; with the expansion of studies on environmental toxins, neonatal and perinatal exposures, vitamin/mineral deficiencies, hormonal variations, genetic deviations, and interactions of all of the above, there is much room for more research. However, if you wait until all the chips have fallen, today's babies will be grown up already. A parent looking for help can benefit from knowing that a diet such as Feingold is not harmful and that it can be a place to begin the journey to find help for their child. Use of the diet does not prevent other needed treatments, including the use of meds, if still needed. Shulae (talk) 03:02, 5 August 2016 (UTC)[reply]
You obviously have a strong opinion, but it seems out-of-step with the science wrt Feingold. Much of what you write might be better discussed at our Diet and attention deficit hyperactivity disorder article, but this article is about the Feingold diet, and we need sources on that. So far as I can see it was an elimination diet with some whacky ideas that came and went and has now fallen into obscurity source-wise. Any current debate on the topic of diet and ADHD doesn't frame it in terms of the Feingold diet but mentions it - at most - in passing. Alexbrn (talk) 05:22, 5 August 2016 (UTC)[reply]

This is rather like saying that research on cholesterol has nothing to do with heart disease treatment. Okay. Forget the "reviews" ... I challenge you to a duel of studies. Suggest any study you believe disproves the Feingold diet. Such a duel only works if we both have the full text - I have most of them, and will be happy to provide you with the one you want if I have it. I assume you will do the same. Since, as you say, there are really no modern studies of the diet as a whole, you will have to go back and look at the old ones, but you seem quite knowledgeable, so go ahead.

If you don't want to do that, then pray take a look at a modern study not yet included in any of the reviews, so by Wikipedia rules it can't be mentioned in Wikipedia, I guess. Eagle (2014) studied the effect of artificial food colors and salicylate-containing foods (the basic Feingold diet, whether he used the name or not). Both affect an enzyme variously named PST (Phenol SulfoTransferase-P) or SULT1A. He not only describes the process of enzyme inhibition, but also the "U" shaped effect that explains for the first time why some kids actually get worse for a few weeks on the diet before they get better. It also explains, he says, some of the studies that showed little effects from their "active" challenges - because the placebo vehicle used contained the same kind of chemicals as the experimental item. The study I have is under password protection and not open to the public, but I can send it to you via email. It is published in the peer reviewed journal Physiology & Behavior and is indexed in MedLine.Shulae (talk) 16:47, 5 August 2016 (UTC)[reply]

Not interested in a duel, sorry. It seems sources (even ones concerned with additives and ADHD) have left the "Feingold diet" to history, and it would be WP:SYNTH for us to connect any dots we think there might be. Simply put, we just reflect what good sources say about the Feingold diet. As I say, some of the recent work on additives may be useful for informing our Diet and attention deficit hyperactivity disorder article. Alexbrn (talk) 16:53, 5 August 2016 (UTC)[reply]
Actually, not. If you look again, you will see that Dr. Feingold himself recommended studying the food dyes first .... not because they were more important, but he figured that it would be easier to study 7 dyes than thousands of flavorings or dozens of salicylates. There have been very few "diet" studies since they are expensive ... and those studies were of varying quality. And very old. Then there were the many studies in which children were put on an additive-free diet (a Feingold-type diet, in full or in part) followed by a challenge of one or more food dyes for those who responded to the diet. Those are the studies Kavale & Forness reviewed. Today's studies on food dyes are done exactly the same way, whether they say the name "Feingold" or not. One reason many do not use the "F" name may well be the campaign mounted by the food additive industry to make "Feingold" practically a dirty word. This was done in a way similar to that mounted by Big Tobacco against the "wacky notion" that smoking could cause lung cancer.
Obviously, I have been wasting my time since instead of any kind of compromise suggestion you have resorted to name-calling. You have stated that the Feingold Association (teaching the diet since 1976) should be "shunned." That Dr. Feingold (Chief of Allergy of Kaiser Permanente, not just some fly-by-night quack) had "wacky ideas." If I show you new reviews, then I am "cherry picking." Something from 1983 is "ending the debate" while conclusions by others in 1999, 2010, etc. are "too old." There was more, but these come to mind as being certainly way beyond the pale of a NPOV. Shulae (talk) 20:02, 5 August 2016 (UTC)[reply]
Sorry, but I have to agree that it is original research to further a WP:POV if we have to assume sources are related to the Feingold diet in some manner. --Ronz (talk) 20:53, 5 August 2016 (UTC)[reply]
Hi Ronz, I am glad to see a new name on here, but can you clarify what you wrote? How could a study on food dyes and behavior not be related to the Feingold diet? From the beginning, food dyes alone were the usual challenges, no matter what else was eliminated (or not) before challenge. Shulae (talk) 20:57, 6 August 2016 (UTC)[reply]
Assuming they are related is original research. We might be able to avoid OR if Feingold had made a list of all the dyes he studied, and then later studies were done on all those specific dyes. --Ronz (talk) 17:44, 8 August 2016 (UTC)[reply]

Ronz, all the certified (FD&C and D&C) dyes were eliminated by Dr. Feingold. He specified all of them - therefore, a study on any of them is relevant. He himself didn't do any dye-related research; he was a clinician interested in patients. He called for researchers and biochemists to do the research and predicted it would take 30 years.

Therefore, any study on food dye and behavior ... or flavorings and behavior ... or BHT and behavior ... would be relevant because they are components of the Feingold diet used for behavior.

A study on food dye and cancer, on the other hand, would not be related to the Feingold Diet because the Feingold Diet is not concerned with treatment or prevention of cancer.

It is true that more and better studies are needed, but that doesn't mean those already done are not relevant. Shulae (talk) 01:15, 9 August 2016 (UTC)[reply]

And even then it would be difficult, I think, since AIUI the Feingold diet also stipulated things about family behaviour and perfume-wearing, e.g. Alexbrn (talk) 17:46, 8 August 2016 (UTC)[reply]
He specified all of them - therefore, a study on any of them is relevant. Then it's OR. --Ronz (talk) 17:50, 9 August 2016 (UTC)[reply]

Alexbrn, no change in "family behavior" is now, or ever was, required in order to properly do the Feingold diet. I know Barrett at Quackwatch says so, but he is simply making that up.

Nothing is wrong with perfume, either -- if it is natural and not a petrochemical. FAUS helps parents find natural products, including perfumes. But what does any of this have to do with the research?Shulae (talk) 01:15, 9 August 2016 (UTC)[reply]

  • Third opinion request: A request was filed for a third opinion on this dispute. Since there are already three participants, the 3O process does not really apply. I will say in passing, though, that the reliability of a reference is quite different from its relevance, and that it is not our job to extrapolate from the findings of a scientific study (unlike in academia, where such extrapolation would be quite acceptable). Whether or not these particular studies are relevant, I will leave it to you folks to determine. Vanamonde (talk) 12:52, 6 August 2016 (UTC)[reply]

Compromise?[edit]

Would you accept this as a second paragraph for this page? (citations to be added properly of course)

Although popular with parents, much of the research on the Feingold diet has been disappointing. The scientific panel convened by the National Institutes of Health in 1982 reviewed all of the research then available and concluded that "these controlled challenge studies do not appear to have addressed adequately the role of diet in hyperactivity." [NIH pg. 163] Even today, although the scientific consensus is that the eliminated food dyes do affect behavior [Nigg 2014, Stevenson 2014], research on salicylates and preservatives is still lacking. Shulae (talk) 01:25, 9 August 2016 (UTC)[reply]
WP:LEDEs are meant to summarize what is discussed in more detail in the article body, so getting body content would be a first step. But we'd need sources relating the research to the Feingold Diet. Alexbrn (talk) 02:30, 9 August 2016 (UTC)[reply]
Do you mean I should edit the body of the article first? Be happy to. As for relating the sources TO the Feingold Diet, please clarify. Shulae (talk) 03:29, 9 August 2016 (UTC)[reply]
Yes, I mean that is what would need to happen. However, I'm still not convinced: I mean text we insert needs to be backed firmly by a source and not imply things about the diet that cannot be found in good sources. Alexbrn (talk) 06:34, 9 August 2016 (UTC)[reply]
I agree that good sources must always be used to back up statements. As I understand it, a "good source" is considered one published in a peer reviewed journal. Not all, however, are equally good. Am I allowed to comment on a source? I don't mean an opinion, but pointing out something factual, like whether their numbers add up correctly? Shulae (talk) 16:06, 9 August 2016 (UTC)[reply]
Of course (on Talk anyway). Alexbrn (talk) 16:08, 9 August 2016 (UTC)[reply]

Page edits[edit]

Under "History" - I have clarified Dr. Feingold's actual professional history, since he was far more than "just" a pediatrician/allergist. I can cite his biography page in Wikipedia or the Feingold Association's biographical page at http://feingold.org/about-the-program/dr-feingold/bio/, but if you prefer a history book, I will get the citation. I am writing while on a trip across country, and I didn't bring all those books with me.

Also, I might as well ask in advance: Is it okay to quote from his own books or papers to describe the original Feingold Program, or do I have to quote only what somebody else said about it? In a similar vein, may I quote the Feingold Program Handbook if describing some detail of the actual Program? Shulae (talk) 07:09, 12 August 2016 (UTC)[reply]

Question re procedure: I noticed that the citation of the National Health Museum (Footnote #10) just goes to the website http://www.accessexcellence.org/HHQ/qow/qow05/qow051031.html and one would be on their own to find the information referred to. The information is correct, but is such a general source considered sufficient or should I actually find some better or more specific citation for the statement? Shulae (talk) 07:20, 12 August 2016 (UTC)[reply]

WP:PSTS. Primary sources can be used, but with care since articles should be based on secondary sources. This is usually decided case-by-case but I'd say any quotation from a primary source must be unexceptional and hung off something in a secondary source to establish that it's WP:DUE. Alexbrn (talk) 07:33, 12 August 2016 (UTC)[reply]

Barrett citation[edit]

There is a notation "Check date values in: |access-date= (help)" in the Quackwatch (Barrett) citation in reference #3. I have looked at the cited page and the date (2004) is correct. The page on Quackwatch has not been updated since then. IMO there are a lot of problems with that document, but the date is not one of them, so I will fix the problem with the citation date if somebody can explain the question. Thanks. Shulae (talk) 01:56, 16 August 2016 (UTC)[reply]

Alexbrn, please explain what your comment in your revision means: Re-accurify to source
I am unfamiliar with the word "re-accurify" and it is not in my dictionary.
Do you feel that what the parents did to help each other with this "difficult" diet is not a bona fide part of a section called "Reception?" Or was there something wrong with my presentation of that information? Shulae (talk) 05:40, 16 August 2016 (UTC)[reply]
Where is the stuff about the Seventies sourced? Alexbrn (talk) 05:43, 16 August 2016 (UTC)[reply]
I'm sorry -- which stuff are you asking about? If you mean about how hard the diet is, that information was there before. The source listed is Barrett of Quackwatch which in my opinion is an awful source which I would never use for anything, but I didn't want to delete it since it has been on there for years. I can find other sources for you if you like. Or if you mean the development of support groups in the 1970s ... well the Feingold Association was incorporated in 1976 as an umbrella for all the little "kitchen-table" support groups. If the history on the Feingold website is not okay as a source, I can find others. Smith talks about it in his history book. It is mentioned in various other places, and I actually have the IRS letter granting FAUS exemption from Federal income tax. This is history, not my personal opinion. Possibly it belongs under the History heading rather than under here. I await your explanation of what you need. Shulae (talk) 06:32, 16 August 2016 (UTC)[reply]
We can't relate the development of the food industry to the FD unless we have sources that explicitly do so. Do we? Alexbrn (talk) 06:45, 16 August 2016 (UTC)[reply]
The section claims that the diet is too hard because there are few foods without additives available resulting in a narrow selection of foods etc. It is written in the present tense, indicating it is a claim true today. Certainly, Barrett has no current source whatsoever to support his assertion of this being true today. In fact, he never did have any real source beyond quoting someone else's opinion. And surely that paragraph looks ludicrous to anyone who knows that they can walk into a Walmart and buy organic ketchup (no additives or corn syrup) to go with their Hormel Natural Choice deli meat or all natural hot dogs ... or that they can get a Foodlist at the Feingold website which has thousands and thousands of brand name processed acceptable additive-free foods. That Foodlist, by the way, would be a perfect source showing the change in foods related to the Feingold diet... in particular because the Foodlist has grown from 2 pages in the early 1980s to over 400 pages now. Would that be an acceptable document as a source? Or, how about just taking out that whole paragraph and leave the second paragraph only? Shulae (talk) 07:16, 16 August 2016 (UTC)[reply]
If a source doesn't mention the the Feingold diet, it's hard to see a legitimate use for it. If tense is a problem, change the tense. Alexbrn (talk) 07:30, 16 August 2016 (UTC)[reply]
My question is: Can I use the Feingold Foodlist expansion from 2 pages to 400+ pages as an indication that more additive-free processed foods are available today for families wishing to use the Feingold Diet? This was not covered in any reviews or studies, but I do have the actual physical books. It's simply a fact. What you would call original research. I have done a search of Matthew Smith's history of the Feingold Diet (gotta love Kindle books) and indeed a search for "supermarkets" brings up the information that after the Southampton studies showed that kids were more hyper after eating food dyes, the food industry began changing their products ... to remove the additives, in particular the food dyes ... because people didn't want them. This is a history book, and the whole book is about the Feingold Diet, the history, the research, etc. -- is that enough of a connection for you? I cannot give you a page number because it is a Kindle, but I can copy the section if you need to see it. Shulae (talk) 07:53, 16 August 2016 (UTC)[reply]
Looks a useful source, so long as any of Smith's arguments are attributed to him. That would probably be the best way of presenting it. Alexbrn (talk) 08:26, 16 August 2016 (UTC)[reply]
Thanks. Shulae (talk) 23:14, 16 August 2016 (UTC)[reply]
How about chapter # and a brief, relevant quote for verification?
I modified it slightly, making some assumptions about the source and trying to be more precise and encyclopedic. --Ronz (talk) 16:54, 17 August 2016 (UTC)[reply]
Will be out this afternoon -- will do as soon as am backShulae (talk) 20:27, 17 August 2016 (UTC)[reply]
I am assuming that you meant the Smith book, not the Barrett document. The following is the section about additive-free food being increasingly available in supermarkets. Although the book was published in 2011, if you live in the US, you have surely noticed that by now almost every supermarket has either a "health food" section of its own or has incorporated many additive-free and/or organic options in its offerings. I hope this is the info you wanted.
Chapter 9, Conclusion.
In addition, many large companies in the British food industry decided to preempt legislative action and changed the production and packaging of their products to accord with nutrition concerns. . . . Marks and Spencer, for example, removed 99 percent of the artificial colors and flavors found in their foods, and other supermarkets followed suit.(40) . . . Other food manufacturers and supermarkets, often responding to pressure from parents, began to use natural dyes such as beetroot instead of those made from petrochemicals and emphasized on the packaging of certain products that they were free of artificial additives. (42) . . . a number of organic supermarkets, such as Trader Joes and Whole Foods Market, have become more visible in the United States, providing American consumers with additive-free products. Many of the Feingold families reported relying almost exclusively on these supermarkets for their groceries...(43)
Matthew Smith. An Alternative History of Hyperactivity (Critical Issues in Health and Medicine) (Kindle Locations 2305-2314).
Much appreciated. The corresponding article content seems a bit too much OR, even after my changes. --Ronz (talk) 17:04, 18 August 2016 (UTC)[reply]
I am a little confused. by "corresponding article" do you mean the history book excerpt above? Or do you mean the Feingold Diet page? If so, which part are you referring to as too OR? Perhaps I can fix it. Shulae (talk) 23:20, 18 August 2016 (UTC)[reply]

The corresponding content in this article seems to require original research with just this source as verification. --Ronz (talk) 17:50, 19 August 2016 (UTC)[reply]

Perhaps I am being dense ... but is this a problem? All reviews require original research - that is what they review, isn't it? That doesn't mean that they all come to the same conclusion. Unfortunately, some of these reviewers have ties to the food industry, and so do some of the original researchers. For example, when the Nutrition Foundation funded Harley back in 1970s to do a study of 10 preschoolers using the Feingold and a "control" diet, 100% of the kids did better on the Feingold diet by parent reports --- yet he managed to report that there was no support for the Feingold diet because there weren't any teachers involved (didn't he know they were PRE-schoolers when he started?).
Ah - maybe what you mean is that I need more than one supportive review? How many reviews would even talk about supermarkets related to the Feingold diet? There are no studies on "availability of foods to use." But I will see what I can find. Shulae (talk) 13:23, 20 August 2016 (UTC)[reply]
All reviews require original research What are you referring to re "reviews"? --Ronz (talk) 15:47, 20 August 2016 (UTC)[reply]
There are critical reviews, meta analyses, and various other kinds of reviews of the science. There are also textbooks and history books. What they are all discussing is original research (except that some meta analyses actual review a collection of other reviews). The reviews can come to different conclusions based on the research they choose to include (Millichap & Yee, for example, left out almost all studies done after 1990 even though they wrote their review in 2012). The result is that no review is itself without a POV ... but some have better scientific support than others. I can't understand why you have this question - surely you know what a review is?Shulae (talk) 18:03, 20 August 2016 (UTC)[reply]
You've completely lost me. What does the type of research within the sources have to do with this? --Ronz (talk) 16:06, 21 August 2016 (UTC)[reply]
What's not to understand? Not all reviews are created equal. Some include only those studies that support their own prejudice or that of the people hiring them to write the review. Start looking at both sides, instead of choosing only those sources that agree with the original negative message on this page. As it stands, rather than conveying proper information, this page has become a soapbox for the food additive and drug industry. Shulae (talk) 16:32, 22 August 2016 (UTC)[reply]
I'm sorry, but it appears you don't understand my concerns at all, and think for some reason I'm concerned with the types of research in the sources rather than the interpretation and original research necessary on our part with the content in this article that's supposedly verified from the actual sources. This is a case of WP:OR on our part. --Ronz (talk) 16:50, 22 August 2016 (UTC)[reply]
I was told that OR is not acceptable and that the only sources that can be cited are reviews, histories, etc. And although in the Guidelines it said individual studies can be cited sometimes, any study I cited was criticized as being OR, apparently because the studies I chose supported what would be a minority view. Can you consider for a moment that the POV of the current article really might be wrong? Shulae (talk) 17:46, 22 August 2016 (UTC)[reply]
I cited was criticized as being OR, apparently because the studies I chose supported what would be a minority view You don't appear to understand the concerns. The OR is in asserting that the studies apply to the Feingold diet, when they don't mention the Feingold diet at all.
Note that this is totally off topic from the concerns that I'm trying to discuss in this thread. --Ronz (talk) 17:58, 22 August 2016 (UTC)[reply]

In Britain ...[edit]

... the Feingold diet appears to be under the control of this group. Their diet seems a bit different. Any sourcing on such non-US Feingold diets, I wonder? Alexbrn (talk) 08:38, 21 August 2016 (UTC)[reply]

This is the Hyperactive Children's Support Group. I have their materials but not with me (I am traveling). They do use the same symptom list as we do on their website, and according to the papers she sent me, they eliminate the same additives but of course they have to use the E-numbers and their list is slightly different because the additives found in their foods are slightly different. In other words, there may be food dyes our FDA accepts that the UK doesn't and vice versa, and that will make the list slightly different. She mentions salicylates, but again I don't have her list with me. You may have noticed she mentions MSG ... FAUS marks products with MSG in their Foodlist for those who want to avoid it. However, FAUS has not made MSG one of the big items to eliminate, partly because it is used under so many pseudonyms and clones that the effort may well be impossible. Nevertheless, FAUS educates members about avoiding it as much as possible, and why. I don't see much other difference. They are not a franchise of the US organization, but are likely too similar to be called a "version." They were allowed to use the "Feingold" name a long time ago and I don't know the details. If you need them, I can find out. I think she does not maintain a Foodlist like FAUS does, possibly because of lack of manpower.
FAUS also has an international program now that is used in several countries by individuals. The main difference is the use of E-numbers to identify additives to be avoided, and a lack of a Foodlist. Again, that is due to lack of manpower and access to information of each country's products. Instead, FAUS provides a "skeleton" Foodlist that the family can fill in as they identify products that they tolerate.
Not sure if you are aware that FAUS does cover Canada in its Foodlist, but that is the only country outside the US with a FAUS-generated Foodlist. Shulae (talk) 10:45, 21 August 2016 (UTC)[reply]
Wonder if there'a any secondary sourcing on this (a long shot, probably). Alexbrn (talk) 10:48, 21 August 2016 (UTC)[reply]
I can look to see if the Smith history mentions it. The CSPI history probably doesn't, but I can look there too. One would think that in a factual situation - where either something does or does not exist, and no POV is involved - one should be able to go to a source of the fact. Shulae (talk) 15:20, 21 August 2016 (UTC)[reply]
The issue then is weight. If no secondary source on the planet mentions something, why should Wikipedia? (which is meant to be a tertiary source). Alexbrn (talk) 15:23, 21 August 2016 (UTC)[reply]
That is a reasonable question; and no, neither of those histories mention it. Of course, the information may be important to those people living in another country who might like to know how to access such information in their country. Shulae (talk) 20:01, 21 August 2016 (UTC)[reply]
Yes, but for that they need something other than an ecyclopedia. WP is WP:NOT a directory. Alexbrn (talk) 20:07, 21 August 2016 (UTC)[reply]

Effectiveness[edit]

JamesWatson (?) seems to think that I am supposed to limit myself to making suggestions for you to change this page since my interest causes a COI. So let's see how that works.

Under Effectiveness it says "In general, as of 2014 there is no evidence to support broad claims ..."

Obviously, you can't say "as of 2014" when you are citing a book published in 2013. Most likely the book only includes studies up until 2012 at the latest, but I don't have a copy and can't prove that. To give him the benefit of the doubt, I did a PubMed search but Tomaska appears to have published no studies himself on either food dyes, additives, or adhd in any year. Therefore, kindly change that phrase to "as of 2013" Shulae (talk) 16:02, 22 August 2016 (UTC)[reply]
Thank you for making the correction.Shulae (talk) 17:50, 22 August 2016 (UTC)[reply]
    • Just in case you don't know, Dr. Feingold never ever claimed that food dyes (or any other additives) CAUSE hyperactivity or ADHD. What he always said from the beginning is that such things trigger those symptoms in the people genetically predisposed to them.Shulae (talk) 00:47, 23 August 2016 (UTC)[reply]


Can you explain why the term "broad claims" is appropriate here: "there is no evidence to support broad claims ..." It appears to be a statement less about truth and more to establish that particular POV as inarguable and to quash any minority view. Like, if I give you evidence such as an animal study that shows tartrazine induces anxiety, aggression and hyperactivity in rats at ordinary human doses, that study indicates a connection but it is not a "broad" claim. Using words like that seems inappropriate for an encyclopedia although I don't know the Wikipedia term for it. Can you enlighten me?Shulae (talk) 18:43, 22 August 2016 (UTC)[reply]
What source says it "indicates a connection" ? And how do we even know the study was sound? Inexpert dabbling in primary research takes us straight into WP:OR territory. The WP:WHYMEDRS essay is good on this. Alexbrn (talk) 19:14, 22 August 2016 (UTC)[reply]
I was not arguing for using any particular study -- there are lots and lots of them, as a matter of fact. Each is a piece of the puzzle and if you put them all together you have quite a good picture. What I am saying is that the use of the term "BROAD CLAIMS" is inappropriate. It means that any future study, review or analysis can be termed "not broad enough" .... in other words, it is a qualifyer without any real measurable meaning, used to prevent any discussion. It should be removed from the sentence, which can then be followed by the minority opinion (which I will be happy to give). Shulae (talk) 23:58, 22 August 2016 (UTC)[reply]
What you may not know is that the early studies (those reviewed by Kavale) and most later ones, too, used tiny amounts of "challenges" -- either because they didn't know any better and were told to use that amount by the Nutrition Foundation, or because they themselves wanted to make sure they got no results. Imagine studying aspirin but insisting that only a half a baby aspirin can be used in any studies. You would conclude that aspirin is useless. The Ward 1990 study, for example, used a HALF a mg of Yellow 5 ... that he actually got measurable results is astonishing, but then he was a chemist and not a psychiatrist. Yet he was criticized for getting "small" results ... suppose he had used 50 mg or 100 mg ... even in 1978, the FDA was very aware (yes, I have their 2000-page report) that kids were eating up to 300 mg of food dyes per day. Yet no study has EVER been done on that amount. So ... you got a bunch of stupid studies with teensy amounts of dye and no amounts of salicylate and ignoring the preservatives altogether ... and yet they are making "broad claims" ... I don't think that they have the right to be making ANY claims, personally. Of course, that is my POV. Shulae (talk) 23:58, 22 August 2016 (UTC)[reply]
It is not our job as amateurs to "put them all together": that is WP:SYNTHESIS. There is the sound of an axe being ground here and this is not directly relevant to the Feingold Diet (unless sources say so). As I have written several times now, some of this may be relevant to our Diet and attention deficit hyperactivity disorder. If changes get made there, then our brief summary of the state of research can change here as it is in WP:SYNC with that article. Alexbrn (talk) 03:51, 23 August 2016 (UTC)[reply]
I'll go over there. Are you the admin / editor for that page too? How do editors get assigned? Shulae (talk) 15:46, 23 August 2016 (UTC)[reply]
Visited your blog, BTW, and I'm very impressed by your photography. Shulae (talk) 18:52, 23 August 2016 (UTC)[reply]

Technique[edit]

In the last sentence of this section, the word treated is in Scare quotes (aka hostile quotes), as follows: not just the subject being "treated" The source cited, Kanarek (2011), used the word treated only once, saying "Feingold treated hyperactive children with a diet..." This is straightforward, without the sneering sense imparted by hostile quotes. I am requesting in the interest of NPOV, please remove the hostile quotes. Shulae (talk) 18:24, 22 August 2016 (UTC)[reply]

New sentence under Effectiveness[edit]

"In common with other elimination diets, the Feingold diet can be expensive and boring, and so difficult for people to maintain."

While sounding negative, the sentence means nothing. All food costs money, and you can get tired of hamburgers, too. Also, there is quite a difference between an oligoantigenic diet that allows 5 items total and the Feingold diet which allows all kinds of food and plenty of processed foods, restaurant foods, candy, ice cream, soda ... you name it, there are acceptable brands, even in vending machines.

So ... the article does not specifically prove anything about the Feingold diet -- and we are not talking here about any other diets.

Why no proof? Because there isn't any. No study has ever tested the boringness or expense of using the Feingold diet. This is just somebody's opinion. Or is POV okay as long as it agrees with the "broad picture" of the page?

This sentence cannot be fixed and should be removed. Since I am not an official editor any more, please just remove it. Shulae (talk) 00:42, 23 August 2016 (UTC)[reply]

Again, that's all your original source to further a pov not in the sources. --Ronz (talk) 16:53, 23 August 2016 (UTC)[reply]
Granted. But just because somebody published an opinion without proof, does that give us the right to say it in an encyclopedia as if it were true? I would not object to saying that the author of that paper assumed the diet would be difficult, boring, and expensive. But to say it like a fact, we should know it is backed up by at least some proof, and there is none. Shulae (talk) 18:30, 23 August 2016 (UTC)[reply]
It's a typical application of WP:FRINGE. Opinions from independent experts analyzing fringe theories are generally acceptable. --Ronz (talk) 20:01, 23 August 2016 (UTC)[reply]

Newer Reviews of Studies[edit]

It really would be nice to refer to some research done after 1982, don't you think? Do you have objections to any of the following newer reviews of studies?

Stevenson et al (2014). J Child Psychol Psychiatry.
Research review: the role of diet in the treatment of attention-deficit/hyperactivity disorder--an appraisal of the evidence on efficacy and recommendations on the design of future studies.
Verlaet 2014:
Nutrition, immunological mechanisms and dietary immunomodulation in ADHD.
Sonuga-Barke et al 2013
Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments.
Stevens et al 2013.
Mechanisms of behavioral, atopic, and other reactions to artificial food colors in children.
  • Malakar 2014:
Minding the greens – Role of dietary salicylates in common behavioural health conditions http://www.TalkingAboutTheScience.com/studies/Malakar2014.pdf

Shulae (talk) 03:42, 23 August 2016 (UTC)[reply]

No, it wouldn't be nice to use newer reviews, unless they explicitly discuss the Feingold diet. Alexbrn (talk) 03:55, 23 August 2016 (UTC)[reply]
Okay:
  1. Stevenson 2014 refers to "Feingold" 6 times
  2. Verlaet 2014 refers to "Feingold" 2 times
  3. Sonuga-Barke 2013 refers to "Feingold" 5 times
  4. Sonuga-Barke 2015 (an editorial in the Journal of Child Psychology and Psychiatry not listed above) refers to "Feingold" 3 times and also uses the words "promoters" and "sceptics" once each in his conclusion
  5. Stevens 2013 refers to "Feingold" 10 times
  6. Malakar 2014 refers to "Feingold" 21 times
I hope you will find at least one of these useful. Some of them are openly available, but I have all the full texts if you need any of them. Shulae (talk) 14:22, 23 August 2016 (UTC)[reply]
Well what do you propose? Alexbrn (talk) 05:56, 26 August 2016 (UTC)[reply]

Rimland (Contentious label)[edit]

Please remove the word controversial from "the controversial autism researcher" as it is WP:LABEL. Shulae (talk) 15:20, 23 August 2016 (UTC)[reply]

What do the sources say? --Ronz (talk) 16:54, 23 August 2016 (UTC)[reply]
The source given is the paper by Rimland himself. I have never heard of him referred to as controversial -- except, perhaps, in the very beginning when he was the first to claim that autism was not caused by "refrigerator mothers" as mainstream medicine then believed. Is there any compelling reason to discredit him? Shulae (talk) 18:14, 23 August 2016 (UTC)[reply]
If the material related to this article fits what's discussed in Bernard_Rimland#Conflicts_with_medical_opinion, then I can see why the label is being used. --Ronz (talk) 20:07, 23 August 2016 (UTC)[reply]
You have a point; his view of thimerosal as one of the causative agents of autism is controversial. The article by him on this page, however, has nothing to do with autism or mercury; it is an analysis of Kavale's review, which he was well qualified to write. Using that label is an attempt to downgrade his contribution. Shulae (talk) 16:44, 24 August 2016 (UTC)[reply]
Given the review was written in '83, I'm not clear why the label is appropriate. --Ronz (talk) 21:13, 24 August 2016 (UTC)[reply]
Thank you. I believe the controversy over mercury did not begin until 1999 or later. The label is an attempt to discredit or diminish Rimland, possibly because he doesn't agree with Kavale & Forness. It would be really great if you were willing to just remove that word "controversial" from the sentence (my history with the diet apparently creates a technical COI, so I am not supposed to edit anything directly, I'm told.). Shulae (talk) 06:45, 25 August 2016 (UTC)[reply]

Ronz, you took off Rimland's review with the comment that you "dont see why a 1983 opinion has weight here" ... if you really believe that, then pray take off the Kavale-Forness 1983 review too. I gave a list of recent ones that specifically refer to Feingold and have asked you and Alexbrn to choose which one(s) you would like to mention. As it happens, every single review on food dyes/additives and behavior in the past decade says that behavior IS affected by food dyes/additives. The only recent review negative to the Feingold diet is Millichap and he (not surprisingly) ignores all the newer research and stresses only those same old studies (which is why his review is not on my list). Shulae (talk) 21:04, 25 August 2016 (UTC)[reply]

The two sources are nothing alike. --Ronz (talk) 19:22, 26 August 2016 (UTC)[reply]

Scare Quotes[edit]

Please remove the quotes around the word "treated" in the last sentence under Technique WP:SCAREQUOTES. Shulae (talk) 15:20, 23 August 2016 (UTC)[reply]

Maybe use a different word altogether if there's a problem using it without quotes. --Ronz (talk) 16:55, 23 August 2016 (UTC)[reply]
The article by Kanarek actually refers to the child being treated. Straightforwardly using the word. Whether or not the treatment works, he is still being treated and the added scare quotes are an inappropriately added sneer.Shulae (talk) 18:07, 23 August 2016 (UTC)[reply]
You suggested using a different word to avoid the quotes. How about this, which is closer to, but a little shorter than, what Kanarek actually wrote (p.387): Feingold stressed the importance of adherence to the diet by the whole family (for support), and that the individual sensitive to food additives would avoid them for life. Shulae (talk) 17:07, 24 August 2016 (UTC)[reply]