The Feingold Diet to cure ADHD????

Cecil's Columns/Staff Reports
1

I was astonished to see this claim in the recent Staff Report Does corn cause hyperactivity in kids?

Rather than actually answer the basic question, the Staff Report chose instead to advance the premise that artificial additives could cause or exacerbate ADHD. Oddly, the usual culprit (caffeine, which studies have also shown can treat ADHD) was not mentioned, but the Feingold Diet came up. This was a bit of hokum pretty well debunked over twenty years ago by a double-blind study which demonstrated absolutely no benefit of the diet to children with ADHD. The diet is questionable for other reasons, including recommending avoiding flouride toothpastes and speaking out heavily against flouridation of the public drinking water, two thinks which have greatly reduced the incidence of dental caries.

Corn sweetener has also shown no link to ADHD in controlled studies, though there are many people trying to sell books who will tell you otherwise. I have yet to see a study show a positive link between sugar (which is all corn sweetener actually is) and ADHD which actually stood up to scientific scrutiny. Indeed, inattention can be more readily caused by lack of sugar than by excess of sugar. The only exception is diabetics.

In short, there is NO scientific evidence that diet has any effect whatsoever on genuine ADHD. Children without ADHD can become hyperactive from consuming too many stimulants (especially caffeine), and children who are malnourished or have reduced blood sugar levels can consequently display inattention, but this is not ADHD. Even food allergies and irritable bowel syndrome have nothing whatsoever to do with ADHD, although they are certainly frustrating for a child to deal with, and can make it harder for the child to cope. That’s true no matter what the child may be suffering from, ADHD or not.

I’m very disappointed to see such a bastion of science as the Straight Dope fall into this.

For a more skeptical look at the Feingold Diet, please see this articles at Quackwatch.org:

http://www.quackwatch.org/01QuackeryRelatedTopics/feingold.html

I’d also like to point out that one of Quackwatch’s “Signs of a Quacky Web Site” is the claim “Diet is the principal cause of hyperactivity.” I am not going to leap to the conclusion that the Straight Dope is therefore a quacky website, but I do believe Straight Dope Staffer Ken has been suckered in by another quacky website.

I have disabled the link since the Report was removed. – CKDH

2

Boy, that Staff Report could have been a lot shorter. The simple answer to the question “Does corn cause hyperactivity in kids?” is ** No. **

You’ve expressed my sentiments exactly, calliarcale. It was extremely surprising and disappointing to me that the response to a medical and scientific question did not include a single medical or scientific reference. The only reference was to a commercial site promoting the purchase of materials and programs related to the medically unjustified “Feingold Diet”.

Now, regarding some specifics in the report:

SDStaff Ken: Other than the Feingold diet, please provide a citation that pediatricians and pediatric psychiatrists routinely recommend that their ADHD patients avoid corn.

SDStaff Ken: Please provide a citation that eating corn can cause IBS in children.

As calliarcale pointed out, corn sweetener is simply sugar and is indistinguishable from sugar produced from non-corn sources.

Please provide a cite of a peer-reviewed scientific study showing this tenuous link.

Who is “some”?

As far as root causes go, it’s known that ADHD is a complex disorder that is likely to have multiple root causes, and prevailing scientific opinion is that processed foods and “other things” are not likely to be the primary root cause. For example, ADHD has a genetic component (example cites: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11483473&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1514878&dopt=Abstract
http://www.genome.gov/10004303 ).

This phrase almost has too many weasel words to be a statement of fact. “reducing or eliminating”? “as many as possible”? “seems to”? “beneficial effect”? This should be a simple question to answer: can you provide a cite to a scientific study showing a correlation between intake of processed foods and the severity of ADHD symptoms?

Oh, and what exactly are “other things in the environment”? That is a very unscientific phrase. What exactly does this include…for that matter, what could it possible exclude?

…

Regardless of the popular opinions and misconceptions about ADHD, it is believe it or not an actual medical condition that has known treatments and therapies. And I’m talking about more than just Ritalin, the medicine that is popularly associated with ADHD treatment – today there a variety of both stimulant and non-stimulant medications which can be very effective. In addition, there are a number of behavioral therapy programs which are effective either by themselves or in conjunction with medication.

Disclaimer: I am the parent of a child diagnosed with ADHD (combined type) who is being treated with both medical and behavioral therapy for this condition, quite successfully; and the spouse of an adult with ADHD (inattentive type), being similarly treated.

-mok

3

I also have ADD and have done excessive research over the last 3 years of having the disorder (I actually have had it all my life but only managed to garner a diagnosis 4 years ago). The Feingold diet (as previously mentioned) has been well refuted as effective. All double blind placebo controlled studies have turned out no results except for precious few that were actually substance intolerance. The Feingold diet is based around the premise that salicylates (a group of chemicals of which Asprin is a synthetic one) disrupt the thinking processes and neurological development of children. The problem is, that when the diet is analyzed closely, you will find that many compounds that are allowed and profoundly high in salicylate chemicals or derivatives as well as the fact that many foods that are restricted have absolutely no chemical basis (based on his premise for the diet) for being restricted! It is junk science…if you wish to know more, you can read a wonderful article written by Dr. Stephen Barrett at www.quackwatch.org

4

As a ADHD person, and parent of one, I can tell you the Feingold stuff is all crap.

One wishes it were true, but it’s not.

The “Feingold effect” is easily explained-- Everyone likes attention, anytime you pay attention to a person, as in watching what they eat, or cooking up special meals, that person will usually respond positively.

I suggest the original response was well-meaning, but not in the grand old factual style of TSD… At the very least a clarification with some serious backpedaling is in order.

5

grg88, you said it! This is a key statement, and captures in a nutshell the reason so many “alternative therapies” are widely proposed and used for ADHD and related problems (for example, “chelation” for autism :rolleyes: – yes, I know that’s a hijack, but not an entirely unrelated one.)

Speaking from experience as a parent of a child with ADHD, I know that my parental instincts make me want to do anything I can to help my child. And so if an alternative therapy seems to produce benefits over time, it’s difficult as a parent not to believe that the therapy “works”. But from a scientific point of view, that’s just an anecdote. The real question has to be, is the therapy scientifically and medically justified? In this case, concerning corn and the Feingold diet, the answer is such a resounding “no” that I was surprised to see the staff report written that way.

-mok

6

Amen, and very well said.

Neurological and psychiatric disorders in particular are highly affected by the placebo effect – after all, if you think positively, you’ll be in a better mood, and if you’re in a better mood, you’ll be better able to cope. Alternative therapies generally thrive on the placebo effect, and that’s why it’s especially important to conduct double-blind studies to eliminate the placebo factor to tell whether or not the treatment really is safe and effective or at least worth the expense. Some people pay thousands of dollars to nutritionists who recommend these kinds of diets; is that justified, when the same effects could be acheived by persuading the kid that a cheap sugar pill will cure them? And what happens if/when the kid sees through the con? The placebo effect will disappear. What then?

7

The most comprehensive, responsible resource on the internet on ADHD is www.chadd.org, in my opinion. They have this to say about the Feingold Diet:

[[Over the years, proponents of the Feingold Diet have made many dramatic claims. They state that the diet ¾ which promotes the elimination of most additives from food ¾ will improve most (if not all) children’s learning and attention problems. They claim that the diet will lead to improvements in school, and report a deterioration in learning and behavior when the diet is not followed.

In the past 15 years, dozens of well-controlled studies published in peer-reviewed journals have consistently failed to find support for the Feingold Diet. While a few studies have reported some limited success with this approach, at best this suggests that there may be a very small group of children who are responsive to additive-free diets.]]

(Fact sheet #6 = http://www.chadd.org/fs/fs6.htm)

8

As someone who was “on” the Feingold diet as a child let me just hijack and say I did not appreciate the attention of having my mother constantly monitoring my every bite.

My whole childhood felt like a constant battle over food. No you can’t have birthday cake, no you can’t sip a soda.

I partly blame the stupid Feingold diet for the bulimia I practiced in high school and college. A cookie! I might never see another cookie again! Gimme all the cookies you got!

All my mother’s wishes are coming true re: I hope you have a kid exactly like you. But no way would I ever add to the average day’s battle with nitpicky food rules.

9

Regardless of what you think of the Feingold diet and whether it can help children with ADHD, it does not hurt to remove processed, pre-packaged foods from your diet! In fact, it can only make you healthier.

10

Of course, but that is not the point. ADHD is a neurological disorder that often benefits from medication. There is no evidence that diet influences this disorder. One should try to eat whole foods as much as possible, but I doubt very much that food dyes and artificial flavors are such a health risk. And there is no evidence that they cause or aggravate attention deficit disorder.

11

I’m not sure that counts as a thread hijack, since you are presenting your own anecdote about how the Feingold diet doesn’t work to cure hyperactivity, and how damaging it can be in the process.

Anecdotes like yours are precisely why I’m so disappointed in the Straight Dope for publishing such nonsense.

In another anecdotal rebuttal to the staff report, I’d like to point out that me and all of my brothers ate plenty of corn as children. I have ADD, My eldest brother has ADHD. My other two brothers do not (although the youngest one has his own cognitive problems, for reasons definitely unrelated to diet and genetics; he suffered extensive brain damage at the age of four months due to an unexplained coma). And no one in my family has suffered any of the symptoms of irritable bowel syndrome, at any age. Indeed, we all seem to have very good digestion, which probably partly accounts for our expanding waistlines. :smiley:

I find it very sad that some parents think the best response to hyperactivity isn’t trying to understand what their kid is going through but simply blaming it on what the kid is eating, as if it were the kid’s fault they can’t concentrate. Taking away soda won’t help ADD. The old myth of sugar causing hyperactivity was pretty soundly debunked years ago by studies which found no causal link between excessive sugar consumption and attentiveness. (Deficient sugar consumption is definitely associated with inattention, however; if you don’t have enough carbohydrates, your brain will not be able to function at full capacity. So sugar is not evil – in fact, it is absolutely neccesary, even though it is certainly possible to eat more than you really need to.)

Similarily, caffeine does not cause hyperactivity, except in very high doses. If your child is drinking a whole 12-pack in a day, that’s not good. But one can of pop a day will have little to no effect, apart from a short-lived increase in awareness due to the stimulant effect of caffeine. Ironically, in a genuine ADHD sufferer, it is possible that caffeine will actually have a beneficial effect. After all, most of the popular treatments for ADHD (including Ritalin, or methylphenidate) are nothing more than central nervous system stimulants.

12

I’m still waiting on a retraction or a clarification or a correction related to the original Staff Report. Mods, Staff – is there any chance of that happening? The column as it stands is not in keeping with the tradition of fighting ignorance. I think it’s safe to say that’s not just my opinion – the column makes factually incorrect claims. I think it would be great to see the original question and answer “as is”, followed by excerpts or paraphrases from this thread showing the responses, and finally a clarification either by the original author or someone else on what the real science is behind the relation between diet and ADHD.

As many of us in this thread have discussed and provided supporting documentation for, the following points are closer to the truth:

  1. Although conventional wisdom holds that sugar, processed foods, and artificial additives are detrimental to suffers of ADHD, or even “cause” ADHD, numerous studies have shown no such links. As some have pointed out, sugar for example is necessary to proper brain functioning.

  2. Conventional wisdom also holds that caffiene (whether from soft drinks, chocolate, etc.) can exacerbate or cause ADHD. Again, studies have shown no such link. Since caffeine is a CNS stimulant, it may even have a moderate beneficial effect for true sufferers of ADHD.

  3. There are many various diet regimens proposed for treatment of ADHD, such as the notorious Feingold diet (which includes the corn restriction). Studies have also shown that this diet has no beneficial effect.

  4. There is no known or proven physiological basis (no “science”) for why consumption of corn or corn products could lead to ADHD. Corn cannot “cause” Irritable Bowel Syndrome in children, and IBS cannot cause ADHD. They are unrelated disorders.

  5. Everyone should always eat a balanced diet appropriate to their age group. Opinions on what constitue a balanced diet obviously vary by culture, religion, economic class, etc. Processed foods can be part of a balanced diet.

  6. While the cause of ADHD is not fully known, it is known to have a strong genetic component. It is also strongly suspected that problems with early brain development are involved.

  7. There are effective treatments for ADHD other than diet. Some treatments are pharmaceutical. These include both stimulant medications such as Ritalin and Concerta and non-stimulant medications such as Strattera. Some treatments are non-medical. These include behavioral and occupational therapy regimens.

So, what is the process, if any, for correcting columns such as this? I know The Master doesn’t make mistakes, but accuracywise a Staff Report seems fair game for correction if the end result is increased edification.

Anyone?

-mok

13

If I had time, I’d like to write an expanded column on this topic. As it is, I really shouldn’t even be taking the time to be writing this. I think you summed up the main points, mok, however I take issue with two of them:

[[sugar for example is necessary to proper brain functioning.]]

This is not completely true. People can get plenty of carbohydrates through consumption of fruits and vegetables and our brains really do not benefit from eating processed sugar. In moderation, sugar doesn’t really hurt us either and I can’t imagine a life without birthday cake (even though the recently revised food pyramid recommends way less carbohydrates than the old one did). I agree that sugar does not cause or aggravate ADD or ADHD, as you said.

Point 2: While one might assume that the caffeine in coffee would act on the brain like Ritalin does, it really isn’t the same thing. There are special education teachers who swear that it improves the concentration of their students with ADHD, but studies have not found this effect.

Just sayin’.

And yes, I agree that this column should be re-written or expanded - mainly because I’m afraid someone looking up ADHD on the internet might find it and be misinformed. No offense to Ken, however, who is a brilliant, sensitive guy and a good writer, but he just doesn’t happen to know EVERYTHING.

14

I just wanted to do kudos to the OP and other posters who are providing refutation of a poorly done Straight Dope Q and A.

I wanted to do so, but refuting faddish ADD treatments is part of my job, and I didn’t feel like going to work at home.

Well done,

Whistlepig

15

Hmm…ya know, on reading this thread it may seem like I and others have been bashing pretty hard on poor ol’ SDStaff Ken. I know that wasn’t my intention…heck, I wouldn’t know Ken if I saw him; I’ve been just trying to set the record straight. As I indicated above, I have family members who suffer from ADHD so I can, um, well maybe state my case too strongly. So, thanks to Ken for taking on the question in the first place.

JillGat, on the two points you take issue with: I do maintain they are technically correct although perhaps overstated or stated misleadingly; my bad.

Whistlepig: I’d be very interested in learning more about your job which directly involves refuting faddish treatments. We need more people like you around.

-mok

16

Given the vociferous clamour for an addition or correction, is there someone who would volunteer to write it, or to compile it from the various comments?

17

An excellent point. It should be said that carbohydrates are neccesary for proper brain functioning, not just sugars. But sugars comprise a large percentage of the carbohydrates we eat, and you have to have a certain blood sugar level in order to remain conscious, as diabetics know all too well.

Processed sugar isn’t any better or worse than unprocessed sugars. I don’t think our bodies really care where the carbohydrates come from, as long as enough are available to fuel the body’s basic functions. They can come from table sugar (which is typically made from either sugar cane or sugar beets), corn syrup, or a bowl of juicy strawberries. It makes no real difference.

But as you say, sugar is vital to birthday celebrations. :wink:

Also an excellent point. I can anecdotally state that when I drink caffeine, I struggle less with my ADD. But is this a genuine effect or the placebo effect? I don’t really know. The only way to test would be to run a double-blind study on a fairly large group, and I’m not aware of anybody having done this on a large enough scale to really be useful.

I’d certainly recommend avoiding any doctor who said that caffeine was definitely a good treatment. That just isn’t known, and doctors have a responsibility to be honest and scientific.

18

I would be willing to do so.

JillGat and calliarcale, I promise to temper my points with your responses :slight_smile:

-mok

19

calliarcale, that is exactly where I was going, you just said it better. From the point of view of brain effects WRT ADHD, it’s all just glucose once it gets to the brain. JillGat, I agree with you that there are multiple good carbohydrate sources for glucose, my bad on the sloppy use of the word “sugar”.

I agree with you both here - I certainly was not intending to recommend caffeine as a treatment! My key words were “may” have a “moderate” effect. There have been studies done on this, but you are right calliarcale, none on a large enough group – heck I can’t find any in the last 20 years. I suspect that this study will never be done, anyway, since there is no drug company who would fund it obviously :wink: I think the point though, is that caffeine does not necessarily have the effect a layman would think it does on sufferers of ADHD; and that instead of looking for increasingly arcane dietary restrictions in search of a cure, get thee to a doctor trained in (pediatric or adult) ADHD with some knowledge of modern scientific treatment modalities. There are good drugs and good non-drug therapies out there for ADHD, beyond wacky diets.

-mok as always

20

This is a great thread. I also would be interested in whistlepig’s work, if s/he would be willing to share. As an ADHD “sufferer,” when I read the column about the Feingold Diet, I all but swore off corn forever. Thanks for enlightening me.