There are two important parts to the evidence for the low additives and natural chemicals elimination diet when beginning diet investigation for suspected food intolerance. See the attached articles for detail on this complex issue.
We need to remember that we are dealing with adverse reactions to foods or food chemicals that most people tolerate. So the early research was experimenting with just what to exclude at the same time as doing double-blind placebo-controlled trials to verify what they were finding.
Basic research is the research investigating the key question: does diet have a role?
A variety of different research teams in different countries have investigated this central question using a defined diet and challenging with suspect additives or food chemicals, and assessing the change, noting particular, usually ADHD, behaviours. The methodology used has been double-blind placebo controlled trials [DBPCTs]. This research is important to the scientific community. Since many have found a diet-behaviour connection, we can now say that the connection is proved.
The DBPCT research is not able to show what some scientists want in a clear, neat way for many reasons. One is that this diet is not an addition of one test medication but the removal of many dietary chemicals and foods. This means that the research needs to exclude many foods and chemicals and then challenge by returning some suspect ones and measuring the change. This is complicated by the reality that at this the exact suspect compounds are not fully known, as there are several. See the article “ADHD controversy”. The reason the research has shown a connection is because if the total load of suspect compounds, and there are many, is reduced, then an effect will be seen with reintroduction of some. As well one of the suspect compounds is artificial flavour and so it is a problem to disguise. See my thesis for detailed discussion.
Applied research investigates how the relationship between diet and symptoms can be used as a diet therapy for people who wonder if they are food sensitive. It is interesting to note that because Feingold was so sure of his diet there has not been studies just recording what people react to. Clinical research aims to find out the range of suspect foods and food chemicals, and record the full breadth of symptoms that change with diet. Diet has now been shown to change ADHD behaviours, mood, sleep and many physical symptoms such as eczema, headaches, migraine, irritable bowel syndrome, and many more. Applied research is particularly important to those professionals who want to practice diet therapy in the clinical situation.
I have conducted applied research for over 35 years now. The research grew from diet and ADHD, and families who suspected a diet reaction. I developed the Diet Detective Method which incorporates the idea that food intolerance is complex and each food sensitive person needs to manage investigation to find their individual diet. The result of this work, addressing the many ideas mentioned above, is now available in the attached articles.
Review Article The role of diet and behaviour in childhood. Journal of Paediatrics and Child Health (1997) 33, 190-194. This provides an overview of all the important research from 1975 to 1997, both basic and applied.
The Abstract of my Masters Thesis – A report on the use of a low additive and amine, low salicylate diet in the treatment of behaviour, hyperactivity, and learning problems in children. School of Public Health, Queensland university of technology, June 1995.
This provides a description of the literature available on the topic, and clinical trials with a discussion of the diet. The complete thesis is available from this site as one of the books, and as a bonus with the professional set.
The Role of Food Additives and Chemicals in Behavioural, Learning, Activity, and Sleep Problems in Children, Chapter 5 in Food Additives, 2nd Edn, 2000; AL Branen, PM Davidson, S Salminen, JH Thorngate, eds. Marcel Dekker, New York, Basel.
This invited book chapter on the role of diet is an international published source for the clinical findings in my thesis.
Dietary management of hyperkinesis and behavioural problems. Joan Breakey Australian Family Physician, Vol 7, June 1978 720-724.
This in my first report of findings presented in 1977 at the International Congress of Dietetics Post Congress Paediatric Seminar.
A report on a trial of the low additive, low salicylate diet in the treatment of behaviour and learning problems in children. J Breakey, M Hill, C Reilly, H Connell.
Australian Journal of Nutrition and Dietetics (1991) 49:3 89-94.
This reports on the study of the first 500 children and families followed up through child mental health clinics.
Genes, environment and bioactive food components. J Breakey. Presentation at the Dietitians Association of Australia Conference 2006
This outlines who is likely to be food sensitive.
Is food intolerance due to an inborn error of metabolism? J Breakey. Presentation at the Nutrition Society of Australia Conference Brisbane 2008
Food tolerance in infants who responded to dietary investigation of suspected food sensitivity. J Breakey K Fergusson. Presentation at the Dietitians Association of Australia Conference 2001. Abstract. More detail is available in the paper included in Fussy Baby.
My experience working in this area. Overall 2000 families have been followed up.
Submission on the Role of Diet as a Treatment for ADHD by Joan Breakey To the Royal Australasian College of Physicians November 2007
Is the diet right yet? Presentation after 25 years of practice, at the 1990 Seminar of the Queensland Allergy and Hyperactivity Association