Unfortunately there are no tests which show if children react, or are unlikely to react to additives and natural chemicals in the diet. We know the diet works in some children as diet investigation research has shown big changes. We have worked with families to understand which foods need to be considered. The unusual part is that we do not know yet what is not working well in metabolic pathways that cause reactions to happen. Because the mechanism is not known a test cannot be developed. But doing diet investigation can show if diet has a role. Each child is different and should be investigated in an individual way.
Which children might diet help?
Those most likely to respond to diet come from families where members have the sorts of symptoms that diet responders have. These include all allergic symptoms including eczema, rashes and hives, tummy aches, wheezing, urticaria, rhinitis, and hay fever, with mood, fuzzy thinking, or poor sleep. Other important symptoms include migraine, chronic headaches and irritable bowel syndrome [IBS]. No family has all of them! However, the more of these present in the three generations in the family; parents, grandparents, and including aunts and uncles, but not cousins, the more likely your child will have a positive outcome. Food does not need to be suspected in these symptoms, though it is a helpful clue where it is. In addition a positive reaction is more likely where a child has shown a reaction to a specific food that was noticeable, perhaps when the child was young, even though these clear reactions no longer occur. Parents report having noticed symptoms after their child ate chocolate, high additive foods, increased grapes, or tomato dishes, or milk intolerance in infancy. Of course it is important that all other possible medical causes for the symptoms have been considered and some or all of the problems remain before diet is begun.
What exactly might diet change in my child?
A surprising result of the research into diet and ADHD was that the main symptom that parents report diet changing was not hyperactivity, but mood. The research reported a decrease in being irritable, touchy, or cranky. Parents use words like “easier to live with” in those who respond to diet. Children who were “off with the fairies” or “on another planet” were reported to be easier to reason with, and “being demanding or argumentative” decreased. Impulsive behaviour, poor concentration, and restless improved. Concentration improves most in the under five-year-olds, but still improved usefully in older children. Food sensitive children become less difficult to control, throw less tantrums and have less sleep problems (restless sleep, waking often, vivid dreams and nightmares). Another surprise from the results was that all the above symptoms, including being unhappy or “cries easily” improved more than hyperactivity itself. Each child changes in his or her own way. The important idea that comes from that is that what is happening is that dietary factors aggravate the underlying symptoms. Silly children become more flighty, and touchy ones become more inclined to fight.
Where any changes in irritability, activity, sleep, concentration or impulsivity can be explained by the normal ups and downs of life diet does not need to be considered. In other words where difficult behaviour can be explained some other way do not consider diet. However neither should you put up with behaviour that is really outside the normal range and is taking all of your energy as a parent to manage. As parents say “Even if diet is difficult at the beginning it is much easier than a difficult child”. It can be such a pleasure to see your child as he really is, and it is good for him to be his real self too.
The other benefit of diet is that it decreases many physical symptoms that are often present in food sensitive children. Symptoms include those mentioned above as well as lethargy or hypo-activity [the opposite to hyperactivity], car sickness, mouth ulcers, bad breath and body odour, and bed wetting. Some symptoms, such as limb pains, are not often present but where they are, they often resolve with diet.
There is evidence that diet has a role in some children, but not in all.
Because some people hope that diet is uncomplicated and so has a role in everyone or not one, they may say there is no evidence. The Australian National Health and Medical Research Council states that some research studies suggest that food and food additives influence some behaviours in some children. The early research did not show much effect but newer work done after 1985 has definitely provided scientific evidence that diet can be a useful treatment in some children.
If you suspect food sensitivity in your child do follow it up. I have met parents who are coping well with their lives who still say they wish diet had been know better when they were children. They coped but may have put up with nausea, carsickness, and other discomforts throughout their childhood, as well as not doing as well at school as they were capable of, despite much effort on their part. They do not want that for their child and have used diet well. It does not need to be extremely strict. Give yourself the help of an experienced dietitian and use my resources, especially Are You Food Sensitive? and Tolerating Troublesome Foods? See