WTF? I'm sure this is just a CYA, but the idea that most people need the advice of a medical professional to make dietary decisions is absurd. Sure, be careful about any radical fad diets, but adding or eliminating certain foods is quite safe. People do that all the time due to price fluctuations, availability and changing tastes with no ill effects.
People do this stuff all the time when cutting out gluten, starting to take fish oil, etc. It's really weird how someone will choose one thing at random out of all the alternatives, because that thing was pitched to them at just the right time by just the right person, and immediately start to believe it is a powerful force in their lives. There are dozens of dietary "miracle cures" for ailments ranging from depression to acne, and for each one, there are many people who swear by it. A trained doctor can be helpful in tempering expectations, reminding parents that short-term changes can't be taken seriously, and forcing a patient approach.
For instance, if peanut butter is cut from the kid's diet, and two days later the kid has a really bad day at school, many parents would jump to the conclusion that peanut butter was the only thing keeping the kid sane and start feeding it to him every day in every form they could think of. That would be a very bad thing if peanut butter was actually what was causing the problem. The doctor's job is to persuade the parents to be patient and evaluate the evidence more reasonably.
[edit] Not saying that it's a good reason to make that statement, but that's what that CYA aspect probably is...
The diet was composed for each kid individually, but the basic "few-foods" diet was rice, meat, vegetables, pears, and water. Potatoes, fruits and wheat were added for some kids, at prescribed intervals.
They were following this protocol: http://www.springerlink.com/content/k7444741381w544k/fulltex...
I think the concern is that completely eliminating a previously-regularly-consumed food due to potential hypersensitivity may risk a severe reaction when the food is re-introduced.
Have a glance at the charts in the Lancet PDF (that erikpukinskis helpfully linked) to see the improvements versus the control group and the way that reintroducing high-sensitivity foods caused a regression:
http://marrym.web-log.nl/files/adhd-and-elimination-diet-rct...
Wow. If I was a NYTimes health reporter, I would start researching a story on how up-and-coming young families are requesting food allergy tests for their seemingly asymptomatic kids as a matter of course, because that's clearly going to be the trend now.
It might be that their results are limited by the accuracy of the ImuPro test, which would be a shame.
Pelsser compares ADHD to eczema. "The skin is affected, but a lot of people get eczema because of a latex allergy or because they are eating a pineapple or strawberries." According to Pelsser, 64 percent of children diagnosed with ADHD are actually experiencing a hypersensitivity to food. Researchers determined that by starting kids on a very elaborate diet, then restricting it over a few weeks' time.
...
"In all children, we should start with diet research," she says. If a child's behavior doesn't change, then drugs may still be necessary. "But now we are giving them all drugs, and I think that's a huge mistake," she says.
My questions as someone ignorant of this area are 64% seems a confident generalization, theres no real physiological basis with respect to neurochemistry given for what causes these er mental allergies, what foods or absence thereof created the best results, is this scalable - it seems very trial&error so susceptible to misapplication and corner cutting and
I don't know how to read the following statement:
>Also, Pelsser warns, altering your child's diet without a doctor's supervision is inadvisable.
Supposedly they could have created a similar study by just testing a single problematic food item (I don't know, wheat or whatever), and they should also have found an effect - only smaller.
It does not seem to outlandish that different things can trigger allergies, yet all allergic reactions are somewhat similar.
http://marrym.web-log.nl/files/adhd-and-elimination-diet-rct...
http://www.theaustralian.com.au/news/health-science/diet-cha...
http://norvig.com/experiment-design.html
to look at to see just how generalizable these results may be. With the sample size and length of study described here, I'd look for a lot more replication over populations from more countries studied over longer periods before reaching the same conclusion as the NPR story.
[1] http://www.ncbi.nlm.nih.gov/pubmed/8257176 [2] http://www.ncbi.nlm.nih.gov/pubmed/17048717
Is the full text of [2] available anywhere? I can't seem to find it with web searches.
It would be interesting to look at the data, even with this small sample, to see how different the individual diets ended up being.
I have both ADHD and a mild latex allergy. Ironically, the latex allergy makes eating almost any fruit shitty ( http://en.wikipedia.org/wiki/Oral_allergy_syndrome#Cross_rea... )
However, my diet has definitely kept clear of most of these foods when possible for a long time now (although I really do love avocados), and even did the fatty fish thing for a while, but symptoms haven't changed for me.
Their "few-foods diet" was rice, meat, vegetables, pears and water. Then, based on the needs of the individual kids, likes and dislikes (and maybe their known susceptibility to various allergens?), etc, potatoes, fruit and wheat were added.
You could try just sticking with the reduced few-foods diet for a month and see if symptoms improve.
http://www.nytimes.com/2010/11/21/magazine/21Epilepsy-t.html
If I understand correctly, nobody completely understands why these dietary changes effect such significant benefits. But the results are interesting, to say the least.
About six years ago, I was forced to change my own diet quite radically. It has been a huge adjustment, but the process has made me acutely aware of just how much certain foods can effect me physically and mentally. And, too, how the physical reaction to certain foods effects me, mentally. So my bias here is obvious -- it's good to see investigation into possible causes. Especially when the medications for ADHD are a bit scary.
Sorry for the rant - I just think it's easy for non-ADHD people to dismiss ADHD. I see hyper kids who get called "ADD" and then people make comments/decisions about truly ADHD kids from these people ("Just don't feed them red dye #10!" (or whatever)).
As someone who recently abandoned methylphenidate for my new BFF bupropion, I understand the sensitivity to common claims that ADD/ADHD is primarily a lack of will power or a lack of parental/teacher discipline. But I still believe in science. Part of my early treatment involved vitamin supplements for serum deficiencies in iron, B12, and D. Bringing those levels up did not alleviate the symptoms for me, but I'm open to scientific investigation of reports that such supplements were a crucial difference for other people.
Interestingly, IgG is the longer-term response compared to the more immediate Immunoglobulin E response which causes the most dramatic allergy reactions such as rapid airway constriction.
The implication is that IgG type sensitivities are under-diagnosed because the symptoms are elusive and subtle, and ADHD often happens to be one of them.
"We recorded no difference in behavioural effects after challenge with high-IgG or low-IgG foods. These results suggest that use of IgG blood tests to identify which foods are triggering ADHD is not advisable. However, IgG blood tests might be useful in other diseases." [1]
To me, this says that any deviation from restricted diet caused a relapse in ADHD symtoms. A less technical explaination about IgG testing here: http://www.tldp.com/issue/174/IgG%20Food%20Allergy.html
[1] http://marrym.web-log.nl/files/adhd-and-elimination-diet-rct...
I had somehow read only the part about the sequence of food reintroduction having no association but missed the conclusion from that, which now of course seems obvious.
That really is something different. I'm surprised that this lede was buried in the articles on this result I've read. So the mystery continues. Very curious.