There have been documented changes in children’s behaviour during the
last half century. The top seven problems in schools, as reported in
U.S. national teacher surveys, are shown below:
1940
1990
talking out of turn : drug use
chewing gum : alcohol abuse
making noise : pregnancy
running in the hall : suicide
cutting in line : rape
dress code infractions : robbery
littering
:
assault
Increase in ADHD
A sharp increase in children’s behaviour problems in the 1960s and ‘70s
was noted by two U.S. paediatricians who reported their findings in
medical journals. Dr W. Crook described why he became interested in
this problem:
“In my general paediatric practice in Jackson Tennessee (pop 50,000) in
the 1950s, my partners and I were ‘the only game in town’. Yet we only
saw an occasional hyperactive kid ... In the 1970s, I saw so many
hyperactive children that I kept records...“
Both Dr Crook and Californian paediatric allergist Dr Ben Feingold were
convinced that the increase in processed foods was involved in the
changes1. After a number of studies, many funded by the food industry,
this idea was discounted and the general consensus was that
hyperactivity had always existed and was now recognised more frequently.
However, a new survey in the U.S. shows a real increase in the
prevalence of hyperactivity, now called attention deficit hyperactivity
disorder (ADHD). The percentage of doctor visits identifying ADHD
children has increased from 1.4% in 1979 to 9.2% in 19962. Australian
prescribing rates of drugs typically used to treat ADHD suggest a
similar increase: from 23,340 in 1990 to 346,000 in 1998. In the U.S.
prescription rates of drugs such as Ritalin and Prozac have increased
even for very young children. In 1994, there were 3,000 prescriptions
for Prozac for babies under the age of 12 months3.
Why the increase?
Traditionally, children’s behaviour problems were blamed on poor
parenting and studies show that mothers of ADHD children do have poorer
parenting techniques. However, when the children’s behaviour improves
with treatment, so do the mothers’ parenting skills, suggesting that
bad behaviour causes bad parenting rather than the reverse4. There is
evidence to suggest that both food additives and environmental
chemicals may be sources of childhood behaviour disorders5,6,7,8,9.
Food additives have been used in increasing quantities in our food
supply since the 1960s. Irritability, restlessness, inattention and
sleep disturbance rather than hyperactivity were the main effects of
food additives found by researchers in a Melbourne study10. Children
aged 2 to 6 exhibited constant crying, tantrums, irritability,
restlessness and severe sleep disturbance when affected by food
colouring. They were described by their parents as disruptive,
distracted and excited, high as a kite and out of control. Their
parents were exhausted through lack of sleep and the constant demands
of their children, who were unable to be comforted or controlled.
Children aged 7-14 were irritable, aimlessly active, lacking
self-control, whiney and unhappy, “like a bear with a sore head”.
Oppositional defiance
Given that irritability is the main behavioural effect of food
additives, it is interesting to look at a relatively new condition
called Oppositional Defiant Disorder11 of which irritability is the
core feature. Children with ODD like to say no even when it is counter
to their best interests. Other features include:
losing temper
arguing with adults
refusing adult requests or defying rules
deliberately annoying other people
blaming others for his or her own mistakes
touchy or easily annoyed
angry and resentful
ODD can progress to Conduct Disorder which is essentially a failure to
respect the rights of others, from vandalism to robbery to assault, and
generally results in breaking the law.
Medications for ADHD do not work with ODD. The approach recommended by
psychiatrists is to stay calm, to avoid conflict and confrontation, to
avoid backing these children into a corner and to emphasise positivity
and reward, but it is acknowledged that this approach has limited
success12.
Symptoms of ODD respond well to dietary management and this is
demonstrated in a BBC video, which shows remarkable improvements in a
group of young offenders filmed before and after a trial of diet13.
Superintendent Peter Bennett of the West Yorkshire police organised a
study with 9 children aged 7-16 with persistent anti-social, disruptive
and/or criminal behaviours. They were chronic offenders, with an
average arrest rate of more than once a month. All were hyperactive.
Their offences included violence, criminal damage, theft, arson, and
solvent/alcohol abuse. The children remained at home in the care of
their parents while following a restricted diet. The health and
behaviour of all nine children improved. After 2 years, two of the
subjects had abandoned the diet, re-offended and been placed in care.
Two had reoffended at much reduced frequency and violence. Five of the
9 subjects had not re-offended. Researchers concluded, “the [dietary]
approach appears to work within an ethical, efficient, effective,
economical and preventative paradigm without harm”14.
Diet, health and behaviour
Pursuing the link between diet, health and criminal behaviour,
Superintendent Peter Bennett compared two samples of 100 chronic
offenders and 100 non-offenders. Of the chronic offenders, 75% had
health problems often associated with food intolerance, which is much
higher than the rate for non-offenders15.
Symptoms of food intolerance16 include:
eczema, itchy skin rashes, asthma, stuffy or runny nose, frequent ear
infections, stomach ache, irritable bowel symptoms, reflux, colic,
‘sneaky poos’, headaches, migraine, lethargy, impairment of memory and
concentration, anxiety, panic attacks, depression, restless legs, sleep
disturbance, irritability, restlessness, hyperactivity.
How many are affected?
In 1974, Californian paediatrician Dr Ben Feingold proposed that
children’s behaviour and learning ability is affected by food additives
and natural food chemicals called salicylates1. Studies in the
seventies examining the Feingold hypothesis concluded that only about
5% of hyperactive children were affected. Later studies suggest that Dr
Feingold’s diet failed to remove sufficient harmful food chemicals.
Since the 1980s, a number of studies which have eliminated more foods
have achieved success with between 50 to 100% of ADHD
children14,17,18,19,20,21. A study in 1993 measured immunological
responses in more than 1000 ADHD children and found less than 5%
affected22 but reactions to food additives are not true immunologically
mediated allergic responses so this study has no relevance to the
incidence of food intolerance. Food additive reactions are difficult to
identify because they are related to dose, cumulative and often occur
the next day or later. The only way to detect reactions to food
additives is through an elimination diet followed by systematic
reintroduction.
In Australia the Simplified Elimination Diet from Royal Prince Alfred
Hospital (RPAH) is widely used. In a trial of the RPAH diet with 140
hyperactive children, one third improved substantially, one third
improved significantly and, of the other third, some improved but their
parents reported that the diet was “not worth the effort”19,23.
Which foods?
Originally developed for symptoms of food intolerance such as urticaria
and migraine, this diet avoids 50 additives (see below) as well as
naturally occurring salicylates (e.g. in tomatoes and citrus), amines
(e.g. in cheese and chocolate) and glutamates (e.g. in Vegemite and soy
sauce). Dairy foods and wheat are also avoided in the most severe cases.
Food additives to be avoided
Colours
102, 107, 110, 122, 123, 124, 127, 128, 129, 133, 142, 151, 155
160(b) annatto natural colour
Preservatives
200-203 Sorbic acids
210-213 Benzoic acids
220-228 Sulphites
249-252 Nitrates and nitrites
280-283 Propionic acids
310-321 Antioxidants
Flavour enhancers
620-635, HVP
Artificial flavours unregulated
Salicylates
These little chemicals are difficult to understand because they occur
in ‘healthy’ foods like fruit, vegetables, herbs, spices, nuts and
seeds. All plants produce toxic chemicals to protect themselves, and
some humans can be affected by these chemicals. The most common of
these chemicals are salicylates, of which aspirin is the best-known.
The side effects of aspirin have been recognised for nearly a century,
but it is less understood that salicylates in our foods can amount to
nearly an aspirin tablet a day. This is more than enough to affect the
most food-sensitive people24. The majority of people who are sensitive
to salicylates are unaware of their sensitivity because they eat
salicylates many times a day every day and usually react also to some
food additives23.
Sugar not the problem
Although sugar is often blamed for children’s behaviour, extensive
research has failed to find any connection. A possible reason for
improvements observed on sugar free diets is the simultaneous removal
of processed food including many additives and concentrated natural
chemicals in foods like jam and chocolate. One large and expensive
study in the U.S.A found no difference in children’s behaviour and
learning on disguised diets sweetened with sugar, aspartame or
saccharin. However, the children generally improved on all the
experimental diets, which were additive free25.
Diet modification in the community
The prevailing opinion of the medical profession and the food industry
is that so few children are affected by food additives that removing
additives from children’s diets isn’t worth the effort. Yet, where
dietary modifications have been carried out in the community, the
results speak for themselves.
School tuckshop in the UK
In 1996, additive-containing snack foods were banned at school tuckshop
of Wolney Junior School in South London and fruit was introduced
instead. All the teachers noticed a difference in behaviour and
concentration. Within two years, the success rate for 11 year olds in
stage two English almost tripled, from 23% of pupils achieving expected
results in 1996 to 64% in 1998. The school was listed as one of the
most improved in the country26
School lunches in the U.S.A.
The introduction of a low additive, low sugar policy in breakfasts and
lunches supplied by 803 New York City schools over 4 years was followed
by a nearly 16% increase in mean academic ranking compared to the rest
of the nation’s schools, who used the same standardised tests. There
was a significant decline in learning disabled children, from 12% to
5%. The percentage of students who ate school breakfasts and lunches in
each school was positively correlated with the school’s rate of gain27.
Detention centres in the U.S.A.
Similarly, a series of diet studies in U.S. juvenile correction
facilities involving more than 8000 juveniles showed that improvements
in approximately 20% of the youths were responsible for a 47%
institution-wide decline in antisocial behaviour. As in Superintendent
Bennett’s study, researcher Dr Stephen Schoenthaler noted that
improvements continued for months. He concluded, “this diet policy, for
unknown reasons, played a major role in reducing the antisocial
behaviour ... the improvements resulted in a long-term reduction in
institution-wide behaviour problems at no cost and apparent risk to
anyone. Dietary intervention is clearly a cost-effective approach to
reducing institutionalised behaviour problems”28.
Conclusion
Increasing evidence from both small carefully controlled scientific
studies and open trials in the community suggests that there are
significant benefits in behaviour, health and learning to be gained
from dietary modification. The following recommendations can be cheap,
workable and beneficial:
1) A trial of the RPAH diet should be offered routinely for young children with behaviour problems.
2) Schools and other institutions which care for children should promote an additive-free policy.
Sue Dengate specialises in the effects of food chemicals on children’s
behaviour, health and learning ability. She was written several books
on food and behaivour, and also runs the Food Intolerance Network
withher husband Dr Howard Dengate, a food technologist and former
research scientist. Contact www.fedupwithfoodadditives.info.
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