[Zak]

altering your child's diet without a doctor's supervision is inadvisable.

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.

[dkarl]

This statement is necessary because the normal way people approach this problem is to declare one food the culprit, cut out that food, perceive that the problem has been cured, and declare success. There's a placebo affect, for one thing, which would be transmitted from parent to child through the parent's mood and expectations, plus there are random fluctuations in the child's behavior from day to day that will be attributed to whatever is foremost in the parent's mind, which in this case would be the alteration in diet.

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.

[pyre]

There's also the possibility that there will be parents that severely restrict their child's diet in a way that causes malnutrition too...

[edit] Not saying that it's a good reason to make that statement, but that's what that CYA aspect probably is...

[Vivtek]

This shouldn't be downvoted. It's a real risk. It's easy to over-restrict a child's diet.

[tygorius]

Yeah, I raised an eyebrow on that point as well. Funny how the doctor can state authoritatively that 64% of kids' ADHD symptoms can be traced to diet, but there are no specific details on what the relevant diet elements are. It's as if she wants to protect children by keeping parents ignorant.

[mshron]

Thankfully, the original study (linked to below) gives a summary.

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...

[zach]

The researchers did a food allergy panel to determine what foods were individually eliminated according to the subjects' Immunoglobulin G (IgG) response.

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.

[gregburek]

The hypothesis was that IgG tests may pinpoint foods that in some way trigger ADHD symptoms. This was found to be incorrect.

"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...

[zach]

Thank you so much for the correction.

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.

[gregburek]

That conclusion was really buried in there. Some form of confirmation bias on the part of a reader, perhaps?

[zach]

In general, sure it's safe. But once you admit a prior probability of a suspected allergic reaction to food, things change.

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.

[Tichy]

I don't know about most, but a lot of people seem to be making poor dietary decisions to begin with (lots and lots of soft drinks, for example). Are they really all aware how bad it is what they are doing?