Pelsser 2011: Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial

Pelsser2011The Lancet, 2011. Feb 5;377 (9764): 494-503

This is a study of 100 children diagnosed with ADHD but not selected on any basis of expectation of a dietary effect.   The children were randomly assigned to an experimental diet group and a control group.  Parents of the control group children were given a different “healthy diet“ rather than being put on a waiting list as Pelsser did in earlier studies.

The children were all on their respective diets for 5 weeks. By that time, the experimental (Feingold-type) diet group was almost 12 points better on the Abbreviated Conners’ Scale scores and 24 points better on the ADHD Rating Scale (ARS), according to the assessing pediatrician who was unaware of which group the children were in.

After that, those from the experimental diet group who had improved more than 40% on the ARS were entered into the second part of the study: a 4-week double-blind crossover food challenge phase.  In this phase, the children were individually challenged with various foods based on results of an IgG blood test, to see if this test could be predictive of which foods were problematic.  Although the children did react to many of the challenges, it seemed to have nothing to do with their IgG scores.

QUOTE:  “Our study shows comparable effect sizes in patients who are representative of the general ADHD population, supporting the implementation of a dietary intervention in the standard of care for all children with ADHD.”

QUOTE:  “A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food.”

NOTE:  My understanding of the IgG test – and I invite correction if I am wrong here – is that it can indicate what the child has been exposed to a lot, and those may be useful items to eliminate if you want to try eliminating only a few things from the diet.  In doing so, however, you will probably have to eliminate many or most processed foods anyhow, resulting in an “accidental” trial of an approximation of the Feingold diet — and if it works you won’t really know if it is the IgG-related items themselves or the “accidental” elimination of thousands of unknown additives by eating plainer foods.  You might as well first try the general Feingold diet and worry about individual sensitivities later if problems remain.  For more information, see the Feingold Program information.

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