Food Sensitivities and ADHD

shark soupSo, what if you already avoid refined carbs, eat the right kinds of fats, and still have ADHD symptoms?  Perhaps you eat a Paleo Diet, or a low-carb Paleo Diet, or even a ketogenic diet, and are still troubled by ADHD…what then?

 

 

Food sensitivities can cause ADHD symptoms

In my work with children and adults with ADHD, I have seen some patients reduce or even cure their ADHD symptoms simply by removing certain foods from their diet. People are often completely unaware that they have food sensitivity, especially if the food that bothers them is something they eat every day, like wheat or dairy products.  Everybody is different, so food that is the culprit for one person may not bother another person at all.  While any food can be problematic, the ones that have been shown by researchers to be the most commonly associated with ADHD symptoms are:

  • Gluten (from wheat and related grains)*
  • Dairy Products (usually due to casein, a dairy protein)
  • Soy
  • Corn
  • Peanuts
  • Eggs
  • Nuts
  • Citrus
  • Chocolate
  • Tomato
  • Yeast
  • Shellfish
  • Fish
  • Legumes
  • Oats

*People with Celiac Disease (an autoimmune disease associated with gluten) are more likely to have ADHD symptoms, and these symptoms usually improve on a gluten-free diet.  However, people with ADHD are at no higher risk for Celiac Disease than people without ADHD.

Simplified diets can cure ADHD  

Dietary studies have found a strong connection between food and ADHD symptoms.  These studies are small and have their limitations, as most nutrition studies do, but they all produce remarkable results.  These studies compared a standard diet to a special limited diet, and found that the special diet resulted in a dramatic reduction in ADHD symptoms.  Most people with ADHD are not aware of these studies (notice that all of them were conducted in Europe):

Egger 1985 (London)

  • Diet:   Lamb, chicken, rice, potato, banana, apple, vegetable of choice x 4 weeks.
  • Subjects:  76 children with ADHD (hyperactive type), aged 2 to 15 yrs old.
  • Results:  62 children (82%) improved; 21 of these children (28%) cured

Carter 1993 (London)

  • Diet:  Lamb, turkey, rice, potato, banana, pear, vegetables, sunflower oil, margarine x 3-4 wks.
  • Subjects:  78 children  with ADHD (hyperactive type), ages 3 to 12.
  • Results:  59 of 78 (76%) children improved.  2 children (3%) got worse.

Schmidt 1997 (Germany)

  • Diet:  Lamb, turkey, rice, potato, vegetables, vegetable oil, margarine, salt, apple juice x 9 days, compared to Ritalin x 3 days.
  • Subjects:  49 children hospitalized for severe ADHD and/or Conduct Disorder, ages 6 to 12.
  • Results:

Special diet vs regular diet: 12 children (24%) improved and 2 (4%) worsened.

Diet vs Ritalin (36 children total):  Ritalin—16 children (42%) improved and 4 (11%) worsened.  The extent of improvement was the same with Ritalin as with diet.  3 children (8%) responded to diet but not to Ritalin.

Pelsser 2002 (Netherlands)

  • Diet:  Turkey, rice, pears, lettuce x 2 weeks
  • Subjects:  40 children with ADHD, ages 3 to 7
  • Results:  25 children (62%) improved by at least 50%.

Pelsser 2009 (Netherlands)

  • Diet:  Turkey, lamb, rice, fruits, vegetables, margarine, pear juice, vegetable oil, tea x 5 wks.
  • Subjects:  27 children with ADHD, ages 3 to 8
  • Results:  70% improved by 50% or more acc to teachers and parents and no longer met criteria for ADHD (cured).

What was so magical about these diets?  These simple diets removed all of the common food culprits listed above, as well as sugar and processed foods.  These diets have a lot in common with whole-foods hunter-gatherer diets of meats, fruits, and vegetables.  I personally believe the studies may have worked even better if researchers had also removed the fruit juice (high in sugars), margarine (high in omega-6 and trans fats), and white rice (high glycemic index), but nevertheless, these diets worked very well.  62% to 82% response rates in outpatients and a 24% response rate in inpatients—pretty impressive.

What about the Feingold Diet?  

Ben Feingold, MD was a pediatric allergy specialist who wrote a book in 1975 called “Why Your Child is Hyperactive.”  He recommended a diet free of artificial flavors and colors, and advised avoiding foods containing salicylate, a naturally occurring plant chemical found in a wide variety of fruits, vegetables, and spices. He claimed that his special diet was effective for 50% of children with ADHD.  This diet is referred to as the Feingold Diet, or as the “K-P Diet” (K-P for Kaiser-Permanente, the name of the medical center where he worked).

Plants use salicylates as signaling compounds and to protect themselves from infection and insects.  Aspirin is a famous salicylate originally extracted from willow bark.  Below are the foods Dr. Feingold thought to be high in salicylates, and therefore advised eliminating from the diet:

  • Almonds
  • Apples
  • Apricots
  • Berries
  • Cherries
  • Currants
  • Grapes and Raisins
  • Nectarines
  • Oranges
  • Peaches
  • Plums and Prunes
  • Tangerines
  • Cucumbers and Pickles
  • Green peppers
  • Tomatoes
  • Cloves
  • Coffee
  • Teas
  • Wintergreen

Improved food testing methods have since determined that the following foods contain the highest amounts of salicylates [Wood 2011]:

Fruits:  Red grapes, Lemons, Peaches, Pears, Cherries.  Dried fruits typically much higher.

Vegetables:  Asparagus, Eggplant, Broccoli, Mushrooms, Onions, Green Peppers

Beverages:  Coffee, Tea, Beer, Pineapple Juice, Tomato Juice

Herbs/Spices:  All tested were extremely high with exception of garlic (extr low)

Legumes and grains are very low in salicylates.

All animal foods, including meats, organ meats, and dairy products, contain little to no salicylate.

Does the Feingold Diet really work?

NONE of the studies of this diet were able to generate the impressive 50% cure rate that Feingold reported, however, SOME of the studies did find that a small number of children (11% to 33%) were significantly less hyperactive on his diet.

ADHD and Artificial Colors  

An analysis [Schab 2004] of the 15 best studies done on food coloring and ADHD found a clear connection between artificial food colorings and hyperactivity in children with ADHD.  A review of all studies [Stevens 2011] concluded that artificial food colorings can result in significant changes in behavior in people with ADHD, and two studies found that artificial colorings can even cause hyperactivity in people who do not have a history of ADHD.  The vast majority of studies tested complicated mixtures of artificial colors rather than single additives, often in combination with sodium benzoate, a popular preservative.  The artificial colors used in experiments are listed below.  Those in green are still approved for use in foods in the United States:

Tartrazine (Yellow #5)

Sunset Yellow (Yellow #6)

Quinoline Yellow (Yellow #10; not approved for use in food)

Allura Red (Red #40)

Erythrosine (Red #3)

Carmoisine (Red #10; not approved for use in food)

Ponceau 4R (a red dye with no approved uses)

Brilliant Blue (Blue #1)

Indigotine (Blue #2)

Fast Green (Green #3) 

Orange B

Are people with ADHD more Sensitive? 

In my clinical experience I have found that many of my ADHD patients are more sensitive in general, not only to foods and medications, but also to other stimuli, such as scents and sounds, and can be more socially sensitive, particularly to perceived judgment, exclusion, or rejection.  The European studies detailed above make it clear that many (children) have food sensitivities that manifest themselves as ADHD symptoms—could it be that some people with ADHD are simply reacting badly to certain foods?  I know for myself that changing my diet significantly improved my concentration, productivity, motivation and energy, and eliminated my dependence on caffeine to get things done.  

Your Own Body of Evidence

While there are good medical tests available for true food allergies, there are no medical tests for food sensitivities, so how do you know if your ADHD symptoms are being caused by food sensitivities?  There are many other bodily clues to food issues, such as asthma, eczema, fatigue, fluid retention, frequent headaches, or digestive problems.  One possible sign of food sensitivity that is easy to recognize is the presence of dark circles under the eyes, which allergy specialists call “allergic shiners.”  People often mistake dark circles for signs of poor sleep or fatigue, but dark circles are most often a sign of allergy or sensitivity.

An example from my own personal experience:  I underwent complete food allergy (skin) testing and was found to have no allergies to any of the foods included in the panel, including nuts.  However, whenever I ate something that contained small amounts of nuts, the next morning I would see dark circles under my eyes (along with a variety of other unhappy symptoms), which I did not normally have.  24% of people who do not have allergies have “allergic” shiners—how many of these non-allergic people have food sensitivities?  We don’t know.

Unfortunately, the only way for you to discover whether or not your ADHD symptoms are due to a food sensitivity is to do your own dietary experiment.  There are many ways to do this, but the two most popular are the all-at-once approach and the one-at-a-time approach.  You may prefer to remove all of the most common culprits for 2 weeks and see if you feel better, and if you do, then reintroduce one food at a time for at least 3 days in a row to try to identify the guilty food (or foods).  Others prefer to remove one culprit at a time for two weeks to see if that single food is causing the problem.  If it is not, that food can be added back, and the next suspect can be removed for two weeks, and so on.  This approach takes much more time but some people find it easier than removing so many culprits all at once.

The Hypo-allergenic Paleo Diet

When people ask me what diet I recommend to see if food sensitivities may be causing ADHD, I recommend what I call a “hypo-allergenic” Paleo Diet for 2 weeks.  This diet consists of:

  • Chicken, turkey, duck and/or lamb and their organ meats (no sauces or marinades)
  • Any fresh/frozen vegetables you like (except for green beans, wax beans, sprouts, beets and white potato)
  • Any whole fresh/frozen fruits you like except for citrus and tomato.
  • Water, seltzer

No dairy, nuts, soy, grains, legumes, nuts, seeds, beef, pork, chocolate, eggs, yeast, coffee, tea, sugar, juices, processed foods, artificial ingredients, gum, sweeteners (whether natural or artificial), or cold cuts at first.  Avoid preserved, fermented, canned, dried, smoked, pickled, and excessively salty foods.

After 2 weeks if you are feeling better, you can try adding back beef, pork, fish, citrus, tomato, coffee, tea, etc. one at a time for 3 days each to see if they bother you.

Keep in mind that any food can be a culprit, including any food on my “hypo-allergenic Paleo diet”, so some people may need to explore further, but the above diet removes all of the most common culprits.

These dietary experiments can be frustrating and difficult, but they can also be very illuminating.  Once you have figured out your food sensitivities, it does not mean you can never eat that food again—that’s completely up to you—but at least you’ll have more control over how you feel from day to day if you want to!

What about you? 

Have you been able to reduce your ADHD symptoms by making dietary changes? What has or has not worked for you?

Coming soon to the Food and Health Blog:

Ketogenic Diets for Weight Loss and Health—a review of The Art and Science of Low Carbohydrate Living by Dr.s Phinney and Volek.

The role of diet in eating disorders.

If you would like to be notified when new blog posts become available, you may sign up to receive notifications by clicking on the “subscribe” link at the top of this page.

REFERENCES

Carter CM et al.  Effects of a few food diet in attention deficit disorder.  Archives of Disease in Childhood 1993; 69: 564-568.

Egger J et al.  Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome.  Lancet 1985; 1(8428):540-545.

Güngör S et al.  The frequency of Celiac disease in attention-deficit hyperactivity disorder.  J Pediatr Gastroenterol Nutr 2012 [ePub ahead of print].

Kanarek RB.  Artificial food dyes and attention deficit hyperactivity disorder. Nutr Rev 2011;69(7): 385-91.

Kelso JM.  How allergic are “allergic shiners?”  Journal of Allergy and Clinical Immunology 2010; 125(1): 276.

Millichap JG and Yee MM.  The diet factor in attention-deficit/hyperactivity disorder.  Pediatrics 2012; 129: 1-8.

Niederhofer H and Pittschieler K.  A preliminary investigation of ADHD symptoms in persons with Celiac disease.  Journal of Attention Disorders 2006; 10(2): 200-204.

Pelsser LM and Buitelaar JK.  [Favourable effect of a standard elimination diet on the behavior of young children with attention deficit hyperactivity disorder (ADHD): a pilot study.] Ned Tijdschr Geneeskd 2002; 146(52): 2543-2547.

Pelsser LM et al.  A randomized controlled trial into the effects of food on ADHD.  Eur Child Adolesc Psychiatry 2009; 18: 12-19.

Pelsser LM et al.  Effects of food on physical and sleep complaints in children with ADHD:  a randomized controlled pilot study.  Eur J Pediatr 2010; 169: 1129-1138.

Rapp DJ.  Does diet affect hyperactivity? Journal of Learning Disabilities 1978; 11(6): 56-62.

Rimland B.  The Feingold Diet:  an assessment of the reviews by Mattes, by Kavale, and Forness and others. J Learn Disabil 1983; 16(6): 331-333.

Schab D and Trinh NT.  Do artificial food colors promote hyperactivity in children with hyperactive syndromes?  A meta-analysis of double-blind placebo-controlled trials.  Dev Behav Ped 2004;25(6):423-434.

Schmidt MH et al.  Does oligoantigenic diet influence hyperactive/conduct-disordered children—a controlled trial.  European Child & Adolescent Psychiatry 1997; 6: 88-95.

Stevens, LJ et al.  Dietary sensitivities and ADHD symptoms:  thirty-five years of research.  Clinical Pediatrics 2011; 50(4): 279-293.

Wood A et al.  A systematic review of salicylates in foods: estimated daily intake of a Scottish population. Mol. Nutr Food Res 2011; 55: S7–S14.

  • Des

    Hi Dr. Ede, great post!

    In the future, will you also consider writing about acid-based vs alkaline-based foods? People are led to believe that they eat too many acidic foods and should therefore gorge on greens, legumes and fruit to “balance” their scale. I just don’t buy it. All I eat is primarily acid inducing food ( meat, fat and coffee).

    • http://diagnosisdiet.com/ Dr. Ede

      Yes, this is a question that often comes up at presentations, so I would like to explore it further. I will add it to my list of future topics on the homepage. Since the body maintains pH within a very narrow range without error (except in the case of certain diseases, especially diseases of the kidneys or lungs, which are the body’s primary pH regulation organs), whether a food is acidic or alkaline has no effect on the pH of the body. However, I understand that the claims about acidic foods being bad for us has to do with the downstream effects of that pH regulation (i.e. bone metabolism). I will see if I can get to the bottom of it..

      .As for your question about when/where I will be giving future presentations:

      I wanted to focus this fall on establishing the website, but come January I will be scheduling new talks for the coming year. I will definitely be attending next summer’s Ancestral Health Symposium in Atlanta and will be submitting a talk proposal to them shortly. As soon as I have new presentations scheduled I will post announcements on the homepage and on the speaking page. Thanks for your interest!

      • Des

        Thanks Dr. Ede, I very much look forward to your talks and to meeting you someday:)

  • Someone, Somewhere

    Hi Dr. Ede,

    Thank you for another interesting, informative post. I resonate with much of what you’re written here.

    That said, I’d like to question one statement you made: “While there are good medical tests available for true food allergies, there are no medical tests for food sensitivities.”

    I have completed a couple of medical tests—both ordered for me by MDs—that did, in fact, identify my food sensitivities. I am aware that they are not as well-known, well-studied, or well-regarded by medical professionals compared to traditional allergy tests, but the research I’ve seen on these tests seems to be improving and increasing. Perhaps these tests haven’t identified all of my food sensitivities, but they have identified a huge number of them for me. And when I cut out the foods that were identified by these tests, I experienced a huge decrease in indigestion, acne, fatigue, anxiety, hyperactivity, inattention, and depression. When I eliminate these foods completely, I have virtually no symptoms whatsoever.

    When you “underwent complete food allergy (skin) testing and was found to have no allergies to any of the foods included in the panel, including nuts,” were you only tested for traditional IgE antibodies, or were you also tested so-called “delayed reaction” IgG antibodies as well? Also, have you been tested for intestinal IgA (mucosal) antibodies via stool testing?

    I’ve been tested for IgE antibodies and nothing came up. But when I was tested for IgG and IgA antibodies, a bunch of foods came up, and eliminating those foods virtually eliminated my symptoms. Prior to that, I tried elimination-challenge diets, to no avail, probably because I wasn’t eliminating enough foods and didn’t have principles like yours to guide me.

    IgA stool testing revealed that I am gluten intolerant/sensitive. However, prior to the stool testing, I had received a colonoscopy and a duodenal biopsy, which came back negative for celiac disease. What most people don’t realize is that celiac disease is not the same thing as gluten intolerance/sensitivity. Celiac disease, as I understand it, is when someone damages their intestines as a result of a gluten intolerance/sensitivity so badly that the damage is visible under a microscope. If the damage isn’t bad enough to be visible under a microscope, someone may still have a gluten intolerance/sensitivity, but does not, by definition, have celiac disease.

    Here are the tests I received, both available through the mail:

    Gluten sensitivity stool test: http://enterolab.com/StaticPages/TestInfo.aspx#stool_gluten_sensitivity

    The nurse at Enterolab advised me to do the gluten sensitivity test first and pay to have them test for other sensitivities only if I first tested positive for gluten sensitivity, because she said that in her experience, people only test positive for the other sensitivities they test for if they also test positive for gluten sensitivity, since gluten sensitivity acts as a gateway for other food sensitivities.

    For those too young for the stool test, if they haven’t eaten much gluten in their lives, a saliva DNA test is available. I just ordered it for my 2 year-old half-brother, since the chances are good that he has it, since the propensity is genetic and I share a quarter of his genes.

    I also received the Food Allergy IgG Fingerstick by Alletess. The version that tests for 96 different foods is available here (a 184-food version of the test is also available, though I don’t know if it’s available oniine):

    http://www.healthremedies.com/food_allergy_igg_fingerstick_by_alletess.html

    This test may be less sensitive than the stool test, since it’s a blood test, and because food has to reach the bloodstream rather than just the intestines to come in contact with IgG antibodies, as opposed to IgA antibodies. However, the advantage of this test is that it can test about 100 or 200 foods, rather than just the dozen or so that Enterolab tests for.

    The most helpful website I’ve found to understand food sensitivities is from a veterinarian called http://dogtorj.com On that site, I found these two pages most helpful: http://dogtorj.com/what-is-food-intolerance/gluten-vs-glutamate-vs/ and http://dogtorj.com/main-course/the-g-a-r-d-the-glutamate/the-g-a-r-d-made-simple-2/ (http://www.msgtruth.org also has some interesting ideas).

    The “food” to which I’m most sensitive is MSG: It gives me horrible, horrible headaches. This got me reading about glutamate, which seems to be a common factor in many food sensitivities. Based on my reading of the website I just mentioned—dogtorj.com—I get the impression that gluten damages intestines in genetically susceptible individuals. Dairy, soy, and corn tend to make the damage worse. Excitotoxins such as glutamate then leak through the holes in the intestines into the bloodstream. Glutamate is found especially, according to the creator of this website, in “gluten grains (wheat, barley, rye), soy/legumes/peanuts, dairy products, nuts, seeds, meats and the gluten-grain substitutes (quinoa, amaranth, tapioca as well as the non-gluten grains millet, flax and sorghum).” This matches pretty closely to the list of foods to which I was found to be sensitive to by the two tests I mentioned above (the results of which, by the way, concurred with each other):

    GRAINS:
    Gluten (Wheat, Barley, Rye)
    Oats

    DAIRY PROTEIN

    EGG PROTEIN

    LEGUMES:
    Beans (soy, green, pinto, lima)
    Peas
    Coffee
    Peanuts

    NUTS:
    Walnut
    Almond
    Cashew

    SEEDS:
    Sesame
    Sunflower
    Black Pepper
    Mustard

    VEGETABLES:
    Eggplant
    Broccoli
    Cauliflower
    Basil
    Garlic

    FRUITS:
    Tomatoes

    MISCELLANY:
    MSG
    Yeast (Baker’s, Brewer’s)

    Thoughts?

    • http://diagnosisdiet.com/ Dr. Ede

      Hello SS

      Thank you very much for sharing this very interesting information here. I will explore all of the references you provided and then write a more comprehensive reply to your comment soon. I personally met with 3 different allergy specialists, all of whom did not think it would be worthwhile for me to pursue additional testing, however, I also was not particularly motivated to obtain additional testing, since I was feeling well at the time and had already figured out my own sensitivities by process of trial and error years before. It would be interesting nonetheless, for educational purposes and out of sheer curiosity, to see if any of the additional tests you found helpful would be positive for me, and whether they would agree with my own experiential observations.

      In my reading of the allergy and sensitivity of the literature thus far, I repeatedly come across the same recommendations about food sensitivities, which is that elimination diets are the best and most reliable way to figure them out, as frustrating as that can be. I would be curious to know if you consider yourself currently symptom-free or if you are still fine-tuning your diet? I appreciate the thorough and thoughtful commentary you have posted.

      It is absolutely true that gluten sensitivity is a real condition, and there are even research studies that support its existence, finally. In fact, a recent post by my favorite nutrition-oriented physician, Dr. John Briffa (based in the UK), does a nice job of highlighting a new study about this very topic: http://www.drbriffa.com/2012/12/15/patients-story-in-british-medical-journal-demonstrates-why-we-doctors-sometimes-need-to-listen-to-our-patients-more/

      I would also like to explore the glutamate hypothesis in more detail and will write back about that as soon as I can.

      • Someone, Somewhere

        Hi Dr. Ede,

        I’m glad you found my latest comment useful.

        In my experience, allergy specialists tend to focus only on traditional IgE antibodies. To get tested for sensitivities/intolerances, as opposed to traditional allergies—via IgG and IgA antibodies—I’ve had to visit more “holistic” MDs, outside of the HMO system (of course, the border between “holistic” doctors and “quacks” is a fine line, so one has to be careful). I’m actually very conservative when it comes to science, but as you probably know from experience, mainstream medicine can be very slow to adopt new(er) ideas and technologies, unless big money and big pharma are giving things a push. I’ve read a fair amount of peer-reviewed research on IgG antibodies (which apparently give rise to so-called “delayed reaction allergies,” such as migraines); I imagine there’s an increasing amount of research on IgA antibodies as well, though I haven’t personally read it (I imagine that Enterolab can point you to the most relevant publications, if you’re interested).

        Since you’re a physician, Dr. Ede, you should be able to order the IgG fingerstick from Alletess directly, rather than going through the nurse practitioner at the website I shared before. This gives you the advantage of being able to order the 184-antigen test, as opposed to the 96-item test available from the website I provided before. You can order the 184 IgG Elisa food panel by serum fingerstick here: http://foodallergy.com/kits.html The Enterolab tests, by contrast, is available to anyone, without a doctor’s order.

        I have generalized based on the test results I received to exclude most categories of foods from my diet, leaving only meat, fruit, salt, and water. That’s all I eat; no seasonings, marinades, vegetables, etc. When I stick to meat, fruit, salt, and water, I am completely symptom-free (except for the occasional fruit that causes indigestion). However, the moment I eat anything that isn’t prepared by myself from scratch, all bets are off. Even if I read ingredients on packages or give special instructions to the chef and think I’m safe, there’s still a good chance that I will end up with a flare-up of indigestion, acne, and agitation (and when MSG is involved, a horrible, horrible headache and dry mouth).

        Like you, I have read repeatedly that the best and most reliable way to discover food sensitivities is elimination diets. The problem is, there are many thousands of foods available on this earth, so without solid principles to guide one’s experiments, it can be virtually impossible to figure out what to try eliminating or get any clear results. Plus, the body—particularly the intestines—takes time to heal from injury, so results can take awhile to be clear. Prior to the testing I mentioned in my last post, I tried tons of elimination diets, with no success. Once I got the testing done, however, I didn’t need to perform any more experiments, other than simply eliminating what was on those lists and generalizing to broader categories of food. I suspect that the medical professionals who say that elimination diets (or elimination-challenge diets) are the best and most reliable way to discover food sensitivities either don’t know about or are skeptical of the tests that I’m talking about.

        Thank you for the link to Dr. Briffa’s post. I just read it, as well as his original post about the BMJ article. Sometimes, I’m amazed at the dinosaur’s pace of some aspects of mainstream medicine. The BMJ paper apparently suggests that “non-celiac gluten sensitivity” is “newly discovered.” It’s been well-established for years by doctors at labs like Enterolab, which simply count gluten antibodies in the most logical place to look for it: the stool (a gene for gluten sensitivity propensity has also apparently been identified, and Enterolab tests for it as well, via cheek skin cells, not saliva as I erroneously stated in my last post). It would be nice if the measured pace of mainstream medicine could be attributed solely to scientific conservatism, but everything I’ve read and observed suggests that money and politics also play a huge role. HMOs and drug companies wouldn’t make an additional dime if their gastroenterologists suggested a patient purchase a $99 stool test through the mail, rather than ordering a colonoscopy and biopsy, and/or prescribing medication. Plus, small labs like Enterolab don’t have the money to fund double-blind placebo-controlled trials. But I digress…

        I’d love to hear your thoughts about the role of glutamate in food sensitivities, after you’ve had a chance to read about it and give it some thought. Just yesterday, I accidentally ingested some MSG (damned taquerias keep putting it in their soups, along with unexpected corn) and felt *extremely* agitated within minutes of ingestion (fortunately, I didn’t eat enough to get the dreaded headache or dry mouth). As a psychiatrist, I imagine that you understand the role glutamate plays in the brain better than I or the veterinarian to whose website I linked before. I’d be very interested to hear what you think happens neurologically when large amounts of glutamate enters the bloodstream via damaged intestines, and make their way through the blood-brain barrier into the brain.

  • L. Amber Wilcox-O’Hearn

    Hello, Dr. Ede. Thank you for this.

    I am exploring the role of salicylates in rosacea. Coconut oil is apparently very high in salicylates, which is unfortunate, since it has such a nice fat profile, and is popular among keto dieters.

    I have read a theory that rosacea may be controlled by eliminating salicylates, amines, and glutamate.

    So to add to the long request list, I’d like to hear your thoughts on amines.

    • http://diagnosisdiet.com/ Dr. Ede

      Hello, Amber

      Very interesting–I am happy to add rosacea to my to-do list (and have updated homepage to reflect your suggestion). Thank you for the idea. I personally do not tolerate coconuts and have often wondered if the hype about fruit/nut oils such as coconut, palm fruit, and olive oils is overrated…that is yet one more thing I would like to try to get to the bottom of… If you have any additional information about the rosacea theory (a link or book or article) that you would like me to use as a jumping-off point, feel free to pass it along!

      • L. Amber Wilcox-O’Hearn

        Thank you! Actually, I haven’t found much at all beyond anecdotes. However, the common food triggers are interesting. For example http://www.rosacea.org/patients/materials/triggers.php lists:

        Liver, Yogurt, Sour cream, Cheese (except cottage cheese), Chocolate, Vanilla, Soy sauce, Yeast extract (bread is OK), Vinegar, Eggplant, Avocados, Spinach, Broad-leaf beans and pods, including lima, navy or pea, Citrus fruits, tomatoes, bananas, red plums, raisins or figs, Spicy and thermally hot foods, Foods high in histamine.

        Looks like it could possibly be salicylates + amines.

        • http://diagnosisdiet.com/ Dr. Ede

          Just look at all those plants:) It really is unfortunate that the questions we most want answered are not typically asked in research studies…I’ll see what I can find out!

    • Micah

      I know this was nearly a year ago, but can I ask something I think should be glaringly obvious, “Have you cut out wheat?”

      From your comments, it doesn’t look like you have. From personal experience, I find that people are willing to give up all kinds of things, EXCEPT the true offender….wheat.

  • Someone, Somewhere

    Hi Dr. Ede,

    I just wanted to point you and anyone else who might be interested to an article I read recently that I found very helpful, by the inventor of the gluten sensitivity antibody stool test, Kenneth Fine, MD:

    “Early Diagnosis Of Gluten Sensitivity: Before the Villi are Gone”

    at

    https://enterolab.com/StaticPages/EarlyDiagnosis.aspx

  • Sally Annie

    Hi Dr Ede
    My mum was told by my pediatrician when I was a baby that I was failure to thrive and not ADHD at all but to keep me away from sugars and food colourings. She did, so effectively that when I was 6 I had a piece of birthday cake at school and they had to call my parents to get me down from the top of a book shelf. Another time I had a handful of smarties at a party and was found in the laundry trough shaking and crying. As I got older the more extreme reactions wore off but even now I have trouble with sugar and colourings. I always thought I was ADHD but never got tested. As an adult I have a diet that is 90% fresh whole foods and know my own sensitivities i.e. I love potato chips but they give me excema (although my dr doesn’t believe that). I observed myself for about a year with the knowledge that food does affect me so strongly and used the process of elimination as you suggest. I found out that my dad also has ADHD and with his help I implemented many behavioural techniques such as daily routines so I didn’t lose things, and games to help my attention to detail. These things all helped, but I still had many ADHD symptoms that I wanted to manage more effectively. I spoke to a psychiatrist who put me on ritalin. The dose I’m on is 20mg 3 times a day but I vary it depending on how I feel. My concentration and motivation has never been better! Attention to detail has improved, people remark on how I don’t just blurt things out anymore and can keep secrets, and even the dog will cuddle me for longer than the 2 minutes it used to take before I got wriggly and annoying to her! I’m a much more rational and reasonable person now. So yes, I see exactly what you mean about diet affecting ADHD, but I also think that medication is a massive help to people who need an extra hand to understand their brains. I wish there were more studies. I would love to be a part of any studies on ADHD to understand my own brain and help others who feel like I have my whole life.
    Also, I’ve noticed the anxiety that is attached to my (and potentially others) ADHD and the ways that sugar impacts on the high and low points i.e. feeling super excited after eating sugar, then feeling sad and sick afterwards. This has evolved for me to mean that if I don’t have small, regular, blood sugar level stabilising meals, I get the hypoglycemic symptoms of feeling faint, nauseous and dizzy. If I’m desperate, a small amount of chocolate gets me going quickly, but I hate how I feel afterwards. I had been reading up on these symptoms and everywhere said “hypoglycemia = diabetes”. I know my body, and that wasn’t quite it. This article helped clear up a lot of my concerns, so thank you.

    • http://diagnosisdiet.com/ Dr. Ede

      Hello, Sally Annie

      What a wonderful history you provide here–thank you! I completely agree that medication can be very useful for many people and I do prescribe medications frequently for those with ADHD. Sometimes dietary changes are not enough to correct the chemical imbalances that people with ADHD have and I do support the use of medications when necessary. Thank you for pointing that out!

      And yes, the highs and lows associated with sugary diets are very common. For readers out there who are not familiar with the sugar roller coaster, please see my carbohydrates page (under the FOODS tab).

  • http://www.addrena.com/adhd-med-alternative-addrena-testimonials Thomas Lartin

    Very interesting about the food sensitivities, thanks.

  • Mark

    Dr Ede,
    If I was Paleo diet, how important is it for me to give eggs and coffee.If Eggs need to be given up what do I eat for breakfast? Is honey okay? I have ADD as an adult. It is effects everything. Especially my work. It takes me twice as long to complete my paper work. Praying this helps.

    • mark

      edit : Dr Ede, If I was start Paleo diet, how important is it for me to give eggs and coffee? If eggs need to be given up what do I eat for breakfast since must cereals are out. Can I have honey? I have ADD as an adult. It is effects everything. Especially my work. It takes me twice as long to complete my paper work. Praying this helps.