Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student Research

A study of the relationship between food intolerance and behaviour in children

Brett Churnin
Master of Science (Nutrition and Dietetics), University of Wollongong
Supervisors: Anne Swain, Velencia Soutter, Robert Loblay
June 1998

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For many years, a wide range of behaviours have been attributed to adverse food reactions, particularly in children. The hypothesis suggests that behavioural problems are aggravated by certain foods and chemicals in food intolerant children, and that removal of these substances from the child's diet will provide an improvement in the child's behaviour. Since the 1970's, many studies have evaluated the diet-behaviour hypothesis, though confusion and controversy exists due to conflicting and contradictory results. More recent, clinically controlled studies have demonstrated positive behavioural food effects through diets eliminating salicylates, amines, food colours, preservatives and additives.

To investigate the relationship between food intolerance and behaviour in a cohort of children presenting to the RPAH Allergy Unit by:
1) Documenting the occurrence of food intolerance and behaviour problems; 2) Determining the extent and nature of dietary compliance on leaving the Allergy Unit; and 3) Examining the effects of dietary intervention on behaviour and associated symptoms.

Data was collected from medical and dietetic notes on 423 children who presented to the RPAH Allergy Unit between 1995 and 1998 for behavioural problems. Parents were sent a Questionnaire to obtain additional information about the child's symptoms and dietary modifications. They were also sent a Conner's Parent Rating Scale (CPRS) to compare their present behaviour with that recorded on the CPRS which they completed on presentation.

Seventy-seven percent of children started the elimination diet (SED) as prescribed by the RPAH Allergy Unit, with 91% reporting improvement in symptoms. Eighty-one percent continued on 'modified diets', regardless of whether they started or completed the elimination diet or challenges. The most common chemicals reacted to were amines, salicylates, colours, glutamates and preservatives respectively, and hence were the most restricted. Thirty-eight percent reported significant improvements in behaviour, and 50% rated children's symptoms overall as much better or completely well. Statistically significant improvements in conduct, learning, impulsivity and hyperactivity were demonstrated by the CPRS comparisons.

Results confirm a diet-behaviour connection in children who participated in the study, though a low response-rate (31%) and possible response-bias preclude generalisability.