Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Food Allergies, Chocolate and Hyperactivity

Category: Asthma and Allergy


True food allergies are much less common than people think. Between one and seven percent of children have true food allergies and only about one percent of adults. Many patients have something different which we cannot explain immunologically called food sensitivity. This is just a general term and can describe any number of unusual reactions which may be triggered via food but are not measurable as an allergy reaction in the body.

True food allergy reactions are usually caused by proteins in foods. Seven foods cause about 95% of the food allergy reactions in patients studied in numerous studies over the past ten years. These seven foods are eggs, milk, soy, fish, peanuts, tree nuts and wheat. Chocolate has been given a bad rap in that most people think it commonly causes food allergic reactions. Actually, research shows that it is a very uncommon cause of food allergic reactions and that other food components with the chocolate are actually causing most of the reactions. Ingredients in the manufacturing of chocolate actually cause most of the true allergic reactions associated with chocolate. These ingredients include corn syrup, milk, gluten, nuts and soy lecithin. True chocolate protein allergy is extremely rare and studies indicate that out of 100 patients researched for chocolate allergy who thought they were allergic to chocolate only about 1% had true chocolate allergy.

What about hyperactivity? Do chocolate and other candies, food additives and sugar cause hyperactivity as many people believe? Carefully designed and controlled studies fail to show the connection of these suspected foods when done in a controlled fashion with a placebo. In other words, the Feingold diet, which was popular in the 70's, has been essentially abandoned by 99% of pediatricians and allergists and experts for attention deficit disorder because of lack of evidence that restricting sugar, candy, caffeine, artificial food colors or chocolate has any effect on the attention deficit hyperactivity syndrome in children.

Question: Are there rare patients in which these foods do cause a problem? I'm certain there are, and most big studies show this to be true in about 1% of patients studied. The lesson is to keep an open mind but not to restrict a child's diet if there is no evidence that your child is bothered by these things. Treatment of attention deficit hyperactivity disorder requires a team approach with several resources including education, counseling and, perhaps, medication. If a true food hypersensitivity is proven, then help from a dietitian may be in order in rare circumstances.