Food for the Brain: Child Survey: Review Part 4

Professor Patrick Holford of Teesside University (and also Head of Science and Education at Biocare) and Drew Fobbester are joint researchers and authors of the Food for the Brain Child Survey, September 2007 (pdf). Holford Watch has taken an interest in this report: so much so that we have dedicated three posts to looking at the literature overview – Part 1, Part 2 and Part 3.

In short, out of 10 references, 1 was appropriate, albeit mis-reported, so, if that sort of thing bothers you as it does us, then not one of the references is used in an acceptable manner. Not one. One of them doesn’t even exist.

If you want the gory detail, read the above posts. But, to summarise:

• Benton’s review^[1] has the potential to be a relevant reference but Holford and Fobbester mis-report the findings as indicative of “significant improvement” rather than “positive response” (it does matter) and they mis-report the number of RCTs. They also fail to notice Benton’s caveats about generalising the results to the wider population of children.
• Holford and Fobbester’s overview suggests that most of the trials to which they refer were conducted in a general population of children, however:
  • Richardson’s review^[2] is about the role and putative benefits of fatty acids for children with developmental and psychiatric disorders and there is no evidence to suggest that her findings can be generalised to the wider population of children who do not have developmental complications
  • the fish oil trials^[3,4] in these references were similarly for a specialised population and not generalisable (as above).
• Holford and Fobbester supply 3 references for the putative value of a “diet with a balanced glycemic load” for children^{[5, 6, 7]} but none of the references address this:
  • Haapalahti et al^[5] discuss the dietary habits of children with functional gastro-intestinal disorders. These results are not representative of a wider population of children
  • Benton’s review^[6] examines the importance of breakfast to later mood and performance. He makes some suggestions about the importance of meal scheduling on the cognitive performance of some of the population
  • Lien et al^[7] discuss the consumption of soft drinks and associations with the incidence of hyperactivity, mental distress and conduct problems in adolescents. They do not discuss ‘glycemic load’, whole foods or the importance of regular meals.
• both Egger et al^[9] and Carter et al^[8] discuss children with hyperkinesis symptoms who have food and chemical sensitivities. However, both of these studies concern children who have co-morbidities; ADHD and hyperkinesis are not necessarily equivalent; and all of the children had been referred to specialist clinics. These findings can not support the assertion about the wider population of children with complex behavioural difficulties, far less have any verifiable and substantial contribution to the study of nutrition among children who do not have these symptoms or disorders
• Holford and Fobbester’s reference for gluten sensitivity and children with behavioural disorders^[10] does not exist.

This looks like a list of assertions for which the authors feel the truthiness, and attempt to create the necessary scienciness through referenciness.

References

[1] Benton D, Micro-nutrient supplementation and the intelligence of children. Neurosci Biobehav Rev. 2001 Jun;25(4):297-309.
[2] Richardson AJ, Long-chain polyunsaturated fatty acids in childhood developmental and psychiatric disorders. Lipids. 2004 Dec;39(12):1215-22.
[3] Richardson AJ, Montgomery P. The Oxford-Durham study: a randomized, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics. 2005 May;115(5):1360-6. [The authors misquote the name in the FFTB Survey.]
[4] Sinn N, Bryan J. Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD. J Dev Behav Pediatr. 2007 Apr;28(2):82-91.
[5] Haapalahti M, Mykkänen H, Tikkanen S, Kokkonen J. Food habits in 10-11-year-old children with functional gastrointestinal disorders. Eur J Clin Nutr. 2004 Jul;58(7):1016-21.
[6] Benton D. The impact of the supply of glucose to the brain on mood and memory. Nutr Rev. 2001 Jan;59(1 Pt 2):S20-1
[7] Lien L, Lien N, Heyerdahl S, Thoresen M, Bjertness E. Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway. Am J Public Health. 2006 Oct;96(10):1815-20.
[8] Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ, Taylor E. Effects of a few food diet in attention deficit disorder. Arch Dis Child. 1993 Nov;69(5):564-8.
[9] Egger J, Carter CM, Graham PJ, Gumley D, Soothill JF. Controlled trial of oligoantigenic treatment in the hyperkinetic syndrome. Lancet. 1985 Mar 9;1(8428):540-5.
[10] The FFTB Child Survey cites: Gerarduzzi T et al. Celiac disease in USA among risk groups and general population in USA. Journal of Pediatric Gastroenterology and Nutrition. Vol 31 (suppl) 2000: pp S29, Abst 104. [Having searched Jnl of Ped Gastro and Nutr, this paper doesn't seem to exist as per this reference. It appears in Google Scholar as a citation only which might indicate an error.] Holford Watch has previously mentioned our difficulty with this reference: Running out of tolerance.

Further Reading

Food for the Brain Child Survey 2007: The Promotion
Holford Watch looks at the literature review:
Food for the Brain Child Survey 2007: Review Part 1
Food for the Brain Child Survey 2007: Review Part 2
Food for the Brain Child Survey 2007: Review Part 3
Food for the Brain Child Survey 2007: Review Part 4
Food for the Brain Child Survey 2007: Review Part 5

Holford Watch appeals for help to Professor Holford and two members of the Scientific Advisory Board who approved this report and then looks at the data and analyses:
Food for the Brain Child Survey 2007: Review Part 7
Food for the Brain Child Survey 2007: Review Part 8
Why Don’t Food for the Brain Report Their Survey Results on Supplement Pills Survey: Review Part 9
Food for the Brain Child Survey 2007: Review Part 10