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Information to Users INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the' quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send UMI a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. Oversize materials (e.g., maps, drawings, charts) are reproduced by sectioning the original, beginning at the upper left-hand corner and continuing from left to right in equal sections with small overlaps. Each original is also photographed in one exposure and is included in reduced form at the back of the book. Photographs included in the original manuscript have been reproduced xerographically in this copy. Higher quality 6" x 9" black and white photographic prints are available for any photographs or illustrations appearing in this copy for an additional charge. Contact UMI directly to order. U-M-I University M:croftlms Ir~lerr~JI'Onal A Be!1 & Howe!' Ir,rorm3lior Corn..'ar'! 300 ~Jortr Zeeo Road ,l,nn Arbor MI48'06·1346 US;' 313 761-4700 800521.0600 Order Number 9300340 Behavioral effects of food: An exploratory study Niino, James Shigeru, Ph.D. University of Hawaii, 1992 V·M·I 300 N. Zeeb Rd. Ann Arbor, MI 48106 BEHAVIORAL EFFECTS OF FOOD: AN EXPLORATORY STUDY A DISSERTATION SUBMITTED TO THE GRADUATE DIVISION OF THE UNIVERSITY OF HAWAI'I IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN PSYCHOLOGY AUGUST 1992 BY James S. Niino Dissertation Committee: Richard A. Dubanoski, Chairperson Daniel D. Blaine Thomas J. Ciborowski Walter Nunokawa Donald B. Char, M.D. @ Copyright 1992 by James shigeru Niino iii ABSTRACT A careful review of the vast literature on the effects of food and diet revealed some evidence of advarse reactions to food and food ingredients. There is, too, an increasing body of literature indicating that stress may be an important, if not necessary, precipitating factor in the expression of symptoms in various illnesses. A double-blind, time series procedure utilizing two teenage male wards at a juvenile detention facility was designed to test for behavioral effects and assess the influence of stress on reactions. Two suspected offending foods were identified for each subject. The results were mixed. The data obtained included changes in levels of fidgeting in response to one food for each subject. The value of this study is that it tested a procedure for investigating behavioral reactions to food. Refinements in the design to improve its usefulness are discussed. iv TABLE OF CONTENTS Abstract ••• •••.•••• . .. iv List of Tables •• ••• •• viii List of Figures •••••• ix Chapter 1: Introduction 1 Feingold K-P Diet and Hyperactivity • 14 Clinical Ecology. • . •••. 61 Food Allergy. •••.••• ..• 73 Sugar Studies ••• •. •••••• 79 Diet and Antisocial Behavior. •••. 92 In vitro and Animal Studies ••..•• 103 Stress and Illness ••••••• 107 Hypotheses. •..•••.•.•..• 131 Chapter 2: Method. •. •.•••. 133 Design ... ......... 133 SUbjects .••••••••• 135 Apparatus ............... 137 Reaction Time. .••. 137 Blood Pressure/Pulse ••••. 138 Time Estimation. • •••. 139 Setting •••••• 139 Foods and Placebo • 140 Procedure 142 Dependent Measures ••••••. 142 SUbject Expectations and Guesses 145 Stress ••••• .... 145 v Practice Sessions. ...... 147 Baseline/Stress Verification . 148 Elimination Diet .....•• 149 Verification of Intolerance. 151 Double-Blind Challenges. 152 Chapter 3: Results. 154 Autocorrelation •. 154 Error Rates • 156 Measures. •• 156 Hypothesis 1 · 157 Hypothesis 2 · 164 Verification of Stress. 176 Hypothesis 3 · 179 Hypothesis 4 180 Hypothesis 5 · 184 Hypothesis 6 · . 196 Blood Pressure and Pulse Rate • 206 Subjects' Expectations and Guesses. 208 Chapter 4: Discussion. 211 Review•• 211 Design. 221 Baseline 221 Elimination Diet . 222 Foods. 222 stress • 224 Measures • 225 vi Future Research · · ·· · · · ·· · . · · ·· 227 Appendix A: Medical History Questionnaire - Part I- · · ·· · · · ··· .. ···· 230 Appendix B: Medical History Questionnaire - Part II · · ·· · · · ··· · · · · 231 References ..... · 232 vii LIST OF TABLES Table 1. Definitions of Food allergy and Related Terminology ••••• 3 2. Offending Foods 63 3. symptoms Reproduced in Patients by Testing for Allergies •••••••• 64 4. Typical Adverse Reactions to Foods. 65 5. Mean Time Spent Fidgeting Under Stress and Nonstress Conditions ••••••• ••• 177 6. Pulse Rates After Stress and Nonstress Conditions . · · · · · · · · · · · · 178 7. Lowest Mean Reaction Time in each Condition for Subject 1 · · · . ···· · · ··· 181 8. Lowest Mean Reaction Time in each Condition for SUbject 2 · · · . ······ · · · 182 viii LIST OF FIGURES Figure 1. Reaction Time During ELIM I and ELIM II for SUbject 1 • • • • . • • 158 2. Fidgeting During ELIM I and ELIM II for SUbject 1 • • • • . • • • • 160 3. Reaction Time During ELIM I and ELIM II for SUbject 2 • • • • . • • 161 4. Fidgeting During ELIM I and ELIM II for SUbject 2 • • • • . • • . 162 5. Daily Means of the Time Estimation Trials for SUbject 1 · · · · · · · ··· ·· · 165 6. Daily Means of the Time Estimation Trials for SUbject 2 · · · · · ·· · ·· · · · 166 7. Fidgeting During Challenge Phases for SUbject 1 • • • • . • 167 8. Reaction Time During Challenge Phases for SUbject 1 ·· · ··· · ··· · 169 9. Reaction Time During Nonchallenge Phases for SUbject 1 ··· · · · · · ·· · · · 170 10. Fidgeting During Nonchallenge Phases for SUbject 1••••.••••• 171 11. Reaction Time During Challenge Phases for SUbj ect 2 • • • • . • . • 172 12. Fidgeting During Challenge Phases for sUbject 2 • • • • . • • • 173 13. Reaction Time During Nonchallenge Phases for SUbject 2 • • • • . • • •. 174 14. Fidgeting During Nonchallenge Phases for.Subject 2 ••••.••••• 175 15. Comparisons to Reaction Time Under the Stress Condition During Baseline for SUbject 1••...••••.• 186 ix 16. Comparisons to Reaction Time Under the Nonstress Condition During Baseline for Subject 1 • • . • . • • . 187 17. comparisons to Fidgeting Under the stress Condition During Baseline for SUbject 1••.•••••.• 189 18. Comparisons to Fidgeting Under the Nonstress Condition During Baseline for SUbject 1••.••.••... 190 19. comparisons to Reaction Time Under the stress Condition During Baseline for SUbject 2•.••••••.•• 191 20. comparisons to Reaction Time Under the Nonstress Condition During Baseline for SUbject 2 . • . • • • • • • 192 21. Comparisons to Fidgeting Under the stress Condition During Baseline for SUbject 2•••••.•••• 194 22. Comparisons to Fidgeting Under the Nonstress Condition During Baseline for SUbject 2.•••••••••• 195 23. comparisons to Reaction Time Under the stress Condition During Baseline for SUbject 1.•..••••••• 197 24. Comparisons to Reaction Tima Under the Nonstress Condition During Baseline for SUbject 1 • . • • • • • • • 198 25. Comparisons to Fidgeting Under the stress Condition During Baseline for SUbject 1•••...•••• 199 26. Comparisons to Fidgeting Under the Nonstress Condition During Baseline for SUbject 1...•••••••• 200 27. Comparisons to Reaction Time Under the Stress Condition During Baseline for SUbject 2•.•.•.••.•• 202 28. comparisons to Reaction Time Under the Nonstress Condition During Baseline for Subject 2 . .• .•• ... 203 x 29. comparisons to Fidgeting Under the stress Condition During Baseline for SUbject 2 • • • • • • • • . • 204 30. Comparisons to Fidgeting Under the Nonstress Condition During Baseline for SUbject 2 • • . • • • . 205 3l. Daily Differences in Pulse Rates for Subject 1 ... .. 207 32. Daily Differences in Pulse Rates for Subject 2 .... .. 209 xi 1 CHAPTER 1 INTRODUCTION The realization that food can adversely affect susceptible individuals is by no means new. For example, the Greeks recognized idiosyncratic reactions to shellfish, shrimp, rhubarb, buckwheat, and cashews (Randolph & Moss, 1980). Hippocrates stressed how important it is for physicians to understand the totality of effects of food and drink and recorded observations of unpleasant reactions (e.g., fatigue, mental dullness) to different foods (Dickey, 1976b). Lucretius, a Roman poet, also wrote in about 60 B.C., "One man's meat is another man's poison" (Truswell, 1985). One of the problems that becomes immediately evident when reviewing the literature in this area is that there is no clear, common language. This is probably due to the complex nature of adverse reactions to food. Many have recommended that the various terms that are often used interchangeably, be precisely defined and used in a consistent manner in order to facilitate meaningful dialogue (Bock, 1980, 1984; Businco, Benincori, & Cantani, 1984, 1986; Coombs, 1984; Hanson, 1984; May, 1975, 1982, 1984, 1985; Metcalfe, 1984; Panush & Webster, 1985; Pearson & McKee, 1985; Pratt, 1958; Taylor, 1986; Truswell, 1985). The definitions proposed by the American Academy of Allergy and Immunology Committee on Adverse Reactions to Foods as 2 presented in Anderson (1986) appears in Table 1. This terminology was incorporated in this paper. Most of the authors above agree with these definitions. Some, however, prefer the term food sensitivity
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