This book demonstrates how phosphates in our diet can affect the biochemistry of children (and adults) who have a sensitivity to it.

Attention Deficit Disorder (ADD) was first described a century ago - about the same time as phosphate baking powder was introduced.

Phosphate is used very widely as an additive by the food industry because of its versatility. This means a child may be consuming 50% more phosphorus than the RDA.

The author; a German research pharmacist, had a hyperactive child herself. She gives a detailed account of her observations and experience; of visits to each health professional - neurologist, psychiatrist, psychotherapist; her son's reaction to drug medication and his problems at school.

Then in 1975 she came across the work of Ben Feingold who claimed there was a link between food and behaviour. This led her to discover a link between phosphates and behaviour. On a low phosphate diet, her child became 'normal'.

Her research was published in the first edition of this book back in 1978 in German. Since then thousands of parents have put their children on such a diet with good results.

ADD is not considered to be an allergy but an imbalance in metabolism that is inherited. Phosphate ingestion creates an imbalance between it and calcium, potassium and magnesium. This in turn creates an imbalance between the sympathetic and parasympathetic nervous systems. Hyperactive children have higher levels of dopamine and epinephrine, affecting the central nervous system. A shift towards alkalosis takes place. This causes a number of physical and emotional problems. Children can become very alkaline. This can be detected in the blood and saliva. By reducing the pH, improvements in behaviour can be seen. There are several ways of achieving this.

A simple short-term solution is vinegar. This neutralises the alkali. "It works just as rapidly and effectively as a Ritalin tablet."

Antacids such as aluminium hydroxide and calcium acetate can also be used as a prophylactic measure since they prevent phosphate absorption.

However the only long term solution is to keep to a low phosphate diet, which is the kind of diet people would have eaten a century ago.

A simple and reliable way of testing whether a child is phosphate sensitive is presented. It can be deter-mined in four or five days.

Although food labeling is not perfect, it is much easier to administer this diet than it was when the author was experimenting with it over 20 years ago. Relapses will not happen as often as in the early days when it was a hit and miss affair. A listing of what to eat and what to avoid is given as well as other useful advice.

The author also looks at ADD and the effect of phosphates on food labeling in childhood and puberty in some detail. She also covers the relationship between ADD, criminal behaviour and drug addiction. Numerous brief case histories of before and after dietary modification are described.

This is a very impressive book. A very well supported hypothesis is presented. It is well researched and the diet is practical and clearly works for many children. Medical trials are needed to confirm or deny the theory.

Unfortunately the author has come across the same problems so many other researchers have had to face when presenting something new, something that flies in the face of the accepted wisdom and challenges the existing power structure.

A psychiatrist carried out a small trial in 1977 which demonstrated the adverse effect of phosphates on 15 children. Her results were made known at a conference held at the German Ministry of Health. "The recommendations...were not considered acceptable then and, even today [20 years later], they are barred from publication". The psychiatrist had her funding cut, her colleagues were "persuaded" to leave, and low phosphate food could no longer be prepared. She was barred from talking to the author and her ward was eventually shut down.

An investigation did take place into phosphates but "the tests were conducted in such a way that it was inevitable that they would contradict our experiences." Nevertheless some studies have taken place that show the diet to be of benefit, and several children's institutions do administer it.

Although the book concentrates on behavioural problems, learning difficulties and juvenile delinquency, a low phosphate diet may also be appropriate for treating other symptoms of this metabolic imbalance, including disorders such as eczema, asthma, hay fever, neurodermatitis, stomach and duodenal ulcers, and migraine. It also makes it clear that physical and psychological problems can continue throughout adult life.

This book will be of interest to all dietary therapists, as well as those interested in the relationship between food and mood, metabolic typing and acid/alkaline balance.