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The Role Nutrition Plays In Helping ADD/ADHD |
“Research indicates that most children's ADD/ADHD symptoms, and often their learning problems, are caused by nutritional imbalances, deficiencies, excesses, allergies, and sensitivities. Studies show that improved nutrition is as effective as Ritalin for three-fourths of the children diagnosed with hyperactivity and attention deficits! Amazingly, most physicians recommend medication for symptom control over dietary changes. While cleaning up your child's diet requires some effort on your part, your youngster's health should be a priority. Clean up your own eating habits, and your behavior and mood are likely to improve, too!
Kids and Food
Carol's parents were not happy that their daughter consumed more candy bars and cookies than apples and asparagus, more pizza and potato chips than bananas and broccoli. But her diet didn't seem much different from her friends', and they were unsure how to improve it. They knew they could not control what Carol ate when she was at school or with friends, and they understood that food struggles could set the stage for an eating disorder during adolescence. Her parents gave her a multivitamin tablet each day and insisted she drink milk with meals so she would get enough of that all important bone-builder, calcium. Because she ate plenty of peanut butter sandwiches, they knew she was getting enough protein.
They never really worried about her diet until she was diagnosed with ADD/ADHD. Her mother asked the doctor about the Feingold diet, which had worked wonders for her nephew's hyperactivity and attention deficit.
Sidebar: When it comes to food allergies, cow's milk leads the pack. Infants produce the enzyme needed to digest their mother's milk; then, production slows. In most cultures, only babies drink milk. Youngsters can get enough calcium from vegetables, including cabbage, broccoli, parsley, okra, beets, carrots, celery, and greens.
Carol's pediatrician had very strong opinions about the importance of good nutrition for physical health. She delivered an impassioned lecture about the sorry state of most children's diets. "Obesity and exploding cholesterol levels are expected to translate into an epidemic of heart attacks in the coming decades," she said. Nevertheless, she said that diet did not cause behavior problems, and the best diet in the world would not clear up ADD/ADHD. "Think of it this way," she said. "Most kids have terrible eating habits, but only a small percentage is hyperactive with attention deficits." That made sense to Carol's parents, and they dropped the subject. They were surprised when they later learned that the pediatrician was seriously misinformed.
The Food Controversy
When parents ask if nutritional problems could be contributing to their youngster's ADD/ADHD symptoms or if a change in diet could relieve them, most doctors give the same answer: the notion of a connection between ADD/ADHD and food is an unfortunate myth, according to a national survey investigating pediatricians' knowledge and attitudes concerning diagnosis and treatment of ADD/ADHD published in the Archives of Pediatric Medicine in 1995. Many health care professionals feel strongly about this subject, as strongly as the many researchers who say that poor nutrition can cause ADD/ ADHD symptoms and good nutrition can cure them.
The Feingold Diet
Most doctors warn patients away from dietary cures because of a controversy that began in the 1970s. A research investigation found that removing dyes, additives, and salicylates from the diets of a group of children diagnosed with ADD/ ADHD reduced their hyper-activity and problems with inattention. The news made headlines and caused untold numbers of parents to embrace a diet formulated by Dr. Benjamin Feingold that would relieve ADD/ADHD symptoms. Following the Feingold diet is a major undertaking. Anything containing salicylates is forbidden, and they are in a wide range of fruits and vegetables. They are the main ingredients in aspirin, as well as in countless over-the-counter medications and cosmetics. Salicylates can be absorbed through the skin, so parents even have to be careful about the shampoos and skin lotions their child uses. Feingold diet chapters across the country provide support meetings and offer parents the opportunity to share advice and recipes.
Food Fanatics
Parents were alarmed by the news that children could be harmed by the artificial colors, sweeteners, preservatives, and texturizers that companies add to packaged foods. Public concern about the widespread contamination of the food supply intensified when it was realized that the residue from the pesticides used on crops and the hormones fed to farm animals was building up in people's systems.
In the heated debate over food additives and impurities, people with an interest in ADD/ADHD split into two factions with equally extremist views. The Feingold fanatics (mostly parents, nutritionists, dieticians, naturopaths, and holistic healers) maintained that better diet was the solution for every child with hyperactivity or attention deficit , even though many youngsters on the diet did not improve and it was obvious that other problems can cause ADD/ADHD. The Feingold bashers (mostly physicians) declared that food affects the body but not the brain, even though it is obvious that the brain is an organ like any other and that people cannot think clearly when they are hungry or ill. Most ADD/ADHD research went to investigating medications, but a handful of scientists continued to study nutrition and found links between certain dietary problems and ADD/ADHD. Emotions on the subject clouded all reason, and most parents and professions twisted the findings to fit their personal beliefs.
Sidebar: The Feingold diet may be more than your child needs. Eliminating just one or two chemicals may be enough for your youngster's thinking to clear, her mood to stabilize, and her behavior to normalize. For optimal health, serve only fresh, organic foods, and avoid all artificial ingredients.
The Food Connection
Research on the food/behavior connection is unequivocal: nutrition affects the functioning of the brain, but particular ingredients affect children differently. For instance, caffeine is a stimulant that energizes most children, creates a sense of well-being, and boosts concentration. But some youngsters react by becoming distracted, nervous, cranky or weepy, and so jittery that their hands shake and they cannot sit still. How a particular child reacts to an ingredient can change over time. A sugar feast typically induces feelings of contentment, but most preschool children crash when the sugar hits the bloodstream, and their mood, thinking, and physical coordination deteriorate. Wender and Solanto found significant decreases in performance on a continuous performance task among hyperactive children after they ingested sugar, according to a 1991 research report in Pediatrics. Older children and adults are not usually so strongly affected.
Artificial food colorings and preservatives have a significant impact on hyperactivity levels in very young children, according to research conducted at the University of Southampton in the United Kingdom and reported in the Archives of Disease in Childhood. Nearly 300 three-year-olds were screened for hyperactivity and allergies. During the first week, the children ate only foods free of the preservative sodium benzoate and artificial colorings such as tartrazine, sunset yellow, and carmoisine. During the second and fourth weeks, they were given a daily dose of fruit juice, with or without colorings and preservatives. The children became significantly less hyperactive during the period when the additives were removed and more hyperactive when they were put back into the diet.
Sidebar: How do I protect my child from salicylates? They are found in tea, peanuts, mint, and many fruits to name a few. Lists of foods that contain them are available at www.feingold.org. See www.nlm.nih.gov for a list of over-the-counter medications.
In 2003 a group of researchers undertook the massive task of reviewing all of the studies on ADD/ADHD. They concluded that there are eight main risk factors for this disorder.
* Allergies to foods and additives
* Toxicity from heavy metals and other environmental pollutants .
* Low-protein/high-carbohydrate diets .
* Mineral imbalances .
* Deficiencies of essential fatty acids and phospholipids .
* Amino acid deficiencies .
* Thyroid disorders .
* B-vitamin deficiencies
The researchers concluded that for children with ADD/ADHD, "These findings support the effectiveness of food supplement treatment in improving attention and self-control." An additional finding was that food supplement treatment was often as effective as Ritalin. Yet a study published in the Archives of Pediatric Adolescent Medicine reported that most pediatricians continue to believe that nutrition does not affect ADD/ADHD. In fact, one-fifth of the pediatricians surveyed said that parents of children with ADD/ADHD suffer from the "common misperception" that diet can cause it. [Ed: If we change the question slightly to: “Can diet aggravate ADHD?” I think there will be more consensus between the parties.]
The finding that nutritional problems can cause ADD/ADHD symptoms does not mean that the Feingold diet can cure them. Many youngsters are allergic or sensitive to a food or ingredient that this diet allows. In that case, eliminating additives and salicylates may not be enough to overcome problems with hyperactivity and/or inattention.
Food Allergies and Sensitivities
An estimated ten to twenty percent of children have food allergies. Besides causing the behavioral symptoms associated. with ADD/ADHD, common physical symptoms include dry, scaly skin or eczema, a stuffy or runny nose, watery or red eyes, and asthma. One telling sign is dark shadows under the eyes that give them a sunken appearance. Adverse reactions to foods and food additives (as well as to ragweed, pollen, animal dander, dust, etc.) are called "allergies" if the immune system identifies them as harmful and produces antibodies to try to fight them off. Elevated blood levels of immuno-globulin E (lgE) indicate that a youngster has recently been exposed to something she is allergic to. Many specific allergies can be identified by an allergist via a skin prick test. Allergists can prescribe medications to suppress the physical symptoms, but the medication may not help with the behavioral symptoms. In fact, some allergy medications worsen ADD/ADHD symptoms. The only solution is to eliminate allergens from your child's environment altogether.
Adverse reactions to foods and additives (as well as to pollutants) are called "intolerances" or "sensitivities" if no antibodies are produced. Intolerances and sensitivities do not show up on skin or blood tests, but they cause a wide range of neurological reactions, from hyperkinesis to seizures, from minor headaches to migraines, from difficulties focusing attention to fainting. Food sensitivities also cause a wide range of physical reactions, including upper respiratory problems (sneezing and runny nose), digestive problems (especially upset stomachs and diarrhea), diffuse pains (achy legs), skin ailments (flaking and eczema), and hives.
Identifying ingredients your child is sensitive to and eliminating them from his diet can be difficult, but it is definitely worth the trouble. This has been shown to stabilize children's brain waves on EEG tests and improve their behavior as effectively as Ritalin. Identifying which foods and additives a child is sensitive to (the "offending substances") can be difficult. Allergic reactions tend to occur within minutes of exposure to an allergen, but up to 48 hours can elapse before symptoms of sensitivity appear. To further complicate matters, when a youngster is exposed to a variety of mildly offending substances faster than the body can detoxify itself, toxic overload may develop. That means that even though a child does not have a problem with individual ingredients, certain combinations trigger an adverse reaction.
The Food-and-Mood Journal
The first step to identifying allergies and sensitivities is to keep a food-and-mood journal for one or two weeks to establish a base-line. Keep track of everything your youngster eats and note all of his emotional and behavioral changes. Involve your school-age child in the process of creating and keeping the journal. If he turns out to be sensitive to some foods, you can refrain from serving them at home, but it will be up to him to refrain from eating them at other times. He will be more likely to just say no if he understands the consequences. Do not criticize what your child eats or attempt to improve his diet during the baseline period, as he may decide not to admit to everything he eats.
Journal for John Age 10
Breakfast : Orange Juice, wheat cereal, wheat toast, milk butter.
Time Mood Notes
7:30 Happy In a good mood
8:00 Sad Tearful.
8:30 Mad Tantrum
9:00 Silly Disrupting class
9:30 Hyper Out of seat 3 times
10:30 Spacey Daydreaming
11:00 Sleepy Yawning .
All mental, emotional, and behavioral changes should be recorded. It is a good idea to record all physical changes as well. A hiccup can indicate digestive problems. Stumbling or spilling something can indicate that coordination has been adversely affected. Needing to have a question or comment repeated might mean that fluid in the ears is muffling incoming sounds. Watch for a sneeze, the scratching of an itch, the rubbing of an eye, a yawn, and ask your child to report all physical sensations: a knee ache, numbness or tingling of the feet or hands, feeling sleepy, etc. Be particularly alert to the behaviors that have been problematic. .
Mood swings: Bouts of tearfulness, whining, worrying, nervousness, fearfulness, frustration, irritation, depression, and crankiness as well as feelings of well-being and contentment. .
Behaviors: Restlessness, impulsiveness, aggression, hyperactivity, sluggishness, defiance, calm, cooperative, able to delay gratification, able to tolerate frustration, disorganized.
Thinking: Confusion, forgetfulness, spaciness, disorganization, difficulties concentrating, difficulties shifting attention, slow to respond, clouded thinking.
After keeping a journal for a week or two, review all of the entries and see if you can discern any patterns. If restlessness, hyperactivity, and fidgeting increase after eating a sandwich, a bowl of cereal, spaghetti, and apiece of cake, wheat might be a problem. Whether or not patterns emerge, the next step is to begin an elimination diet.
The Elimination Diet
An elimination diet involves methodically removing specific foods from your child's diet and looking for changes in mood and behavior to determine which ingredients are having adverse effects. Because school-age children trade lunches, buy items in the cafeteria to supplement lunches from home, purchase snacks from school vending machines, and eat at class parties and after-school programs, it may be best to put your youngster on an elimination diet during a school vacation. There are several types of elimination diets. One of the least complicated is a "hypoallergenic" diet. That involves avoiding the foods that are the most problematic for the largest number of children. These are:
Milk, Corn..Wheat. Citrus fruits, .Rye, Nuts,.Barley, Chocolate,.Oats, Coffee,.Eggs, Food additives,.Soy.
To eliminate corn you must also eliminate corn syrup and cornstarch. To eliminate milk you must check food labels for milk solids and whey. Wheat is in an amazing number of processed foods. To avoid all the dyes, preservatives, and flavor enhancers means avoiding restaurants, take-out dinners, and most frozen, canned, and packaged meals. There are various opinions about which foods and beverages are the least likely to cause adverse behavioral reactions and are therefore safest for children on an elimination ~t. Besides mineral water, vitamins without sweeteners and artificial colorings, and sunflower oil, some allergists allow Iamb, chicken (free-range, without chemical additives), potatoes, rice, banana, and apple. Some also allow broccoli, spinach, cabbage, cauliflower, Brussels sprouts.
For one study, a group of young children diagnosed with ADD/ ADHD were restricted to rice, turkey, pear, and lettuce for two weeks. Sixty-two percent showed a fifty percent improvement on both the Connor's and the ADD/ADHD Rating Scales. Keep track of your youngster's diet and reactions by entering information into the food-and-mood journal. Do not be surprised if your youngster's behavior deteriorates before it improves. Lots of children become very cranky during the first week, as if going through withdrawal. Mother Nature seems a bit perverse, because people have a tendency to crave the food items they are most allergic to. Provide extra doses of TLC, but do not pamper your child with food!
Phasing in Ingredients
If your child's ADD/ADHD symptoms improve while on the elimination diet, that means she is allergic to one or more ingredients. The next step is to begin adding various foods back into her diet one at a time. If the food-and-mood journal indicates a setback within 72 hours after eating a particular ingredient, eliminate it again and see if her behavior improves. In actuality, adverse reactions can appear within minutes or take longer than a week; the average is two to three days.
If your youngster turns out to be sensitive to a wide range of very common ingredients, as is often the case, do not despair! After completely abstaining from an ingredient that is causing problems for a time (some doctors say four to six months; some say for six months to a year), there is a good chance that your youngster will be able to tolerate it in moderate doses. Exceptions are allergies to peanuts and shellfish, which tend to last a lifetime.
Source of article -
Maati Talk Newsletter No 37 dated 14.03.06
www.maatismarket.com
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