ADHD

What every parent needs to know

Paying closer attention to the role of nutrition & food allergies

Attention deficit hyperactivity disorder (ADHD) has reached epidemic proportions among U.S. schoolchildren. The primary medical treatment for ADHD is the stimulant drug, Ritalin; its use has increased by 700 percent over the past five years. Although Ritalin can control some symptoms of ADHD, its long-term risks or benefits are not known, and the drug does not get to the root of the problem.

Beyond Ritalin

Scientific research shows that nutritional factors are a contributor to ADHD. I have personally treated hundreds of children with ADHD over the past 20 years, and almost all have improved without the need for Ritalin. To help them and their parents, I have used a series of questions that search for the causes of ADHD in each individual child.

The first question is: How effective are the parents at parenting? All children, especially those with behavioral problems, need affection, consistency, and the clear setting of limits. A related question is: How appropriate is the educational setting for this child? Some children need to work consistently with their hands and need to keep physically active -- these children will become restless and inattentive when deprived of physical work. Their problem is not a medical disorder, but inappropriate schooling or ineffective parenting. Fortunately, most of the parents whose children I see in my medical practice understand these principles well.

Investigating ADHD, nutritionally -- step by step

First and foremost, these parents are consulting me for nutritional advice. I ask the following questions to get the nutritional answers I need, and I recommend that you, as parents, ask these questions of your own children:

#1 How nutritious is your child's diet? Over half of children with ADHD crave sweets, often at the expense of nutritious food. About 70 percent of children who crave sweets have much more control over their behavior when their food is low in added sugar. My first line of advice is: keep your children away from sugary cereals, pancakes or waffles with syrup, soft drinks, candy, cakes, cookies, doughnuts, ice cream, frozen yogurt, and chocolate. Every ounce of sugar reduction helps. Sugar alone, however, does not cause hyperactivity; it reduces the nutritional quality of the diet and may aggravate food allergy or food intolerance (see below). Concentrated sugar in the upper intestinal tract makes the intestine "leaky," increasing the absorption of allergens into the body.

#2 Are there any foods or food additives to which the child is sensitive or intolerant? During the 1960s, Dr. Benjamin Feingold, a California pediatrician, observed that many hyperactive children became excited after eating foods containing high concentrations of salicylates. These compounds occur naturally in many fruits and vegetables and are especially concentrated in grapes, raisins, nuts, apples, and oranges. They are also used as preservatives (BHT and BHA, for example) or as the basis for artificial colors or flavors. Feingold developed a low-salicylate diet that has helped many children overcome ADHD.

Thirteen years ago, the National Institute of Mental Health convened a consensus panel which concluded that 8 to 10 percent of children with ADHD are sensitive to salicylates and benefit from the Feingold diet. Sensitivity to salicylates in food is probably not a salicylate allergy, but a chemical effect of salicylates on the brain. Some researchers believe that these chemicals act to inhibit the activities of enzymes that decrease the brain's sensitivity to allergic reactions. I have seen several children with ADHD whose ability to tolerate other foods, like wheat, improved when they eliminated apple juice and grape juice.

A study performed at the Hospital for Sick Children in London, published in the leading British journal, Lancet, demonstrated that most children with severe ADHD are salicylate sensitive, but that 90 percent of these children have additional food allergies. The British researchers performed exhaustive dietary trials, closely supervised by hospital dietitians. After determining that 80 percent of the children had apparent food sensitivities as a cause of hyperactivity, they then performed double-blind, placebo-controlled challenges with the offending foods. Using this most rigorous clinical research method, the investigators confirmed the presence of food intolerance in the majority of children with ADHD.

Subsequent research by the leading investigator of this study suggested that these food intolerances represent a true food allergy. The foods to which children with ADHD most commonly had allergic reactions were:

* cow's milk products (which included milk, cheese, yogurt, and ice cream)

* corn (an additive in many prepared foods)

* wheat

* soy

* eggs.

Altogether, 48 different foods were incriminated as triggers for hyperactivity.

Digging deeper into the food allergy possibility