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ADHD: 7 Clues to a calmer kid

MagazineFebruary 2013 (Vol. 23 Issue 11)ADHD: 7 Clues to a calmer kid

Your doctor will likely prescribe a drug for your child's ADHD, but most cases can be solved by investigating these seven suspects

Your doctor will likely prescribe a drug for your child's ADHD, but most cases can be solved by investigating these seven suspects

After her youngest child was born, Sally Bunday learned to live without sleep. For years, Miles slept for just three hours a night, and when he was awake he was irritable, clumsy and so active and distracted that he could concentrate for only a few minutes at best.

When they were out together in public Sally was often blamed for his disruptive and hyperactive behaviour; 'If he were mine,' she would repeatedly hear whispered behind her back, 'he wouldn't be behaving like that.'

Doctors claimed Miles's attention-deficit was due to some sort of brain imbalance, but Sally thought there might be another reason, particularly as her son had other strange symptoms. For one thing, he was always thirsty. He also suffered from constant headaches, a runny nose and stomach aches. His hearing was often very poor.

She decided to do some investigating of her own and eventually discovered the Feingold Diet, which treated hyperactivity in children as largely a reaction to food additives and other allergies.

Within four days of Miles starting the diet, every one of his symptoms disappeared. "And that was the first time in six years," says Sally, "that I got a good night's sleep."

Sally was so impressed by this remarkable transformation that she decided to become a professional ADHD detective, exploring different environmental and dietary causes of the surge of cases of children with attention deficit in the US and UK.

That was 35 years ago-and Sally went on to found the Hyperactive Children's Support Group, which has helped thousands of families investigate and find the source of their child's ADHD (www.hacsg.org.uk). After observing that many children, like Miles, suffered from excessive thirst and dry skin and hair, she and her mother, the late Irene Colquhoun, were the first to propose that children suffering from ADHD might be deficient in essential fatty acids (EFAs).1

Although medicine classifies hyperactive attention-deficit in children as a 'brain disorder', as Sally and many nutritional doctors have discovered, mostcases of hyperactivity or attention-deficit are nothing less than an environmental or dietary assault. In 1973 the late American paediatrician and allergist Ben Feingold introduced the then groundbreaking theory that foods containing artificial colours and artificial flavours were mainly responsible for hyperactivity.

He discovered that reducing a child's intake of sugar and artificial additives and locating possible allergies could help. Although study after study has backed Feingold's theories, many standard medics still label his approach a fad and are happier to reach for the prescription pad and sentence a small child to many years of stupefying, potentially addictive medication with stimulants like Ritalin (see The pill approach, below).

What the standard medical approach fails to consider is that hyperactivity doesn't stem from a single cause. Dr Sidney M. Baker, the former director of the Gesell Institute of Human Development in New Haven, Connecticut, who has worked with many learning disabled and hyperactive children, emphasizes that short attention spans and impulsive restless behaviours are indicative not of a brain imbalance, but of an "individual chemical imbalance" stemming from anything from nutritional shortages to food sensitivities to constant exposure to toxins or food additives, a situation often exacerbated by the typical American and British child's constant consumption of "altered, adulterated, sweetened, fatty and refined foods".

If you are faced with a hyperactive child and a doctor poised to write out a prescription, says Dr Baker, first try a bit of detective work (ideally with a trained nutritional practitioner) to find out both what is lacking and what the child might be getting too much of.

Here are your seven biggest suspects. Following these clues will almost certainly lead you to a calmer kid.

See WDDTY's seven clues to beating ADHD:

Clue 1
Suspect allergies or food sensitivities

A new study from the Netherlands suggests that the rise in ADHD cases is mainly down to food sensitivities. Dr Lidy Pelsser, of the ADHD Research Centre in the Netherlands, estimates that around two-thirds of cases are the result of hypersensitivity to foods.

She tested the theory on 100 ADHD children, aged between four and eight years, who were randomly assigned to five weeks of either a restricted elimination diet or a general healthy diet. By the end of the trial, 64 per cent of the children on the restricted diet reported a dramatic decrease in, or a complete reversal of, ADHD symptoms, while none of those on the general diet reported any improvement.2

After publication, Dr Pelsser told journalists that teachers who had worked with her on the project were "flabbergasted" by the results of her dietary approach. "It was a miracle. After the diet they were just normal children with normal behaviour," she said.

One Great Ormond Street Hospital study discovered that each of the ADHD children reacted to one of 48 foods, particularly wheat, dairy products, chocolate and oranges.3

Another study of 13 hyperactive children tested them with 40 different foods and inhaled allergens. Foods containing salicylates, aspirin-like substances found in many fruits and vegetables, triggered the highest rate of responses (80 per cent) while sugar, corn, beef and egg caused 25-30 per cent of responses.

Among your suspects don't forget to consider environmental allergens. In the above study, cat hair and house dust caused another 25 per cent of ADHD.4

Other research into ADHD children found that most had allergic nasal symptoms or skin problems and skin reactions to dust and pollen.5

When investigating food allergies, first suspect the big five-wheat, dairy, chocolate, egg and oranges-plus salicylates (see Avoid these foods, below). If eliminating them from your child's diet doesn't do the trick, try a more formal elimination diet with a nutritional therapist experienced in allergy treatment who can also investigate airborne allergens.

Clue 2
Look upon junk food and additives as likely suspects

Junk food and additives have been suspected for many years of causing hyperactivity. Dr Feingold's suggestion of a link between hyperactivity and additives was independently proven in 1985, when researchers at the Great Ormond Street Hospital in London put 76 hyperactive children on an additive-free diet and saw their behaviour significantly improve within a matter of weeks.3

The UK's Food Standards Agency confirmed these findings in 2003, when they gave a group of non-hyperactive preschoolers a cocktail of additives (sunset yellow, tartrazine, carmoisine, ponceau 4R and sodium benzoate), while another group was given a healthy drink. The behaviour of the children given the chemical cocktail deteriorated rapidly and the toddlers quickly became hyperactive, demonstrating all the hallmarks of ADHD.6

Put your child on a diet free of processed food and see what happens.


Clue 3
Investigate a lack of good fats

Following Sally Bunday's first discoveries, numerous studies have concluded that an EFA deficiency is a major factor in ADHD.7 Two of them, arachidonic acid (AA) and docosahexaenoic acid (DHA), play a major role in the workings of the brain and eye, constituting 20 per cent of the dry weight of the brain and over 30 per cent of the retina.

Two others, eicosapentaenoic acid (EPA) and dihomo-gamma-linolenic acid (DGLA), are crucial for normal brain development.

Linoleic acid (omega-6 series, to which DGLA and AA belong) and alpha-linolenic acid (omega-3 series, to which EPA and DHA belong), cannot be synthesized by the body and so must be supplied
in the diet.

Both AA and DHA are termed 'longer-chain polyunsaturated fatty acids' (LC-PUFAs) and can usually be synthesized from their EFA precursors.

These precursors are critically important as they work together with a complex group of highly biologically active compounds, including prostanoids (prostaglandins, thromboxanes and prostacyclins, among others) and leukotrienes.
These compounds perform numerous regulatory functions in the brain and the rest of the body.
Deficiencies in these omega-3 fats have been linked to visual and mental problems.8

Add several portions of fish to your child's diet (or flaxseed or purslane, which both contain omega-3s, if your child's vegetarian) and consider a daily dose of omega-3 complex supplements.

Clue 4
Eliminate the white stuff

Hyperactivity is often blamed on a high intake of sugar, but sugar itself isn't so much the culprit as sugar ingested in place of a well-balanced meal.

C. Keith Conners, director of behavioural research in the department of psychiatry at the Children's Hospital National Medical Center in Washington, District of Columbia, was the first to suggest that the effect of sugar can be modified by the foods consumed along with it.

Conners and his colleagues found that when sugar is consumed alone, the effects are different from when it's eaten along with protein or starch or as part of a well-balanced meal.

The combination of sugar and starch in the absence of substantial protein (a combination found, for example, in children's sugary breakfast cereals) increased deviant behaviour not only in children who were mentally disturbed, but also in normal children.

In one of Conners' studies, three groups of hyperactive children ate either a high-carb breakfast, a high-protein breakfast or no breakfast. On different days, children in each group also received a non-nutritive orange drink sweetened with aspartame or sucrose.

Children who received the high-carbohydrate breakfast with the sucrose drink did significantly worse than controls on a recognition test, while those eating the high-protein meal did substantially better than the other groups.9

Conners' conclusion: hyperactive children may benefit from a high-protein, low-carb, sugar-free diet.

Two other studies showed that hyperactive children process food more rapidly than others and are smaller than normal and so may need more protein than most.10

In another study of children aged 4-7, the higher the ratio of carbohydrates to protein in their diets, the greater their destructive, aggressive and restless behaviour.11

Dr Leo Galland, the American nutritional expert on the diets of children, suggests that you cut all sugar out of your hyperactive child's diet other than 4 oz of fruit juice and two pieces of fresh fruit each day.

The real issue may simply be that children overloading on carbs are invariably taking in a good deal of processed white stuff. Ditch it from their diets.

Clue 5
Zero in on your child's gut bugs

Many children with learning difficulties have 'bad' bacteria, called 'Clostridium', in their gut, earlier research has established. Probiotic bacteria, the 'good-guy' gut bacteria in live yoghurt and supplements, given to autistic children improved their behaviour and concentration to such an extent that the medical trial that made the discovery had to be stopped. Parents whose children were taking placebos demanded that theirs also be given the probiotics.

The effect of the 'friendly bacteria', which helps in the proper functioning of the gut, was so pronounced that the parents correctly guessed whether their child was being given a probiotic or a placebo.

Professor Glen Gibson, the microbiologist at the University of Reading, Berkshire, who conducted the trial, said he was disappointed that it had to be stopped. The early signs were very positive and many parents told him their children's concentration and behaviour had improved.

The probiotic used by Professor Gibson was designed to reduce or eliminate clostridial levels and promote 'friendly' bacteria, which helps the gut process food and nutrients.

While the trial was running, children taking the probiotic also showed fewer signs of autism, Professor Gibson said. The probiotic was taken every day in powder form.

Clue 6
Probe for poisons

One reason for the increased incidence of ADHD may be environmental. Your first likely suspect: pesticides, especially organophosphates, which are present in non-organic food.

A study from the Universities of Montreal and Harvard published in 2010 was one of the first to demonstrate that pesticides may contribute to hyperactivity and cognitive problems in children.

The worrying factor about this recent study is that the more than one thousand children who were being monitored were not all living on farms or in rural areas, suggesting that the pesticides are in the food they eat or even in the air they breathe and the water they drink.12

Also investigate whether your children are being exposed to environmental pollutants such as lead, mercury and PCBs (polychlorinated biphenyls), which are toxic to children and can affect developing brains.13

PCBs are found, among a raft of other items, in hydraulic oils and other lubricants, various electrical equipment (such as switches and circuit breakers), plastic toys, fire retardants (used in textiles and ceiling tiles), paints and varnishes, printing inks and wood treatments.

ADHD children may also have higher than normal levels of perfluorinated chemicals (PFCs) used in food packaging, stain-resistant coatings and fire-fighting foams. Researchers from the Boston University School of Public Health analyzed blood samples taken from 571 children aged between 12 and 15 years, 48 of whom had ADHD. The ADHD children had higher levels of PFCs than those not diagnosed with hyperactivity.14

Also steer clear of 'diet' foods and drinks like Diet Coke. Most are laden with the artificial sweetener aspartame, which contains phenylalanine, known to cause ADHD-like symptoms.

If you're pregnant, be sure to avoid the stuff as it can affect your unborn child even in the womb.15 Your child can also take in heavy metals from ordinary tap water, processed foods and toiletries.

Your assignment: go un-processed, use eco-toiletries, filter your water and limit your child's exposure to plastic toys.

Clue 7
Isolate dietary deficiencies

Sally Bunday worked with London's Biolab Medical Unit and Dr Neil Ward of the University of Surrey to conduct laboratory investigations of hyperactive children, which turned up other nutritional deficiencies. Hyperactive children are often low in zinc and B vitamins, particularly B6, and magnesium. Deficiencies in just a single nutrient adversely affect your child's mental capacity and can cause behavioural disorders.16 Studies have shown that adding B6 and magnesium can help to calm ADHD children.17

Add a quality multivitamin/mineral supplement to your child's daily regime along with extra EFAs, zinc (10 mg/day) and magnesium (100 mg/day).

References

1. Med Hypotheses, 1981; 7: 673-9
2. Lancet, 2011; 377: 494-503
3. Lancet, 1985; 1: 540-5
4. Int J Biosoc Res, 1983; 4: 40-2
5. J Learn Disabil, 1978; 11: 383-9
6. Food Standards Agency Library [Project T07004], 4 November 2002
7. Prostaglandins Leukot Essent Fatty Acids, 2000; 63: 1-9
8. J Pediatr, 1994; 125: S39-47; Proc Natl Acad Sci USA, 1986; 83: 4021-5
9. Conners CK. Medical Tribune, January 9, 1985 10
10. Am J Clin Nutr, 1984; 39: 520-4
11. J Consult Clin Psychol, 1980; 48: 760-9
12. Pediatrics, 2010; 125: e1270-7
13. Environ Health Perspect, 2001; 109 Suppl 6: 813-6
14. Environ Health Perspect, 2010; 118: 1762-7
15. Neuropsychology, 2003; 17: 458-68
16. Int J Biosoc Res. 1981; 1: 21-41
17. Biol Psychiatry, 1979; 14: 741-51; Ann Acad Med Stetin, 1998; 44: 297-314

Every seventh child

Medicine generally classifies ADHD as a 'brain disorder or imbalance' or 'biological dysfunction', which is variously blamed on genes, faulty thyroid, a bad prenatal start or even binge-drinking by pregnant women.

If that's the case, we're getting more dysfunctional by the day. In the US an estimated one in every seven American children under the age of 18 is regularly given a stimulant such as Ritalin to treat his or her ADHD, a figure so high that even the World Health Organization has urged a more cautious approach. And even that number has skyrocketed by 66 per cent in the last 10 years as more children are being diagnosed.

Out of a population of 73 million under-18s, 10.4 million are now taking Ritalin or another psychostimulant drug, according to figures for the year 2010, and around 6.2 million under-18s were diagnosed with ADHD 10 years earlier.

In fact, any child who has trouble paying attention, controlling any impulsive behaviour and being 'overly active' will probably be labelled as having ADHD and prescribed a drug.1

The UK is catching up fast; its drug use increased by 21 times during the 1990s and there is no sign of this acceleration slowing today.

In the UK, Professor Barry Carpenter, who has headed up a British government review into special-needs provisions in schools, announced a whopping 29 per cent increase in pupils with learning difficulties in just the five years between 2004 and 2009.

He predicted that, before long, every classroom in the land will have at least two pupils with ADHD and be hopelessly unable to cope with them.

Reference

1. Acad Pediatr, 2012; 12: 110-6


The pill approach

The time-consuming detective work needed to isolate the cause of your child's hyperactivity might seem daunting compared with the medical solution of simply taking Ritalin (methylphenidate hydrochloride). The standard medical theory is that ADHD results from a genetically based abnormality in glucose levels and neurotransmitters, and that amphetamines-which speed up bodily processes in adults-have a paradoxical effect on children, calming them down and readjusting the chemical imbalance.

Not only is there no evidence to support this view, but no evidence that Ritalin makes any lasting changes. And any calming comes at a high cost. The drug has been linked to restricted growth, anorexia, psychosis, insomnia, paranoia, hallucinations, epilepsy-like seizures, stroke and even death. Up to 10 per cent of children taking the drugs develop Tourette's syndrome (which includes facial and bodily tics). 1

It only works during the day to control symptoms and has rebound effects, so parents have to wrestle with full-fledged monstrous behaviour in the morning and later in the evening as their often insomniac children spiral out of control.

In the US this drug is categorized as a class II controlled substance like barbiturates, morphine and other agents with a high potential for addiction or abuse. Using sophisticated brain-imaging techniques, US researchers have concluded that Ritalin exerts the same effect on the brain as cocaine.2

"The data clearly show that the notion that Ritalin is a weak stimulant is completely incorrect," says research team leader Dr Nora Volkow. "This is a cocaine-like drug."

Several years ago the Food and Drug Administration, America's drugs regulator, instructed manufacturers to indicate on labels for Ritalin and Dexedrine, another amphetamine given for ADHD, that the drugs may cause "sudden death and serious cardiovascular events", especially in those who have a history of heart problems.

All this and it still doesn't seem to work. The MTA study (Multimodal Treatment Study of Children with ADHD), which tracked 485 children for three years, revealed that those still taking a stimulant drug at the end of two years showed the same levels of inattention and hyperactivity as those who had never taken a drug. Most of the children had taken the drugs for only 14 months (the original MTA study) and had then stopped.3

References

1. Arch Pediatr Adolesc Med, 1994; 148: 859-61
2. J Neurosci, 2001; 21: RC121
3. J Am Acad Child Adolesc Psychiatry, 2007; 46: 989-1002

Avoid these foods

The following foods, which contain high levels of salicylates, are often implicated in cases of ADHD. Try avoiding these first to see if it makes a big difference in your child's behaviour. If it doesn't, then try eliminating the big five (wheat, dairy, orange, egg and chocolate).

  • Almonds
  • The following fruits: apples, apricots, avocado, all berries, cherries, dates and dried fruits, grapes and raisins, currants, oranges, nectarines, plums and prunes, pineapples, tangerines, tomatoes
  • The following vegetables: chicory, courgettes (zucchini), cucumbers and pickles (and anything else pickled), endive, peppers (bell and chilli), radishes and water chestnuts
  • The following spices: chilli powder, cloves and paprika
  • Breakfast cereals with fruit, nuts, honey and/or coconut
  • Cider & cider vinegar
  • Coffee and tea
  • Cornmeal and corn/maize cereals and polenta
  • Food colourings and preservatives
  • Green olives
  • Rose hips or acerola (often found in vitamins)
  • Wine and wine vinegar
  • Wintergreen oil

WDDTY's verdict

Hyperactivity and ADHD are not situations or 'conditions' with a single suspect, but complex examples of slow-motion poisoning by modern industrial life.

Once you've done your detective work and isolated your biggest likely suspects, you can best treat your child with an organic, wholefood, unprocessed diet that is rich in essential fatty acids and low in or free of gluten and dairy, and with good-quality supplements.

Happy snooping.


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