This month, Experience Life, had a great article by Pamela Weintraub summarizing some of the current research and thoughts in the field regarding attention and behavior related to diet, titled, "Connecting ADHD and Nutrition." Weintraub's writing details the start of concerns regarding diet and behavior in the 1970's to recent, rigorous studies to examine the diet/attention connection. She also provides several tips for parents regarding how to integrate, nutrition-based approaches into their child's life to see if these changes impact behavior.
Questions about how diet could affect behavior was first developed by Dr. Ben Feingold, a pediatric allergist, in the 1970's when he came to believe that food dyes, preservatives, and some chemicals in food could cause hyperactivity. There became a lot of controversy about Dr. Feingold's theories, with some studies disproving him, but many parents insisting that his recommended diet was working for their children.
Weintraub noted that a problem with Dr. Feingold's approach was that it pointed to too many problematic substances and didn't create for a way to separate out for various diagnoses. She stated "the only way to tell whether eliminating a given food or additive might aid a certain disorder is to conduct studies to the highest standards of science. And in recent years, researchers have done just that." (page 62) Notably, Dr. David Schab of Colombia University Medical Center performed a meta-analysis (an analysis of all the placebo-controlled, double-blind studies) and found that artificial food colors had an enormous, negative effect of focus and concentration, and increased hyperactivity in a subset of children and teens. In addition, the preservative sodium benzoate can trigger hyperactivity and inattentiveness. These effects were more pronounced for young children and for those with more exposure to the dyes or sodium benzoate. In addition, Lidy Pelsser, Ph.D., a researcher at the ADHD Research Centre in the Netherlands placed 50 children with ADHD on a restrictive diet of water, rice, turkey, lamb, lettuce, carrots, pears, and other whole foods rarely known to cause allergies and 64% of children had significant remission of symptoms, and most children relapsed after stopping the elimination diet. Of note, despite criticism given these types of findings the FDA decided after an 8 to 6 split vote not to put warning labels on food with food coloring, while conversely in Europe a similar panel voted to label food and many international food makers are only using natural dyes, while American food products continue to use artificial colorings.
Julia Rucklidge, Ph.D. in New Zealand published a randomized, placebo-controlled, double-blind trail testing a micronutrient mix (14 vitamins, 16 minerals) versus a placebo to find that those taking the micronutrient reported greater improvement in inattention, hyperactivity, and impulsivity. In addition, a greater effect was found for those who had been taking the micronutrient for longer periods.
Weintraub also sites work by Dr. Kenneth Brock in his book Healing the New Childhood Epidemics: Autism, ADHD, Asthma, and Allergies, in which he reports that gluten and casein can sometimes profoundly exacerbate symptoms associated with ADHD. He notes that by removing gluten and casein from children's diets in these cases it is possible to have children who are much calmer, focused, and who have overall better general health.
Next, Weintraub discussed the work of physicians, Drs. Luke Curtis and Kalpana Patel, since they advocate for bundling nutritional and environmental interventions together. In their work they often will eliminate foods and dyes, add whole foods, supplements, and probiotics, and reduce a child's exposure to toxins and then see positive changes for the child.
Weintraub's provides a list from the experts for a "Nutritional Tune-Up"
(Of course, consult your physician or naturopath to discuss these specifically for your family)
1. Remove artificial colorings--especially Red #40, Blue #2, Yellow #5, and Yellow #6.
2. Eliminate food additives--especially the preservative sodium benzoate (commonly in soda and other carbonated beverages, fruit juices, jams, salad dressings, condiments, and pickles).
3. Remove medicines and foods containing salicylates--found in aspirin and fruits
4. Supplement your child's meals with targeted micronutrient--vitamins and minerals including vitamin D, B vitamins, omega-3 fatty acids, amino acids, calcium, iron, magnesium, and zinc.
5. Try a restrictive diet like referenced for Dr. Pelsser above and if symptoms subside slowly reintroduce foods to try and see what your child is having a food allergy to.
6. Try an elimination diet such as a gluten and casein free diet.
7. Consider your child's gastrointestinal health--work with a physician to add a probiotic along with the supplement tricycline to improve problems related to leaky gut if appropriate.
8. Consider a low-glycemic eating plan (high in protein and fiber, low in carbs such as refined carbs and sugar).
9. Rebuild your child's diet based on whole, organic, nutrient-dense foods.
I know this article summary has a lot of information and a lot of tips. My hope is that this information will create opportunities for parents to increase communication with their children's physician's and other providers in the community such as naturopathic providers so that more comprehensive services can be provided for children.
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