Posted by: Ticktock | June 12, 2008

ADHD – Additives, Diets, Herbs, and Deniers

ADHD (Attention Deficit/ Hyperactivity Disorder) is either a myth or a harmful psychiatric neuro-behavioral disorder signified by poor attention and/or hyperactivity and impulse control problems.  There is no known cure for ADHD, but people think they can control it with drugs or supplements.

Some skeptics debate that ADHD is a valid psychiatric malady, but like it or not, the condition is diagnosed in 3-5% of children.  It’s a real problem with unknown causes that run the spectrum from genetic to dietary to behavioral.

Nobody knows the real causes of ADHD, which is why there have been all kinds of speculation and research.  One ADHD denier is John Rosemond, a faith based parenting dick (I mean guru).  He believes that hyperactivity and attention problems stem from bad parenting and unrestricted TV and video games.  Of course, his anecdotal ideas may have some merit, but they’re a little too simplistic and arrogant to be considered valid.

What about diet?  Studies have consistently shown that sugar by itself does not contribute to ADHD.  Lately there have been calls by some scientists to reintroduce the idea that food additives trigger ADHD.  The progenitor of this debate has been the Feingold Association, who promote a very strict diet based on available scientific research.

The Feingold diet has been touted by it’s proponents as a miracle cure for all kinds of problems, but the fact is that there have not been adequate scientific studies to back up all of these claims.  Certainly, anecdotal evidence is strong among Feingold dieters, but the shotgun approach of such a severe change in diet makes it hard to determine why it may work.  Is it because of the removal of salicylates and food additives… or because of other factors?

The standard treatment for ADHD has been Ritalin, an over-prescribed(?) drug that makes parents concerned and scientologists foam at the mouth with anger.  Some supplements have been proven to help children with ADHD:  magnesium, L Carnitine, iron, zinc, and possibly fatty acid supplements, and vitamin B6.  These supplements should be taken in consultation with a doctor.

One herb has just recently been crossed off the supplement list.  A recent study revealed that St. John’s Wort is not an effective treatment for ADHD, not that anybody thought it was effective in the first place.

This is a topic in which I welcome feedback.  I plan on adding to and editing this post as I learn more information in the future, so please feel free to respond.

Latest ADHD News:

Anthropologist Dan Eisenberg compared tribes in Kenya.  He noticed that tribesmen with the ADHD-associated gene were remarkably better nourished than those without the gene.  This may prove that ADHD can be seen as a naturally selected advantage in some situations.


Responses

  1. If you will look at the pages of scientific research at http://www.feingold.org/Research/research.html which is organized by symptom — very little of it can be called “anecdotal” and virtually all of it was printed in peer reviewed scientific journals — you will see that there is more than adequate support for the idea of an elimination diet benefiting people with quite an astonishing array of symptoms. What is more astonishing is that a lot of kids with ADHD also have quite a few of the other symptoms listed; you might call it a “profile” of a likely responder to the Feingold diet. On the other hand, nobody claims that every symptom in every person is going to be cured by a change in diet; that would be ludicrous. But since, as you yourself say, the causes are unknown, then taking the worst of the additives out of your diet may well be a good first step to try. It is most simple, no side effects, and (according to the research) about 70% likely to succeed. Not to mention that the additives being removed have other unappetizing effects such as cancer …. see http://www.feingold.org/Research/dye.html

    At the Feingold Association, we teach people how to do this. Yes, we charge a fee so that we can continue in operation and keep our information updated. This nominal fee makes this probably the least expensive of all treatments for ADHD. Yes, we also give financial aid to those who can’t afford our very reasonable fee. We are in it for the service, not the money, and most of our staff are volunteers.

    By the way, I got a kick out of your observation about the tribesmen with the ADHD gene …. since no scientist has yet discovered any such gene, I am wondering how this gene was observed in action.

  2. Dear Skeptic Dad,
    While I agree with many of the points you make, please take a closer look at what the Feingold diet really is. No, it certainly is not a “miracle cure for all kinds of problems,” as you state. It is a technique to determine if certain synthetic food additives and certain foods are triggering (not “causing”) a wide range of problems. Most of the additives eliminated are made from petroleum so it’s pretty easy to ditch them. As for the foods that are potential offenders, they are temporarily removed and then added back in one at a time.

    We know that many many different things can bring on symptoms of what is now being called “ADHD,” and as the Feingold Association’s newsletter editor, I write about them often. ADHD symptoms might be the result of lead exposure, vision deficits, family dysfunction, food or environmental allergies, side effect of medicine, sensory deficits, nutrient deficiencies, fragrances, among others. Difficult delivery or prematurity can set a child up for learning and behavior problems. One family traced the problem to arsenic exposure…used to treat the wood on their newly-built porch. Another family found that the new laundry detergent, which made his clothes feel scratchy, was the cause of their son’s “antsy” behavior in class.

    As far as a “severe” change in diet, some of the acceptable foods on the Feingold Diet include Big Macs, Coca-Cola and Pepsi-Cola (not diet), Crispex cereal, Duncan Hines Dark Chocolate Fudge Cake Mix, Breyer’s Ice Cream (black box), Dole canned Pineapple, Dannon Yorgut, natural Jelly Bellies, Miracle Whip, Kraft White Cheddar Mac & Cheese Mix, Fritos, Lay’s Potato Chips, Ghirardelli Chocolate candy, Heinz Ketchup, Domino’s Pizza, Subway Roast Beef Sandwich, Cold Stone Creamery Dark Chocolate Peppermint Ice Cream. Doesn’t sound too severe to me.

    I see that you are not impressed by the double-blind studies showing that some food additives can result in disturbed behavior, but since the 2004 meta-analysis of 23 studies and the 2007 Southampton University study showing that a modest amount of food dye triggered ADHD symptoms in most kids, not just those with ADHD, others have been quite impressed. In February the American Acadamy of Pediatrics published a paper saying that they might have been wrong for the past few decades, and that a diet eliminating dyes and preservatives is a reasonable intervention.
    Then, more recently, the British Medical Journal was sufficiently impressed with the studies to say that diet should be considered a standard treatment for ADHD.
    Jane Hersey
    Pure Facts editor
    Feingold Association of the US

  3. Thanks so much for the corrections and detailed response! I’m happy to have your counter-point on the topic, and I appreciate the feedback.

  4. A great post, and I have to say I’m really enjoying your blog :) . But as my 8-year-old has ADHD and is doing extremely well on Ritalin (which I was initially also reluctant to give), I can tell you that the symptoms manifested themselves long before he ever set eyes on a TV screen, or even had any food with synthetic additives – unless he was getting them via breastmilk. I always wondered why his older brother could sit still and ask us to read book after book after book from a very young age, but he could barely sit through one reading of a single book, for example.

    My patient base – made up of ultra-Orthodox Jews – have no TVs or computers in their houses, but quite a few children are on Ritalin or Concerta (I don’t know if at a similar rate as the general Israeli population, but it’s not unknown). Many have first tried dietary changes and supplements; none have seen the dramatic improvements seen when a child is put on pharmacological treatment.

    Ritalin, contrary to popular belief (including my own prejudice, I have to admit), is quite safe and not addictive in the doses given. I gave my son his first dose ever on the weekend so I could see if he was ‘doped up’ or wired…I saw absolutely no change in his behavior. But two days later, his teacher (who’d pointed out earlier there was a problem, but didn’t suggest Ritalin) called up and asked if we’d switched kids on her, the change in class was so dramatic. My son is now the one who insists on taking the pill, as he likes to please his teacher and receive straight A’s.

    That said, I think there’s much to be said about ADHD being a variant of normal behavior that’s always been around, except that it’s perceived as dysfunctional in the context of modern society. My 57-year-old uncle, who was always a ‘handful’ as a child, was also recently diagnosed and put on Ritalin; he’s managed to hold onto his current job for longer than ever before.

  5. Thanks for the information on ADHD.

    We recently wrote an article on if having ADHD affects children in school at Brain Blogger. Having a child with ADHD is hard work, especially when having ADHD affects their school life. There was a study that followed 370 adolescents who have ADHD as well as 740 controls (There were two controls for each adolescent with ADHD.) and showed that ADHD students are absent more, have lower standardized reading scores, dropout of school at higher levels, and are held back more often.

    We would like to read your comments on our article. Thank you.

    Sincerely,
    Kelly

  6. If you will look at the pages of scientific research at http://www.feingold.org/Research/research.html which is organized by symptom — very little of it can be called “anecdotal” and virtually all of it was printed in peer reviewed scientific journals

    I linked to that page in the text.

    My problem with the Feingold Program is your interpretation. A drastic change in diet can alter behavior because of a lot of factors, and that we shouldn’t assume it’s because of salicylates and food additives. You start out eliminating a bunch of salicylate foods, and then add them back in one by one. They all have salicylate, don’t they? If salicylates are the problem, then why don’t ALL the foods cause the problems. Couldn’t it be that a possible allergy is the problem, and not the salicylates? Or that a healthier diet is helping the behavior?

    Maybe I’m wrong, and that’s fine.

    The article (I provided a link) said that it was an ADHD associated gene. You are welcome to click on it yourself and investigate further. I’ll change my wording above.

  7. [...] of ADHD.  I’m not sure how Feingolders will interpret the discovery, but I know from previous responses to my posts that an ADHD gene will be news to [...]

  8. Diet changes for AD/HD? That’s like eating more broccoli when your eyes go bad. Yes, it’s good for your eyes but if your kid can’t see the board in the classroom you would get them the glasses first, no question. Ritalin-like drugs are like glasses. Get them the glasses first, then try the other stuff to see if it works. If the diagnoses is correct, then these drugs are like lifesavers for these kids (and adults). It has been studied and proven safe in a multitude of studies going back to the 1930s.
    Can the same be said for diet changes?

  9. One thing to really consider is whether these ADHD behaviors are manifestations of underlying nutritional deficiencies. Chemical treatments can restore imbalances caused by missed nutrients, but these are simply masking the symptoms.

    While I agree with many of the above posters that ADHD is real, I definitely think that clinicians are sometimes too trigger-happy in the diagnostic process, and gets to the point where “ADHD” is becoming an umbrella term for a wide range of maladies.

    I personally see it as a spectrum of related disorders, each with its own needs and functional impairments. I also believe that proper dietary measures (which may include, but is by no means limited to the Feingold diet).

  10. I’m a little confused by this post – the title of your blog is “science-based” parenting, yet you don’t actually talk about any actual science regarding the definition of this disorder or its treatment. Having worked with children who have ADHD and children who don’t for many years, I can attest first hand that it exists – however, my opinion isn’t the point. Science has demonstrated that ADHD is a neurologically based disorder that affects children and adults across domains of functioning – tons of research has been devoted to its causes and treatments. Just one example – the MTA study – a longitudinal, multi-site NIMH funded well-controlled study examining the difference between stimulant medication, behavioral treatments, a combination treatment, and treatment in the community. http://www.nimh.nih.gov/health/trials/nimh-research-treatment-adhd-study.shtml

    If you’re going to provide scientifically-based opinions about a topic, please do your research first. Children with ADHD who are not treated are at risk for a host of negative outcomes such as poor academic performance, school drop out, substance abuse (especially nicotine dependence), social problems, difficulties maintaining employment, increased risk of depression and anxiety, etc. ADHD is sometimes overdiagnosed, sometimes underdiagnosed, and sometimes misdiagnosed (for example, when the underlying problem is really an anxiety disorder).

    A child suspected of having ADHD should be evaluated by a trained psychologist, and medication should be prescribed by a child psychiatrist or a pediatrician who has specialized training in treating ADHD. Medication should be combined with behavioral treatments like a daily report card and parent training. While diets and supplements (like Omega 3s) may help individual children, they have yet to gain support in the research as generally effective for children with ADHD.

    For parents looking for help with an ADHD child, I recommend the organization CHADD (Children and Adults with attention deficit/hyperactivity disorder) http://www.chadd.org

  11. Ann,

    I mentioned that I welcome feedback on the subject because I’m not an expert on ADHD. I’m a full-time parent trying to bust parenting myths using science as a guide post, and I write these during nap time.

    I understand your disappointment, but my blog title “science-based parenting” comes from how I approach my topics, not that everything will be referenced and scholarly. Maybe I bit off more than I could chew with this one. Sorry about that, and thanks for the additional info.

  12. I am not offended – I am just concerned that people looking for evidence-based information on this (to maybe bust a parenting myth) may see your note about some supplements being “proven” to help kids with ADHD (they’re not) and your notion that people don’t know the causes of it, and not get the important information they need about the research behind ADHD and it’s treatment. There is substantial research now showing the one of the main causes of ADHD is genetics – it’s about as heritable as height when you look at heritability quotients. Also, smoking while pregnant predisposes children to developing ADHD, though there are plenty of kids who have it who did not experience this. There are lots of medications out there other than ritalin now as well and they have also been well-researched. People have enough conspiracy theories and opinions not based in research about this topic – I think this could be a great topic for your blog if you sift through the research a little further.

  13. I personally enjoy the “science based parenting” aspects of your blog so keep up the good work. I have been diagnosed with ADHD and with a child on the way I have been doing tons of research.

    Personally diet changes(raw honey instead of sugar, lower calorie intake, less alcohol, more water) and supplements (B vitamins, long chain amino acids and Omega 3′s) have significantly altered my regular behavior patterns. That and I try make behavioral changes as far as what works for me in completing work related projects.

    I would love to hear your take on the latest NIDA study by Nora Volk about ADHD sufferers showing significantly lower levels of dopamine receptors than the control group. It seems to be a clear cut case of ADHD as a biological disorder.


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