Judith Warner: Why The Connection Between Food and ADHD Is So Tenuous | btcmu.info
The Diet Factor in Attention-Deficit/Hyperactivity Disorder,” the much-cited study released by the journal Pediatrics this week, did not make. Much research has been done on the subject of a helpful diet for ADHD, but according to the Mayo Clinic, experts don't believe that foods. The ADHD diet involves avoiding certain foods believed to More research is needed to link food color additives to ADHD symptoms.
For the older children, the daily amount of additives in mix A equaled the amount of food coloring found in two bags of candy, while the daily amount in mix B was equivalent to four bags of candy. The researchers asked parents and teachers to assess the children's behavior using standard clinical instruments, and also asked independent reviewers to observe the children at school. The older children were also assessed with the Conners' Continuous Performance Test II, which uses visual cues to assess attention and hyperactivity.
The investigators found a mild but significant increase in hyperactivity in both age groups of children — across the board, regardless of baseline hyperactivity levels — during the weeks when they consumed drinks containing artificial colors. This replicated findings of an earlier study they did in 3-year-old children.
Diet and hyperactivity: is there a relationship.
This was similar to the effect size reported in an earlier meta-analysis conducted by researchers at Columbia University and Harvard University. Their analysis of 15 trials evaluating the impact of artificial food coloring suggests that removing these agents from the diets of children with ADHD would be about one-third to one-half as effective as treatment with methylphenidate Ritalin. But like the authors of the British study, the authors of the meta-analysis cautioned that only a minority of children are particularly vulnerable to the effects of artificial additives.
They also pointed out that determining which children are susceptible is difficult, though not impossible. Although some experts have recommended testing children with ADHD for food reactions, there is no test for additives. Parents could try eliminating the major sources of artificial colors and additives — candy, junk food, brightly-colored cereals, fruit drinks, and soda — from their child's diet for a few weeks, to see if symptoms improve. One practical challenge to keep in mind, however, is that studies of sugar elimination have shown that parents may wrongly assume that changes in their child's behavior reflect consumption of a "problem" food.
In one frequently cited study about sugar, researchers recruited 35 mother-and-son pairs. All the mothers believed their sons — then ages 5 to 7 — were sugar-sensitive. The researchers told the mothers their sons would be randomly assigned to an experimental group that received a high dose of sugar or to a control group that received aspartame. In reality, all the boys received aspartame. The mothers who thought their sons ingested a large amount of sugar reported that their child's behavior was significantly more hyperactive afterward.
The researchers concluded that parental expectation may color perception when it comes to food-related behaviors. Omega-3 fatty acids Essential fatty acids fuel basic cell functioning, improve overall immunity, and enhance heart health. By definition, the body cannot make essential fatty acids, so these nutrients must be consumed in the diet. One group, the omega-3 fatty acids eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], and alpha-linolenic acid [ALA]is obtained from salmon, tuna, and other cold-water fish, as well as from some seeds and oils.
The other group, the omega-6 fatty acids especially linoleic acidis obtained primarily from vegetable oils. While a balance of omega-3 fatty acids and omega-6 fatty acids is best for overall health, the typical American diet contains too few omega-3s, often in a one-to ratio or lower with omega-6 fats.
Researchers have explored whether a deficiency of omega-3 fats might contribute to symptoms of ADHD because these fatty acids perform a number of functions in the brain, such as affecting transmission of the neurotransmitters dopamine and serotonin and helping brain cells to communicate.
ADHD and an omega-3 deficiency also share two symptoms: Some evidence suggests that children with ADHD may have low levels of essential fatty acids.
- Does Nutrition Play a Role in ADHD?
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- ADHD and Food: The Connection Is Tenuous
Only a few randomized controlled studies have evaluated omega-3 supplements for children with ADHD. A review by the American Psychiatric Association's Omega-3 Fatty Acids Subcommittee included two placebo-controlled studies that found DHA supplements alone were ineffective at alleviating symptoms of ADHD, and another three that concluded combining omega-3 and omega-6 supplements might help.
But because of the way the studies were designed, it was difficult to determine the specific benefit of omega-3 supplements. Although other studies have been published since the APA review, none have resolved the question of whether omega-3 or omega-6 supplements might help children with ADHD.
Several clinical trials are under way and may provide such answers in the future.
In the meantime, the recommendations of the APA subcommittee are a helpful guide: For children, that means consuming up to 12 ounces two average meals a week of a variety of fish and shellfish that are low in mercury, such as shrimp, canned light tuna, salmon, and pollack, along with daily plant sources of unsaturated fats.
Micronutrients Deficiencies of particular vitamins or minerals — such as zinc, iron, magnesium, and vitamin B6 — have been documented in children with ADHD. Tyrosine and s-adenosylmethionine supplements have provided mixed results, with some studies showing no effects and others showing modest benefits 3334 Amino acid supplements for ADHD show some promise, but more studies need to be done.
For now, the results are mixed. Vitamin and Mineral Supplements Iron and zinc deficiencies can cause cognitive impairment in all children, whether or not they have ADHD 3637 However, lower levels of zinc, magnesium, calcium and phosphorous have repeatedly been reported in children with ADHD 3940 Several trials have looked into the effects of zinc supplements, and all of them reported improvements in symptoms 4243 Two other trials assessed the effects of iron supplements on children with ADHD.
They also found improvements, but again, more research is needed 45 Nevertheless, a trial of a multivitamin and mineral supplement did find an effect. The adults taking the supplement showed a convincing improvement on ADHD rating scales after 8 weeks, compared to the placebo group 49 The results from vitamin and mineral supplement studies have been mixed, but several show promise. Omega-3 Fatty Acid Supplements Omega-3 fatty acids play important roles in the brain.
What's more, the lower their omega-3 levels, the more learning and behavioral problems the ADHD children seem to have Therefore, it's not surprising that many studies have found omega-3 supplements to cause modest improvements to ADHD symptoms 54555657 Omega-3 fatty acids appeared to help improve task completion and inattention.
Additionally, they decreased aggression, restlessness, impulsiveness and hyperactivity 596061626364 Numerous trials have found that omega-3 supplements can bring about modest improvements in ADHD symptoms.
People with ADHD are more likely to have adverse reactions to food, causing speculation that eliminating problematic foods might help improve symptoms 30 Studies have examined the effects of eliminating many ingredients, including food additives, preservatives, sweeteners and allergenic foods. Feingold discovered that food could affect behavior.Pediatrics: ADHD and Food Allergies
In the s, he prescribed a diet to his patients that eliminated certain ingredients that produced a reaction for them. The diet was free of salicylates, which are compounds found in many foods, medications and food additives. While on the diet, some of Feingold's patients noted an improvement in their behavioral problems.
Soon after, Feingold started recruiting children diagnosed with hyperactivity for dietary experiments. His work was celebrated by many parents, who formed the still-existent Feingold Association of the United States Although reviews concluded the Feingold diet was not an effective intervention for hyperactivity, it stimulated further research into the effects of food and additive elimination on ADHD 6970 It improved symptoms in children with ADHD, although recent evidence is mixed.
Eliminating Artificial Colorants and Preservatives After the Feingold diet was no longer considered effective, researchers narrowed their focus to look at artificial food colors AFCs and preservatives. This is because these substances seem to affect the behavior of children, regardless of whether or not they have ADHD 72 One study followed children suspected of hyperactivity. Another study found that hyperactivity was increased when 1, children consumed AFCs and sodium benzoate, a preservative Even though these studies indicate that AFCs can increase hyperactivity, many people claim the evidence is not strong enough 154767778 The EU, on the other hand, requires foods containing AFCs to have a label warning of adverse effects to children's attention and behavior 808182 AFCs may affect behavior in children, although some say the evidence is not strong enough.
Eliminating Sugar and Artificial Sweeteners Soft drinks have been linked to increased hyperactivity, and low blood sugar is also common in those with ADHD 84 Furthermore, some observational studies have found sugar intake to be related to ADHD symptoms in children and adolescents 86 However, one review looking into sugar and behavior found no effects. Two trials studying the artificial sweetener aspartame also found no effects 8889 Theoretically, it's more likely that sugar causes inattention, rather than hyperactivity, as blood sugar imbalances can cause attention levels to drop.
Sugar and artificial sweeteners have not been shown to directly affect ADHD. However, they may have indirect effects.
Diet and attention deficit hyperactivity disorder - Harvard Health
Here's how it works: Follow a very restricted diet of low-allergen foods that are unlikely to cause adverse effects. If symptoms get better, enter the next phase. Foods suspected of causing adverse effects are reintroduced every 3—7 days.
If symptoms return, the food is identified as "sensitizing.