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 The inconclusive nature of the results of many studies related to this question has led many to dismiss the connection between ADHD and food additives.  But recently the issue is being looked at again by the medical community.  In 2008 Pediatrics professor Andrew Kemp of the University of Sydney called for the removal of food additives as standard treatment for kids with ADHD.   He explains that of the 22 studies performed between 1975 and 1994 sixteen found that dietary modifications had a positive impact on children with ADHD.  He claims that eliminating food additives is a relatively harmless intervention and in light of the large number of kids on drugs for hyperactivity it would be wise to institute it as standard procedure for treatment for ADHD.  He cites a recent study that shows an increased hyperactivity in children without ADHD who were fed foods high in food colorings and sodium benzoate to support his claim.  In February of 2008 the editors of the American Academy of Pediatrics publication AAP Grand Rounds cited the same study as Kemp and stated “the overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong.”

 The European Union has agreed to place warning labels on foods containing six artificial colors that appeared in the The Lancet study which are: Yellow no. 5 Tartrazine, yellow no. 10 quinoline yellow ( not approved in the U.S.), Yellow no. 6 sunset yellow, red no. 3 carmoisine ( not approved in the U.S)., Red no. 7 ponceau 4R ( not approved in the U.S.), and red no. 40 allura red.  Sodium Bezoate is a food preservative that can be found in fruit juices, carbonated beverages, and pickles. 

 While the U.S. is lagging behind the European Union in terms of enacting laws requiring warning labels,Marylandis poised to become the first state to do so.  Two bills have been introduced into theMarylandStatelegislature and are awaiting confirmation.  Hopefully by 2012 the following warning will appear on foods containing certain food dyes:

“The color additives in this food may cause hyperactivity and behavior problems in some children.”

 References

Boyles, Salynn “Experts Revisit Food Additives and ADHD” WebMD.com. 24 Jan, 2011. www.webmd.com/add-adhd/news/20080522/experts-revisit-food-additives-adhd

 Gardner, Amanda. “9 Food Additives That may Affect ADHD” msn.com. 24 Jan. 2011. health.msn.com/health-topics/adhd/articlepage.aspx?cp-documentid=100268324

Shapley, Dan. “State May Ban Food Additives Linked to ADHD”

The Daily Green.com. 24 Jan 2011. www.thedailygreen.com/healthy-eating/eat-safe/food-colorings-47020907

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A good first step is to find out if your child with ADD is allergic or sensitive to any foods. While you can use blood tests and skin testing to determine this, you can also use an elimination diet to pinpoint trouble spots in the diet. There are a number of ways to do an elimination diet. One simple one is to begin by eliminating all foods with additives, dairy products, fruit juice, artificial sweeteners, processed meat, wheat, chocolate, and sugar. For two weeks, your child’s diet should consist of vegetables, fruit, and meat. After two weeks, try adding back one food at a time. If there is a reaction that you notice in terms of behavior, rashes, runny nose, it may indicate a problem with this food. Stop the food immediately, wait a couple of days, and add another food.

Once you find out what not to eat, you can look at what to eat. Researchers have found that diets high in protein are excellent for children with ADD. A general rule is to serve 70 percent protein and 30 percent carbohydrates for breakfast. Stick to about 50 percent protein and 50 percent carbohydrates for the other meals.

Omega-3 fatty acids are dietary essentials for everyone, but are especially important for children with ADD, as they are critical in brain function and development. Dr. Alexandra J. Richardson, in an article in Psychiatry says, “Increasing evidence suggests that a relative lack of omega-3 may -contribute to many psychiatric and neuro-developmental disorders.” Eating more flaxseed, sardines, and walnuts can help increase Omega-3 in the diet. You might also want to consider supplements of Omega-3.

Other tips for using an ADHD diet include things that are good advice for anyone’s diet. Drinking lots of water is important, as water acts as a purifier in the body. Additionally, eating lots of vegetables and fruit provides necessary vitamins and minerals.

To end with another substance to avoid, many doctors agree that it is best to avoid food additives. Children with ADHD often are very sensitive, and these chemical substances may contribute to distractibility and activity.

Mom’s Take:

Until I kept a food diary and wrote down what my daughter with ADD was actually eating, I didn’t realize how little protein she was getting. She disliked many foods, and she was filling up on a lot of carbohydrates. Since she doesn’t like meat or cheese very much, we decided to use a protein supplement. I make her a milk shake with protein powder every morning. She drinks that along with her scrambled eggs. I’ve noticed an improvement in her ability to get ready and get out to the bus in the morning.

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But if you don’t feel like printing out a three page article and dragging it to your doctor’s office we’ve come up with our own shorter version of 10 questions for you to print out and take with you to that all important second visit the doctor (the one where you actually come prepared):

1.   What causes ADHD?
2.   How is it diagnosed?
3.  What exactly is the difference between a high-energy kid and a child with ADHD?
4.   Does my child need to be treated with medication? How exactly does the medication work? What are side effects of the medication? Will he need this medication long term?
5.   Are there alternative methods of treatment?
6.   How can I explain to my son that he has ADHD?
7.   Does ADHD run in families? Should I have my other children evaluated? What about myself and my spouse?
8.   Will my child outgrow his or her ADHD?
9.   Is ADHD different in girls from boys?
10. What accommodations does his school need to make for him?

Mom’s Take:

When my child was first diagnosed with ADHD the conversation I found most enlightening was the one I had with my doctor about how to discuss the issue of ADHD with my son. I had no idea how to present the issue of ADHD to my son. I was worried about making him feel different from his friends. My doctor was a fantastic resource. He knew my son well enough to understand what my son would “get” and he told me the best way to present it to him when the time was right. Every kid is unique, but if you are concerned about how to present the issue of ADHD to your child your doctor might have some very helpful advice.

References

Baruchin, Aliyah “What to ask about ADHD” The New York Times. March 13, 2008

“10 Questions to Ask Your Doctor” Webmd.com. June 15, 2009

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Experts in Attention Deficit Hyperactivity Disorder do know that ADHD tends to run in families, so there is a genetic factor involved in the disorder. Close family members of people with ADHD have a much higher chance of developing ADHD, and some of the associated disorders including depression, learning disabilities, and anxiety. Siblings and identical twins, especially, have a high chance of sharing a sibling’s ADHD. Researchers continue to explore specific genes and how they might make a person more susceptible to ADHD.  Generally, researchers believe that the genes that control some chemicals in the brain are different in children with Attention Deficit Hyperactivity Disorder.

In some people, ADHD results from head trauma and brain injury. This may be because the neurotransmitters are damaged in a similar way that they are damaged by a defective gene. Being exposed to some prenatal assaults, such as drugs and cigarette smoke, as well as premature delivery, can increase the incidence of ADHD. Some environmental toxins may also contribute to developing ADHD. These toxins include exposure to lead and PCBs. These toxins may interfere with the development of the brain, and this may predispose a person to ADHD.

Some disorders, including epilepsy and craniosynostosis, are comorbid (exist along with) ADHD. Other comorbid disorders are learning disabilities and conduct disorder.

Some researchers believe that food and nutrition may play a role in developing ADHD. Some researchers believe that food additives may make ADHD symptoms worse. Others believe that a lack of certain fats, including omega-3, may be linked to ADHD.

So there are many factors that may cause ADHD or make ADHD symptoms worse. Researchers actually know more about what  ARE NOT ADHD  causes. ADHD is not caused by laziness, poor parenting, too much sugar, watching too much tv, or bad schools.

Mom’s Take:

This is reassuring. When my daughter was first diagnosed, I drove myself (and everyone around me) a little crazy trying to figure out why this had happened. What were her causes of ADHD? Where had these ADHD symptoms came from? I remembered that I had gotten an ear infection during the pregnancy and had taken antibiotics. Was that it? I thought about the awful preschool she was in for a couple of months. Could this be the reason? On and on…

Resources: Mayo Clinic, WebMD

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While this list is not exhaustive, here are some common myths about ADHD:

1. ADHD is not a medical problem
2. Bad parenting causes ADHD
3. ADHD is much more common in boys than girls
4. ADHD is over-diagnosed
5. People with ADHD are just lazy or developmentally delayed
6. An ADHD diagnosis can be confirmed if stimulant medication is effective
7. Children diagnosed with ADHD will outgrow the disorder
8. Children treated with ADHD medications will abuse drugs when they get older
9. Only children who are hyperactive have ADHD
10. ADHD medication cures ADHD

ADHD is not a medical problem.

ADHD is a legitimate medical diagnosis. The American Psychiatric Society labels Attention Deficit Hyperactivity Disorder (or Attention Deficit Disorder) a medical disorder, as does the US Department of Education and the National Institutes of Health.  A great deal of research has been conducted, and the conclusion is that ADHD results from problems with the neurotransmitters in the brain. This results in behavioral changes, including impulsivity, attention issues, and sometimes in hyperactivity.

Bad parenting causes ADHD

Children with Attention Deficit Hyperactivity Disorder have biological problems making it difficult to control impulses and behavior. Diligent parents may have tried to teach their children to behave, but the brain chemistry is always working against them. It is easy to label children with ADHD as “brats” or “undisciplined,” but the facts are that the changes in their brain are to blame—not the parents.

ADHD is much more common in boys than girls

Because of this myth, it is true that more boys are diagnosed with ADHD than are girls, but there is no evidence that girls are not just as susceptible to the disorder as are boys.

ADHD is over-diagnosed

About 3% to 7% of school-age children in the U.S. have an ADHD diagnosis. Because there is no one test that conclusively diagnoses ADHD, there may be cases of misdiagnosis, but some experts believe that it is more likely that the disorder is under-diagnosed. This is particularly true in the case of girls. Unfortunately, many children go untreated.

People with ADHD are just lazy or developmentally delayed

A person’s intellectual ability is totally unrelated to ADHD. While people who are developmentally delayed can have ADHD, many extremely intelligent people also have the disorder. Untreated ADHD can lead to problems with schoolwork, but, again, this is not because of intellectual abilities.

An ADHD diagnosis can be confirmed if stimulant medication is effective

Some people think that giving stimulant medications, such as Ritalin, can be used as a test to confirm an ADHD diagnosis. However, even children without the disorder can respond to these medications and exhibit behavior changes. A trial of medicine alone is not recommended as a way to diagnose ADHD.

Children diagnosed with ADHD will outgrow the disorder

The vast majority of people an ADHD diagnosis as children continue to have the disorder as teenagers and as adults. Unfortunately, most adults with ADHD do not get a diagnosis and, therefore, do not get treatment. These undiagnosed people are prone to anxiety, depression, and substance abuse.

The good news is that if a child is diagnosed early, he or she can learn coping mechanisms, get support, and find the right medication, if necessary, to develop into highly productive adults.

Children treated with ADHD medications will abuse drugs when they get older

Untreated ADHD is actually more likely to lead to substance abuse. If children get the support they need, in the form of behavior therapy, medication, and parental understanding, the risk of drug and alcohol abuse is reduced.

Only children who are hyperactive have ADHD

While many children with Attention Deficit Hyperactivity Disorder do exhibit hyperactivity, not all do. ADHD is now used to refer both the ADHD and ADD (Attention Deficit Disorder). Some children fall into a category of hyperactivity and impulsivity; some children only exhibit the inattention part of the disorder; and still others exhibit both

ADHD medications cure ADHD

ADHD medications don’t cure the ADHD, but they can be very effective at treating some of the symptoms of the disorder.

While psycho-stimulant medication can help many children with ADHD to be less hyperactive and more focused, medication should be just part of the treatment plan. Other parts of the plan may include psychotherapy and behavior modification therapy.

Mom’s Take:

I guess it makes sense that the myth that hurts the most is number 2, that bad parenting is at fault. I even believed that myself in the beginning. I’d be at the playground with my daughter, and the other mothers were sitting and chatting while their kids played together. I never got to sit down because of the constant barrage of trouble my daughter was causing. She took someone’s toy, she pulled another’s hair, she ran out of the fenced area around the playground and into the street, she screamed for no apparent reason—I could go on. And I saw the way the other mothers looked at me. I felt that I was inadequate to handle my own child and that they knew it. That, of course, was before we got help, but I still hate to think of those days.

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