ADHD Symptoms and Dietary Connections

[bof00]

We all know this isn't just diet. But here are some interesting studies that explain some connections between worsening and bettering of symptoms.

This is mainly on food coloring, but I found it interesting as I found out I'm affected by milk, chocolate, and eggs so far:

Artificial food colors (AFCs) have not been established as the main cause of attention-deficit hyperactivity disorder (ADHD), but accumulated evidence suggests that a subgroup shows significant symptom improvement when consuming an AFC-free diet and reacts with ADHD-type symptoms on challenge with AFCs. Of children with suspected sensitivities, 65% to 89% reacted when challenged with at least 100 mg of AFC. Oligoantigenic diet studies suggested that some children in addition to being sensitive to AFCs are also sensitive to common nonsalicylate foods (milk, chocolate, soy, eggs, wheat, corn, legumes) as well as salicylate-containing grapes, tomatoes, and orange. Some studies found "cosensitivity" to be more the rule than the exception. Recently, 2 large studies demonstrated behavioral sensitivity to AFCs and benzoate in children both with and without ADHD. A trial elimination diet is appropriate for children who have not responded satisfactorily to conventional treatment or whose parents wish to pursue a dietary investigation.

Now for a response to that study, which is just a long-worded explanation that no one actually consumes that amount for food coloring, but they do for sodium benzoate:

A double-blind randomized intervention study has previously shown that a significant relationship exists between the consumption of various mixes of seven target additives by children and the onset of hyperactive behaviour. The present study set out to ascertain the pattern of intake of two mixes (A and B) of these seven target additives in Irish children and teenagers using the Irish national food consumption databases for children (n = 594) and teenagers (n = 441) and the National Food Ingredient Database. The majority of additive-containing foods consumed by both the children and teenagers contained one of the target additives. No food consumed by either the children or teenagers contained all seven of the target food additives. For each additive intake, estimates for every individual were made assuming that the additive was present at the maximum legal permitted level in those foods identified as containing it. For both groups, mean intakes of the food additives among consumers only were far below the doses used in the previous study on hyperactivity. Intakes at the 97.5th percentile of all food colours fell below the doses used in Mix B, while intakes for four of the six food colours were also below the doses used in Mix A. However, in the case of the preservative sodium benzoate, it exceeded the previously used dose in both children and teenagers. No child or teenager achieved the overall intakes used in the study linking food additives with hyperactivity.

This one suggests many sleep disruptions in ADHDers are caused by diet - I believe this would be the case for non-ADHD people as well though not in the study:

Sleep disturbances are common and consequential in children with attention deficit hyperactivity disorder (ADHD). Diet also influences ADHD symptoms. Interrelationships between diet, sleep and behaviour in children diagnosed with ADHD are little studied. We investigated, via parental report, the relationships between sleep and diet in 88 Australian children aged 6-13 years old (M = 8.94, SD = 1.78). This pilot data shows that 30 per cent of the children had sleep disturbance (≥ 2 standard deviations above the mean) with significant relationships between ADHD symptoms, sleep disturbance and diet. Parents who reported more sleep disturbance also reported a higher intake of carbohydrate, fats, and, most particularly, sugar which was also a significant predictor of night time sweating. These findings suggest an interrelationship between diet and sleep in children with ADHD. Given that both sleep and dietary intake are potentially modifiable behaviours within treatment regimes of children with ADHD, further investigation is needed.

Fish oil, magnesium and zinc:

After 12 weeks of consumption of a combination of omega-3 and omega-6 fatty acids as well as magnesium and zinc most subjects showed a considerable reduction in symptoms of attention deficit and hyperactivity/impulsivity assessed by SNAP-IV. Further, the assessment by SDQ revealed fewer emotional problems at the end of the study period compared to baseline and also sleeping disorders. Mainly problems to fall asleep, decreased during the 12 week nutritional therapy. Regarding safety, no serious adverse events occurred. A total of 16 adverse events with a possible causal relationship to the study medication were reported by 14 children (1.7%) and only 5.2% of the children discontinued the study due to acceptance problems. Continuation of consumption of the food supplement was recommended by the paediatricians for 61.1% of the children.

While I believe scientific evidence is credible, I thought I'd throw this one in here to show how biased a "scientific research paper" can be at times. They judged off of what they told them they ate and put them in two categories "Western" and "Healthy" pfff... Then they say the Western dieters had a "higher" rate of ADHD (which means the healthy category had a rate) and follows that up with having no ADHD diagnosed people that were in the "healthy" diet category. How misguided is that?:

Objective: To examine the relationship between dietary patterns and ADHD in a population-based cohort of adolescents. Method: The Raine Study is a prospective study following 2,868 live births. At the 14-year follow-up, the authors collected detailed adolescent dietary data, allowing for the determination of major dietary patterns using factor analysis. ADHD diagnoses were recorded according to International Classification of Deiseases, 9th Revision coding conventions. Logistic regression was used to assess the relationship between scores for major dietary pattern and ADHD diagnoses. Results: Data were available for 1,799 adolescents, and a total of 115 adolescents had an ADHD diagnosis. Two major dietary patterns were identified: "Western" and "Healthy." A higher score for the Western dietary pattern was associated with ADHD diagnosis (odds ratio = 2.21, 95% confidence interval = 1.18, 4.13) after adjusting for known confounding factors from pregnancy to 14 years. ADHD diagnosis was not associated with the "Healthy" dietary pattern. Conclusion: A Western-style diet may be associated with ADHD.

Paper talking about scientific study conclusions for supplements and ADHD:

Attention-deficit/hyperactivity disorder (ADHD) is a chronic, debilitating psychiatric illness that often co-occurs with other common psychiatric problems. Although empirical evidence supports pharmacological and behavioral treatments, side effects, concerns regarding safety and fears about long-term use all contribute to families searching for alternative methods of treating the symptoms of ADHD. This review presents the published evidence on supplementation, including single ingredients (e.g., minerals, vitamins, amino acids and essential fatty acids), botanicals and multi-ingredient formulas in the treatment of ADHD symptoms. In most cases, evidence is sparse, mixed and lacking information. Of those supplements where we found published studies, the evidence is best for zinc (two positive randomized, controlled trials); there is mixed evidence for carnitine, pycnogenol and essential fatty acids, and more research is needed before drawing conclusions about vitamins, magnesium, iron, SAM-e, tryptophan and Ginkgo biloba with ginseng. To date, there is no evidence to support the use of St John's wort, tyrosine or phenylalanine in the treatment of ADHD symptoms. Multi-ingredient approaches are an intriguing yet under-researched area; we discuss the benefits of this approach considering the heterogeneous nature of ADHD.

Restrictive diet:

The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder (ADHD). Dietary studies have already shown evidence of efficacy in selected subgroups. Twenty-seven children (mean age 6.2) who all met the DSM-IV criteria for ADHD, were assigned randomly to either an intervention group (15/27) or a waiting-list control group (12/27). Primary endpoint was the clinical response, i.e. a decrease in the symptom scores by 50% or more, at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale. The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [parent ratings 11/15 (73%) versus 0/12 (0%); teacher ratings, 7/10 (70%) versus 0/7 (0%)]. The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 (cohen's d) and a scale reduction of 69.4%. Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group (cohens's d 1.1, scale reduction 45.3%). A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children's behaviour.

I believe this is the best one yet explaining that it's not just food additives or an allergy to them but also your histamine response controlled by genes which determines how much they affect ADHD symptoms:

OBJECTIVE: Food additives can exacerbate ADHD symptoms and cause non-immunoglobulin E-dependent histamine release from circulating basophils. However, children vary in the extent to which their ADHD symptoms are exacerbated by the ingestion of food additives. The authors hypothesized that genetic polymorphisms affecting histamine degradation would explain the diversity of responses to additives.

METHOD: In a double-blind, placebo-controlled crossover trial, challenges involving two food color additive and sodium benzoate (preservative) mixtures in a fruit drink were administered to a general community sample of 3-year-old children (N = 153) and 8/9-year-old children (N = 144). An aggregate ADHD symptom measure (based on teacher and parent blind ratings of behavior, blind direct observation of behavior in the classroom, and--for 8/9-year-old children only--a computerized measure of attention) was the main outcome variable.

RESULTS: The adverse effect of food additives on ADHD symptoms was moderated by histamine degradation gene polymorphisms HNMT T939C and HNMT Thr105Ile in 3- and 8/9-year-old children and by a DAT1 polymorphism (short versus long) in 8/9-year-old children only. There was no evidence that polymorphisms in catecholamine genes COMT Val108Met, ADRA2A C1291G, and DRD4-rs7403703 moderated the effect on ADHD symptoms.

CONCLUSIONS: Histamine may mediate the effects of food additives on ADHD symptoms, and variations in genes influencing the action of histamine may explain the inconsistency between previous studies. Genes influencing a range of neurotransmitter systems and their interplay with environmental factors, such as diet, need to be examined to understand genetic influences on ADHD symptoms.

You're welcome to comment on any of these studies or share others.

[Effie]

I am soo glad that you posted this. I just got into a tiff with someone about an article they posted on facebook. It was a very unprofessional article on some website that basically said kids have ADHD because of the chemicals in food. I tried to explain to them that the chemicals may exaggerate the symptoms of ADHD but do not cause it. And that ADHD is a chemical imbalance in the brain. It is a real condition and those that have it cannot just "get rid" of it by not eating processed food. So now I am going to direct them to your post. Thanks

[bof00]

Originally Posted by Effie

I am soo glad that you posted this. I just got into a tiff with someone about an article they posted on facebook. It was a very unprofessional article on some website that basically said kids have ADHD because of the chemicals in food. I tried to explain to them that the chemicals may exaggerate the symptoms of ADHD but do not cause it. And that ADHD is a chemical imbalance in the brain. It is a real condition and those that have it cannot just "get rid" of it by not eating processed food. So now I am going to direct them to your post. Thanks

There's a lot of misinformation floating around this week because the FDA is assessing whether they should ban food coloring today. Their decision to look at it is based off a study that showed hyperactivity increases, which is really due to allergic reactions, but some think it means it gives people ADHD and they can just be better if they stop eating food that has food coloring. I'm not sure if that was the topic specifically that you are mentioning, but that is a recent hot topic.

Here are some studies on zinc and ADHD.

This is on zinc and iron supplements lowering hyperactivity, anxiety and conduct problems:

OBJECTIVE: It has been suggested that both low iron and zinc levels might be associated with Attention Deficit Hyperactivity Disorder (ADHD) symptoms. However, the association of zinc and iron levels with ADHD symptoms has not been investigated at the same time in a single sample.

METHOD: 118 subjects with ADHD (age = 7-14 years, mean = 9.8, median = 10) were included in the study. The relationship between age, gender, ferritin, zinc, hemoglobin, mean corpuscular volume and reticulosite distribution width and behavioral symptoms of children and adolescents with ADHD were investigated with multiple linear regression analysis.

RESULTS: Results showed that subjects with lower zinc level had higher Conners Parent Rating Scale (CPRS) Total, Conduct Problems and Anxiety scores, indicating more severe problems. CPRS Hyperactivity score was associated both with zinc and ferritin levels. Conners Teacher Rating Scale (CTRS) scores were not significantly associated with zinc or ferritin levels.

CONCLUSIONS: Results indicated that both low zinc and ferritin levels were associated with higher hyperactivity symptoms. Zinc level was also associated with anxiety and conduct problems. Since both zinc and iron are associated with dopamine metabolism, it can be speculated that low zinc and iron levels might be associated with more significant impairment in dopaminergic transmission in subjects with ADHD.

In this study, zinc did not reduce ADHD symptoms as they expected, but made amphetamines more efficient:

OBJECTIVE: To explore effects of zinc supplementation in American children with attention-deficit/hyperactivity disorder (ADHD). Mideastern trials reported significant benefit from 13-40 mg elemental zinc as the sulfate.

METHOD: We randomly assigned 52 children aged 6-14 with DSM-IV ADHD to zinc supplementation (15 mg every morning [qAM] or two times per day [b.i.d.] as glycinate, n = 28) or matched placebo (n = 24) for 13 weeks: 8 weeks monotherapy and then 5 weeks with added d-amphetamine (AMPH). AMPH dose was weight-standardized for 2 weeks and then clinically optimized by week 13. Zinc glycinate was chosen as having less gastrointestinal discomfort than sulfate. Hypotheses were that zinc would improve inattention more than placebo by effect size of d > 0.25 at 8 weeks; zinc+AMPH would improve ADHD symptoms more than placebo+AMPH by d > 0.25, and optimal dose of AMPH with zinc would be 20% lower than with placebo. An interim analysis requested by the National Institute of Mental Health resulted in an increased dosage, so that 20 received 15 mg/day qAM and 8 received 30 mg/day (15 mg b.i.d.)

RESULTS: Only the third hypothesis was upheld: Optimal mg/kg AMPH dose with b.i.d. zinc was 37% lower than with placebo. Other clinical outcomes were equivocal, sometimes favoring zinc, sometimes placebo, but objective neuropsychological measures mostly favored b.i.d. zinc (d = 0.36-0.7). Safety tests and adverse events were not different between groups. Copper and iron blood indices were not impaired by 8 weeks of 30 mg/day zinc.

CONCLUSION: Doses up to 30 mg/day of zinc were safe for at least 8 weeks, but clinical effect was equivocal except for 37% reduction in amphetamine optimal dose with 30 mg/day zinc (not with 15 mg). Possible reasons for difference from mideastern reports include endemic diets, population genetics, relative rate of zinc deficiency, difference in background nutrition, insufficient dosage or absorption, or wrong anion (sulfate may be necessary for reported benefit). Dose may be especially important: All visually impressive advantages over placebo appeared only with 15 mg b.i.d. rather than once a day. Future research should use larger doses than 15 mg/day, provide a basic recommended daily allowance/intake multivitamin/mineral supplement for all to standardize background nutrition, select participants for low zinc, and consider the issue of anion interaction.

This one indicates a correlation between zinc deficiency and improvement and zinc in combination with other treatment, but not on it's own:

Relations between zinc concentrations and behavior in animals; the relation between zinc deficiency, depression, and ADHD in patient and community samples; and the potential biological mechanisms for these relations were explored. The data support a relation between low concentrations of zinc and mental health problems, especially in at-risk populations. Evidence for the potential use of zinc in treating mental health problems comes mainly from patient populations and is strongest when zinc is given in combination with pharmacologic treatment. Less conclusive evidence exists for the effectiveness of zinc alone or in general community samples.

Here's a link to the study I posted above on fish oil, magnesium and zinc, which has graphs showing 30-50% reductions in inattention, hyperactivity, impulsiveness, emotional instability, and sleep issues. Having these results with a sample size of 810 children is quite convincing.
http://www.ncbi.nlm.nih.gov/pubmed/20868469

[Elektra]

3 year old children? You can't even diagnose at that age.

[Dizfriz]

Originally Posted by Elektra

3 year old children? You can't even diagnose at that age.

You can in some extreme cases but it is rather rare as it should be.

Dizfriz

[jebje]

Coincidentally, I did try the diet without artificial coloring, aspartame, e-numbers, sugar, milk, eggs, and I felt odd at first (probably withdrawal from over-consuming the stuff), but then I really did feel like I could focus a whole lot better. However, some people around me said I seemed more unfocused than usual (they didn't know I had ADD). Could have been placebo.

Just my two cents...

[bof00]

Originally Posted by jebje

Coincidentally, I did try the diet without artificial coloring, aspartame, e-numbers, sugar, milk, eggs, and I felt odd at first (probably withdrawal from over-consuming the stuff), but then I really did feel like I could focus a whole lot better. However, some people around me said I seemed more unfocused than usual (they didn't know I had ADD). Could have been placebo.

Just my two cents...

Maybe it's the same effect I had. When my ability to follow a conversation went from at best 40% to about 80% my wife thought my talking increased and listening got worse, but I know listening is MUCH better. The difference she sees is her thinking I was listening before, but I wasn't and just agreeing and not saying anything because I had no idea what she was talking about. I would only tune in when questions were asked. Now, I'm actually in the conversation and talking more and asking questions which uncovers when I'm not listening, unlike when I don't say anything.

[idahocrystal]

There's some good refence material there and it's very even of you to post counter studies. I wish they used more English... = >

I genuinely believe children are misdiagnosed as having ADHD far too often and many would see improved behavior and concentration with dietary changes rather than medication.

I also know that what works for some, may not work for others, so it's best to try different things until you find what works best for you.

For myself and my son, with symptoms of reactive-hypoglycemia, we have to eat something protien or fiber based every couple hours to keep our blood sugar levels as even as possible. Too much sugar or carbs or too long between snacks and it's mania and crash.

We'd be silly not to consider nutritional impact on those with AND without ADD/HD.

[qinkin]

\/\/\/\/\/\/\/\/\/\

Interesting stuff so far.

Found this thread a better fit for this particular information.. I was kinda' responding to SB_UK. He talks about somewhat of a similar scenario. But I'm going to go even further than just diet, and into lifestyles, as Barliman and others mention in other threads....

----------------->

Originally Posted by idahocrystal

For myself and my son, with symptoms of reactive-hypoglycemia, we have to eat something protien or fiber based every couple hours to keep our blood sugar levels as even as possible. Too much sugar or carbs or too long between snacks and it's mania and crash.

Mount Athos Inhabitants - w/o the God worshiping, is probably more compatible to the culturally and gender diverse civilization. Religion is outmoded. Permaculture is not, it's worth mentioning, became a field of applied science (agriculture) recently. . ||| Self-sustaining, organic, biodiverse, food-forest-ecosystem. Somewhat similar. Applicable in the harshest of conditions. Repeatable improved outcomes to conventional agriculture, and even farming. Layered gardening is more efficient than farming. It's more efficient b/c it requires very little input once established, freaking genius.

Food consumption itself can probably follow this dietary method. It's cured cancer, consistently, and it likely also prevents it. Also, using food forests w/free access as central to plant based diet.

http://ravediet.com/

So here's some videos to show permaculture providing a source food and herbs/herbal medicine, but the kicker is that this is an ecological solution to dead, harsh, and tightly packed environments (like the desert or city).. I'd say it could be of therapeutic use, for most all anybody, esp those who care about ecology..

Back to the Garden~ only this time, we aren't so dumb, etc.

http://www.youtube.com/watch?v=8gPvsl9ni-4

________

http://www.youtube.com/watch?v=-5ZgzwoQ-ao

[SB_UK]

Originally Posted by qinkin

Mount Athos Inhabitants - w/o the God worshiping, is probably more compatible to the culturally and gender diverse civilization.

Exactly.

Permaculture is not, it's worth mentioning, became a field of applied science (agriculture) recently. . ||| Self-sustaining, organic, biodiverse, food-forest-ecosystem. Somewhat similar. Applicable in the harshest of conditions. Repeatable improved outcomes to conventional agriculture, and even farming. Layered gardening is more efficient than farming. It's more efficient b/c it requires very little input once established, freaking genius.

Sounds great.

Food consumption itself can probably follow this dietary method. It's cured cancer, consistently, and it likely also prevents it. Also, using food forests w/free access as central to plant based diet.

Definitely so.

Back to the Garden~ only this time, we aren't so dumb, etc.

:-)

The Tree of Knowledge of good and evil, when felled, leaves Wisdom.

not so dumb

... ... only this time, not nearly as dumb as we've shown ourselves to be (in history)
- no,

not at all :-).

[Amtram]

I don't think that anyone would disagree that certain foods are better for us, and that consuming high amounts of any artificial ingredients is probably not so good, even if they're "generally accepted as safe." However, I'm very skeptical of diets that specifically restrict certain foods, proclaim benefits in vague terms without citing supporting data (or citing only cherry-picked parts of data that appears supportive) or diets that require you spending money to access the plan, or purchase foods/supplements sold by the promoters of the diet.

[SB_UK]

Originally Posted by qinkin

w/o the God worshiping

Substitute the God stuff on Athos with any method of hitting the meditative state of mind, and we'll be fine.

Without going into details though, I have grown to love the collective great texts of religion.

Just the great religious texts {{{nothing more}}}, and all interpreted alone (at least following the education which I have received on-site).

They keep me sane in the insane world within which we live.

Today's main story in the Independent.
http://www.independent.co.uk/life-st...s-2290583.html

How on Earth do cigarette corporation staff live with themselves?

I feel bad when I need to reduce doggy's walk from 2 hours, down, because it's about to start raining ... ... ....

Just don't get it, or at least I both do and don't (simultaneously).

See signature.

Primitive reward system -> cigarette corporation/cigarette corporation staff; they just want you hooked.

Originally Posted by doiadhd

'kerching'

Back on thread - there is no upside to smoking, alcohol, sugar, drug taking, fast food, battery farmed anything ... ... ... ... ... ...
Just feeding the 'demon'.

[SB_UK]

Originally Posted by Amtram

I don't think that anyone would disagree that certain foods are better for us, and that consuming high amounts of any artificial ingredients is probably not so good, even if they're "generally accepted as safe." However, I'm very skeptical of diets that specifically restrict certain foods, proclaim benefits in vague terms without citing supporting data (or citing only cherry-picked parts of data that appears supportive) or diets that require you spending money to access the plan, or purchase foods/supplements sold by the promoters of the diet.

Sounds good.

I'm suggesting an exclusively fresh, organic non-starchy vegetable based diet only (immediately deep frozen organic vegetables as a second best).

No pesticides (toxic to man and ecosystem)
No chemical fertilizer (unsustainable)
No processed food (chemical additives aren't necessary)
No added ingredients (salt,sugar - because of alteration of plasma osmolarity)
No hyperglycaemic agents (eg potatoes - multiple reasons ~eg~ see post above on reactive hypo/hyper -glycaemia)
No meat (since acidifying - alkaline blood pH maintenance is important)

[sarahsweets]

I generally try and avoid additives and dyes when I can but most times we just have certain things we eat anyway. We sometimes let the kids have soda or koolaid on pizza nights and all 3 of my adhd kids act exactly the same as before they drank them. The same goes for sugar. They went to a bbq without me and ate lolipos cake icecream etc way too much and came home and were the same kids.

[SB_UK]

Throw these into (or is that out of) the mix ... ... ...

High levels of reported food allergy to the following various food types is perhaps ! a sign that we're not best suited to them.

google hit

Fact: Although people can be allergic to any kind of food, most food allergies are caused by tree nuts, peanuts, milk, eggs, soy, wheat, fish and shellfish. These eight foods account for 90% of food allergies.

... ... ... and we're still left with the recommendation of the humble fresh, organic, non-starchy vegetable, as the major nutritional component for man.

Noting that each rung higher on the food chain exponentially reduces the number of calories which any fixed packet of land can deliver -
- that vegetable growth is the most efficient form of agriculture which we can engage in.

The healthiest, easiest, most efficient, and
... ... most satisfying method of food production
- no animals need die so that you may live.

The vegetable.