Elimination diet for ADHD
The study by Lidy Pelsser and colleagues (Feb 5, p 494) attempted to determine whether a restricted elimination diet is an effective treatment for attention-deficit hyperactivity disorder (ADHD). Although the design had some methodological strengths, a chain is only as strong as its weakest link.
Unfortunately, the study's design was severely flawed since none of the outcome assessments was blind to treatment status. The investigators should have included at least one objective, independent assessment of attention, impulsivity, or activity level.
Although it is reasonable for families of young hyperactive children to consider elimination diets, this study raises as many questions as it answers with respect to this treatment approach.
The Naturopathic Approach
Give your baby a chance to grow to become the best that s/he can be. Natural medicines can assist to balance and harmonise the body/mind without the nasty side effects and dependency of conventional medical drugs that may lead to long term depression.
If you and your Dr decide that you need to put your child on medical drugs, ensure you are encouraging the normal healthy development of body and brain with proper nutrition and a supportive lifestyle, in time you might need less of the drug or totally eliminate it.
Please read below more information on Naturopathy and ADHD.
Make an appointment today ([email protected]) and start to build better health for your most precious little people.
The term “attention deficit” is misleading. In general, the current predominating theories suggest that persons with ADHD actually have difficulty regulating their attention; inhibiting their attention to non-relevant stimuli, and/or focussing too intensely on specific stimuli to the exclusion of what is relevant. In one sense, rather than too little attention, many persons with ADHD pay too much attention to too many things, leading them to have little focus.
The major neurologic functions disturbed by the neurotransmitter imbalance of ADHD fall into the category of executive function. The 6 major tasks of executive function that are most commonly distorted with ADHD are (1) shifting from one mindset or strategy to another (i.e., flexibility), (2) organization (e.g., anticipating both needs and problems), (3) planning (e.g., goal setting), (4) working memory (i.e., receiving, storing, then retrieving information within short-term memory), (5) separating affect from cognition (i.e., detaching one's emotions from one's reason), and (6) inhibiting and regulating verbal and motoric action (e.g., jumping to conclusions too quickly, difficulty waiting in line in an appropriate fashion).
Causes and Risk Factors
Like most complex neurobehavioral syndromes, the cause of ADHD is unknown (Daruna et al. 2000). Genetic factors as well as other factors affecting brain development during prenatal and postnatal life are most likely involved (Daruna et al. 2000). The use of functional neuro-imaging has led to identification of a number of consistent features in the brains of ADHD children. These features include decreased arousal and glucose metabolism and increased theta (4 to 8 Hz) activity in both the frontal and subcortical regions (Thompson and Thompson 1998). Results of animal studies and the therapeutic success of psycho-stimulant medication suggest that the aetio-pathology (cause of disease) of ADHD may involve hypofunctional (poor function) dopamine pathways and other neurotransmitter imbalances (Kidd 2000).
Heredity: children with ADHD usually have at least one first-degree relative who also has ADHD and one-third of all fathers who had ADHD in their youth have children with ADHD (National Institute of Mental Health 2001).
Gender: ADHD is more prevalent in boys; the male-to-female ratio is 4:1 in epidemiologic surveys and 9:1 in clinic samples (Daruna et al. 2000).
Prenatal and early postnatal health: maternal drug, alcohol, and cigarette use (National Institute of Mental Health 2001); in-utero exposure to toxins, including lead, dioxins and polychlorinated biphenyls (PCBs); nutrient deficiencies and imbalances.
Abnormal thyroid responsiveness (possibly caused by exposure to pollutants during perinatal period) (Kidd 2000).
Learning disabilities, communication disorders (Kidd 2000), and tic disorders such as Tourette's syndrome (American Psychiatric Association 1994).
Nutritional factors: allergies or intolerances to food, food colouring, or additives (Kidd 2000).
Environmental exposures: chronic exposure to lead and other toxic metals have been linked to a variety of neurobehavioral sequelae in children (Kidd 2000).
Extreme or pervasive psychosocial stressors (such as marital discord or parental psychopathology); in isolation probably not a major cause of ADHD, but may contribute in combination with other risks (Wolraich and Baumgaertel 1997).
Symptoms & Signs – Inattentive
Symptoms & Signs - Hyperactive
Hair metal analysis
Useful for screening for metal toxicity, which may be a triggering factor
Check for dysbiosis/gut toxicity(http://www.mariaaugustyn.com/HEALTH-CHECK---Tests.html)
Diet and Lifestyle
Behavioural modification programs are recommended, to assist sufferers and parents establish suitable routines and systems for managing undesirable behaviour.
Patients do best in school and work environments which offer a highly structured approach.
Ensure that punishment is not overly harsh, and that praise is given for acceptable behaviours.
Ensure adequate sleep and physical exercise.
Patients should avoid coffee, cola and other caffeinated drinks (if taking stimulants).
Diet should be low in sugar and carbohydrates, as hypoglycaemia may trigger symptoms.
Each meal should have protein to provide adequate amino acids for healthy neurotransmitter production.
Emphasise foods high in magnesium, such as green vegetables and nuts (www.food2live.org)
Patients should eat small, regular meals.
EPA and DHA have been shown beneficial for behavioural / learning disorders, so including oily fish in the diet 3-4 times per week will be beneficial (www.food2live.org).
Avoid known food allergens – an elimination and rechallenge diet may be beneficial to determine sensitivities. Avoid artificial colours, flavours and preservatives.
Methylphenidate: most commonly used medication; efficacious in 75% to 80% of patients when administered in a dose ranging from 0.3 to 1.0 mg/kg/day with a maximum dose of 60 mg/day; not recommended for children under 6 years of age (Daruna et al. 2000)
Dextroamphetamine: efficacious in 70% to 75% of patients; optimal dose range is 0.1 to 0.5 mg/kg/day with a maximum dose of 40 mg/day in children and 60 mg/day in adults; not recommended for children under 3 years of age (Daruna et al. 2000)
Pemoline: efficacious in 65% to 70% of children; should not be considered first-line drug therapy for ADHD because of its association with life-threatening hepatic failure; not currently available in Australia.
Atomoxetine (Strattera) -- SNRI (Selective Noradrenaline Reuptake Inhibitor) that inhibits presynaptic noradrenalin transporter. Also appears to indirectly stimulant dopamine activity in frontal lobes; up to 1.4 mg/kg or 100 mg daily
Many patients have reported clinically significant improvement with the use of some antidepressants.
Imipramine (Tofranil/Tolerade) -- Inhibits reuptake of norepinephrine or serotonin (5-hydroxytryptamine, 5-HT) at presynaptic neuron.
Bupropion (Bupriorion-RL/Clorprax/Zyban) -- Inhibits neuronal dopamine reuptake. Weak blocker of serotonin and norepinephrine reuptake.
Supportive Programs and Lifestyle
ABO Blood Type Diet
An ABO blood type diet may reduce the risk of consuming allergens and causing digestive upsets, food sensitivities or allergic reaction in the individual.
ABO blood type diet may also help to reduce sugar cravings and balance blood sugar levels, and subsequently help to stabilise mood and concentration
Imbalances in blood sugar and some additives to processed foods can trigger fluctuations in energy and mood while reducing one’s ability to focus and concentrate on the task at hand.
The Wellness Zone Plan incorporates healthy eating recommendations aimed at reducing the intake of processed foods and balancing blood sugar. The plan also provides guidance regarding healthy exercise and lifestyle habits
Children’s Sleep Aid
Improves ability to sleep and quality of sleep, calms excitability and eases irritability, relieves stress, nervous tension and anxiety.
Mitochondrial Energy Maintenance
Reduces attention problems and aggression in ADHD, Improves energy production allowing proper neurotransmitter activity in the brain and allowing cells to “switch off” and prevent excitotoxicity, improves the activity of dopamine in the brain.
Nervous Tissue Support
Enhances concentration, mental alertness and cognitive function, Improves short and long term memory.
The ideal combination of herbal therapy, nutrition and lifestyle/behavioural changes can make the difference between dependency on drugs, weakness of body and character and a strong healthy person.