ADHD and Diet
Tuesday 13th May 2008
The American Academy of Pediatrics -- the organization that sets practice parameters for pediatricians to follow -- has finally acknowledged that dietary intervention is a valid treatment for children with ADHD in a report in the February 2008 issue of its publication, AAP Grand Rounds.
After reviewing the British study published in the September 2007 Lancet, in which researchers found that food colorings and/or sodium benzoate increase hyperactive behavior in children, the AAP concludes with an Editors' Note and a commentary by Alison Schonwald, MD, FAAP, of the Developmental Medicine Center at Children’s Hospital in Boston.
Dr. Schonwald writes:
Despite increasing data supporting the efficacy of stimulants in preschoolers with attention deficit hyperactivity disorder (ADHD) parents and providers understandably seek safe and effective interventions that require no prescription. A recent meta-analysis of 15 trials concludes that there is "accumulating evidence that neurobehavioral toxicity may characterize a variety of widely distributed chemicals." [Schab DW, et al. J Dev Behav Pediatr. 2004;25:423–434] Some children may be more sensitive to the effects of these chemicals, and the authors suggest there is a need to better identify responders. In real life, practitioners faced with hyperactive preschoolers have a reasonable option to offer parents. For the child without a medical, emotional, or environmental etiology of ADHD behaviors, a trial of a preservative-free, food coloring–free diet is a reasonable intervention.
And the Editors' Note which follows states: “Although quite complicated, this was a carefully conducted study in which the investigators went to great lengths to eliminate bias and to rigorously measure outcomes. The results are hard to follow and somewhat inconsistent. For many of the assessments there were small but statistically significant differences of measured behaviors in children who consumed the food additives compared with those who did not. In each case increased hyperactive behaviors were associated with consuming the additives. For those comparisons in which no statistically significant differences were found, there was a trend for more hyperactive behaviors associated with the food additive drink in virtually every assessment. Thus, 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.”