ADHD: It’s the food, stupid
Over 5 million children ages four to 17 have been diagnosed with attention deficit hyperactivity disorder (ADHD) in the United States, and close to 3 million of those children take medication for their symptoms, according to the Centers for Disease Control. But a new study reported in The Lancet last month found that with a restricted diet alone, many children experienced a significant reduction in symptoms. The study’s lead author, Dr. Lidy Pelsser of the ADHD Research Center in the Netherlands, said in an interview with NPR, “The teachers thought it was so strange that the diet would change the behavior of the child as thoroughly as they saw it. It was a miracle, the teachers said.”
Dr. Pessler’s study is the first to conclusively say that diet is implicated in ADHD. In the NPR interview, Dr. Pessler did not mince words, “Food is the main cause of ADHD,” she said adding, “After the diet, they were just normal children with normal behavior. They were no longer more easily distracted, they were no more forgetful, there were no more temper-tantrums.” The study found that in 64 percent of children with ADHD, the symptoms were caused by food. “It’s a hypersensitivity reaction to food,” Pessler said.
This is good news for parents and children who would like to avoid many of the adverse side effects associated with common stimulant drugs, like Ritalin, used to treat ADHD — and bad news for the pharmaceutical industry. The National Institute of Mental Health reports that common side effects from the drugs are sleeplessness (for which a doctor might also prescribe sleeping pills), headaches, stomachaches, decreased appetite, and a long list of much more frightening (yet rarer) side effects, including feeling helpless, hopeless, or worthless, and new or worsening depression. But Pessler’s study indicates that up to two-thirds — or 2 of the 3 million children currently medicated for ADHD — may not need medication at all. “With all children, we should start with diet research,” Pessler said.
There are also questions about the long-term effects of stimulant drugs and growth in children. After three years on Ritalin, children were about an inch shorter and 4.4 pounds lighter than their peers, according to a major study published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2007. A 2010 study in the Journal of Pediatrics disputed these findings, but all the study’s authors had relationships with drug companies, some of which make stimulants. According to Reuters, “The lead author, Harvard University’s Dr. Joseph Biederman, was once called out by Iowa Senator Charles E. Grassley for the consulting fees he has received from such drug makers.”
This is just one example of how the powerful billion-dollar drug industry designs and interprets studies to suit their interests. Since the 1970s, researchers not tied to drug companies have been drawing connections between foods, food additives, and the symptoms associated with ADHD but many have been dismissed or overlooked by conventional medicine. One of the earliest researchers in this field was Dr. Benjamin Feingold who created a specific diet to address behavioral and developmental problems in children. The Feingold diet, as it is now called, recommends removing all food additives, dyes, and preservatives commonly found in the majority of industrial foods.
There are a multitude of credible scientific studies to indicate that diet plays a large role in the development of ADHD. One study found that the depletion of zinc and copper in children was more prevalent in children with ADHD. Another study found that one particular dye acts as a “central excitatory agent able to induce hyperkinetic behavior.” And yet another study suggests that the combination of various common food additives appears to have a neurotoxic effect — pointing to the important fact that while low levels of individual food additives may be regarded as safe for human consumption, we must also consider the combined effects of the vast array of food additives that are now prevalent in our food supply.
In Pessler’s study the children were placed on a restricted diet consisting of water, rice, turkey, lamb, lettuce, carrots, pears, and other hypoallergenic foods — in other words, real, whole foods. This means that by default the diet contained very few, if any, food additives.
As I see it, there are two factors at work in this study: One being the allergic reaction to the actual foods themselves and the second being a possible reaction to food additives, or combinations of food additives, found in industrial foods. Both certainly could be at play in the results of this study, although the discussion of Dr. Pessler’s study thus far hasn’t addressed the latter issue.
One theme in the discussion of the story has been skepticism from mainstream media — the recent Los Angeles Times article (the only major daily newspaper to cover the study) was very skeptical, if not dismissive. The author writes, “Previous studies have found similar effects, but, like this one, they all had fundamental problems that made it easy for doctors to dismiss them.” NPR interviewer Guy Raz asked a question invoking this tone as well, “Now, you’re not saying that some children with ADHD should not be given medication, right?” Pessler does say that there are some children and adults who might benefit from pharmaceuticals but her research indicates that far too many are being medicated unnecessarily — and this is the crux of the story.
The Los Angeles Times article ends on this note: “‘To be sure, the prospect of treating ADHD with diet instead of drugs would appeal to many parents,’ Dr. Jaswinder Ghuman, a child psychiatrist who treats ADHD says. But parents who want to give it a try should be sure to consult their child’s physician first, she warned: ‘It’s not that simple to do appropriately.'”
Call me old-fashioned, but changing your child’s diet seems a lot “simpler” than altering his or her brain chemistry with a daily dose of pharmaceuticals. It does takes patience, trial and error, and commitment to complete an elimination diet — taking a pill to target symptoms certainly requires less effort on the part of the doctors, family, and child. No one is denying that ADHD is a complicated web of symptoms with potentially many contributing factors. But why not start by examining the most basic and fundamental cornerstone of our health — the foods (and non-foods) we put into our bodies?
A version of this post first appeared on Civil Eats.