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Hyperactivity & ADHD
Attention Deficit Hyperactivity Disorder
Where can I find a dietitian who works with developmental disabilities?
Thanks so much for your quick response, as the manger of our hospital's growing and evolving website, I appreciate how much it means. I understand about families with two working adults, my household is the modern chaotic jumble of parents, pets, kids and all that implies. It sounds like you are all too familiar with it as well.
Danny is a big part of making food choices and gets options as often as possible. At eight he is old enough to recognize how his behavior changes when he makes the choice to eat something "with dyes or colors" as he calls it. We try to keep things in perspective. The reason I chose the analogy to diabetes is because then other people take it seriously. You would never have a teacher tell a parent that was managing a diabetic child's diet that it was "ok" if they ate all the M & M's that were used in a particular math exercise because it would be mean not to allow it.
I also would never suggest that all children with ADHD symptoms should be taken off their medication or not see their therapists. Dan's biggest issue now is getting past his negative self-image. The one that came from the difficulty he had learning to read before we changed his diet.
I applaud your focus on empowering children. I think far too many adults see them as extensions to be managed or manipulated. You may have an uphill battle. Danny is eight, great at math, very picky about the socks he wears, a sweet soul and a challenge to the spirit (although I believe that to be because of his Y chromosome).
I agree about the need to educate the public, especially teachers, with ways to better reach students with ADHD. While I'm pretty sure you disagree with their nutritional guidelines, the Feingold web site does have some practical suggestions for teachers working with ADHD kids in terms of the mechanics of teaching them. Thank you again for your quick response.
Thanks for more insight into your son.
The issue I have with restricting food options for children is how it impacts a child's nutritional needs for growth. The potential problem is that parents are the food gate keepers until a child is around 10 or so when they start to make their own food purchases. Parents are responsible for buying foods appropriate for children while allowing them age appropriate food choices from the food parents make available in the home. Given healthy choices, children can establish life long healthy food habits.
Evidence from the gold standard for research (double blind cross over studies) has to prove that specific foods either inhibit or enhance specific symptoms before we start recommending food restrictions especially for growing children. Otherwise we are left with a "I tried it and it worked for me so you should try it" which leads us down a slippery slope of testimonials.
As the parent of a child whose ADHD symptoms are managed by using an elimination diet similar to the Feingold program, I'd like to comment on a response made on your website. Just so you know where I'm coming from, I'm not a crusader with blinders on. I know not all children are magically "healed" by diet alone or medication alone. The ADHD experience is an individual, though similar one, for every family.
I don't take issue at all with the information sited, only with one side comment you made. "A complete artificial color and flavor-free diet may be too time consuming or too expensive for most families to follow. Also, what about foods hyperactive children eat at schools, friends, or grandparent's houses? I would rather teach a child about a nutritious diet and encourage children to make appropriate food choices." Would you take the same view when offering nutritional advice for a child with juvenile diabetes? I use that as an example when I explain my son's dietary restrictions to people. And if it does take a little longer, shouldn't we place a higher value on our children's well-being than on the amount of time we spend grocery shopping?
It was a pain in the neck the first month or so, now it's no different than shopping for your favorite brand of cereal, soup, etc. You know where to look and you go there. Also, the cost is not that much higher, sometimes less, believe it or not. And there can be hidden benefits such as oh, darn, we have to buy Breyer's or Ben & Jerry's. I have four children. I know what it's like to shop within a budget.
The parents of the children my son plays with are all aware of his dietary restrictions, as are his grandparents, teachers, coaches. A little communication goes a long way.
My son has been on his diet for almost three years now. He is healthier than all of the rest of us put together. Less colds, his hair and nails grow faster, etc. This is a good thing, because it is next to impossible to find antibiotics or over the counter (OTC) medications that aren't loaded with something artificial. That is the true challenge of his diet!
For children who do react strongly to artificial dyes and flavors the impact of straying from their diet can be as strong and longer lasting though only "sanity threatening" rather than life threatening, as the reaction is for a child who is insulin dependent "cheating".
As a respected and responsible nutritionist, please reconsider your comment. Thank you for letting me stand on my soapbox, I would welcome your response.
Families with two working parents are very time stressed and need support to make healthy choices in less time. I was trying to get viewers to focus on making healthy choices instead of a long list of "No's". Healthy food choices can be "artificial" free. The key words are "healthy food choices".
My concerns are about parents limiting their child's food choices, especially children who are too young to purchase their own foods. I have seen parents who have eliminated so many foods from their children's meals that it became deficient in some nutrients.
The point I make about teaching children to make healthy choices comes from working with parents who became the food restrictor and ended up with a child who "sneaks" illegal food. It doesn't matter if they have diabetes or ADHD. Kids are smart and I think should be given age level responsibility and input into decisions that affect them. I am for empowering people, especially children to make healthy food choices and adopt a healthy lifestyle.
You are lucky that your child adheres to the food plan you have set up for them. Adolescence though can bring changes in behavior. Most teenagers will seek independence from their parents and want to fit in with their peers, including peer food choices. I encourage you to make your child a part of the food decisions that affect them.
I do make the same recommendations for children with diabetes. Teach them to make appropriate food choices balanced with their medication. Surprisingly, diabetic nutrition therapy has changed and become more liberal. Carbohydrate counting and tracking A1C (glycosated hemoglobin) to control long term complications are paying off for people with diabetes.
Your analogy about diabetes to other parents would impart the seriousness with which you manage your son's diet. Perhaps educating the public about ADHD is really what is needed. You made a start with those people who come in contact with your son.
I decided to write this quick note after reading your Q&A's about Attention Deficit Disorder. Simple definition of ADD (attention deficit disorder) = The lack or reduced ability to focus.
Although hyperactivity is associated with ADD it is not a necessarily symptom of the disease. I am an ADD adult with 3 ADD kids, an ADD aunt and a suspected Add great grandfather. Hyperactivity is present only in my one son and aunt. This fact is important, as many children are not diagnosed with this deadly disease simply because they are NOT hyper. There are many schools of thought on this issue but my personal opinion, based on my experience, is that genetic personality plays a large role in "hyperactivity".
Today’s research shows us the deadly results of non-diagnosis or lack of proper treatment for ADD. Children with ADD are 3 times more likely to be hit by a motor vehicle, visit the emergency room 5 times more often, required or be rescued by police or fire officials 7 times as much as non-ADD children. The greatest and perhaps the most deadly effect of ADD is the social or lack of social acceptance. This leads (in later life) to drug abuse, prison and suicide. It is estimated that 25% of addicts are ADD. (70% are abused and the rest seem to fall into sexual preference category.) Our prisons are quoting a 30% ADD inmate population.
That said, here is my diet experience.
Non-diagnosed ADD adults have found only a few substances that allow a greater ability to focus. Nicotine, cocaine and alcohol are all common. My experience after trying all the natural methods and diets is, there are no dietary advantages or disadvantages. A healthy diet is essential for anyone. You will find a change in diet affects a "normal" person, physically, mentally and emotionally and the same is true for a person (child or adult) with ADD. It is my experience (with the exception of licorice extract) no foods or diet help the actual lack of natural chemical flow to the focus sensors in the brain.
I am not a Doctor and have not written any books about ADD. I have spent the last 3 years exploring this disease and how it affected my life. I have been a fanatic believer in natural treatments and healthy diet. Today, I use the recommended medicines for my children and myself. I must admit that I waited too long in using the recommended treatment for my first son. At age 17 he is showing negative effects of the many years of natural remedies and special diets. It is like denying my diabetic child her insulin.
Keep up the great work Joanne
Thanks for telling your story and your feedback.
A healthy eating plan incorporating a variety of foods from all food groups is the basis from which treatment should start.
I am a 23 year old female, 5 feet and 9 inches tall. I weigh 124 pounds with my chest being 34 inches, waist 22 inches and hips are at 38 inches, I have a medium size bone structure. In the last six months I have taken on a full time job and attend college for more than 20 hours per week. I have gone from 140 pounds to 124.
I also have attention deficit disorder (ADD) and currently taking the medication Dexedrine to help me out. It's a form of speed and I take 10 milligrams total per day. Since I have started school my food intake has gone from eating two meals per day, to one meal every four or five days. I have been taking Dexedrine for a year and a half. Before I started taking it I weighed 150 pounds and looked pretty good. I have always had very inconsistent eating habits. I sleep about five hours per night. I know that I am not fat, but I am deathly afraid of gaining any weight. I am to the point where food is looking very gross and I cringe at the thought. Do I have some signs of anorexia or is this just a phase?
I have gone without the Dexedrine and tried other meds, but my outlook on food does not change! Please email me with a suggestion or two.
I would recommend whether or not your feel hungry (euphoria is a common side effect of this drug) that you should plan to eat 3 meals per day. This doesn't mean that you will necessarily gain weight though. Try to choose a variety of foods from the Food Guide Pyramid (dairy, meat & beans, breads, grains & pasta, vegetables and fruits with a moderate amount of fats & oils). Your healthy body weight for your height is 125 to 168 pounds so you are underweight for height. Underweight can weaken your immune system and weaken bones due to lack of calcium rich foods.
You seem to be burning the candle at both ends with a full time job (40 hours per week) plus 20 hours of school. (BTW there is only 168 hours in a week and you should spend 56 of them sleeping. You need 7 to 8 hours of sleep a night. This only leaves 112 hours left in a week for work, school and play. You should rationally assess whether you should restructure your work or school because you are spending 8.5 hours every day, 7 days a week in these activities.
I would recommend you discuss your Dexedrine dose with your doctor and ask if there is another medication that wouldn't negatively affect your appetite and sleep. Depending on how long you have gone without the Dexedrine, it may take a while to get out of your system even though it only takes 15 - 30 minutes to get into your system. So you might not notice an improvement in your appetite for short periods of not taking Dexedrine. The dose you are taking is moderate, but then you don't weight a lot.
Is there any correlation between hypoglycemia and attention deficit disorder? Thank you.
There is no research to suggest people with hypoglycemia are more likely to have attention deficit disorder or visa versa. Hypoglycemia is low blood sugar which may be a reaction to high sugar / carbohydrate foods whether or not a person has diabetes. Symptoms range from sweating, weak, shaky, difficulty in processing information to passing out. The treatment depends on whether the person has reactive hypoglycemia (needs high protein foods with fewer carbohydrates) to diabetics (needs 15 - 30 grams of simple carbohydrates like fruit juice or milk).
Attention deficit disorder covers a wide range of symptoms and the symptoms are not caused by food based on what science knows at this time. I would suggest you contact your local school and ask to talk to someone in the special education department or the school psychologist about ADD or ADHD.
I am an adult female who was recently diagnosed with ADHD. I seem to recall some research that indicated that certain foods could aggravate symptoms of ADHD. Has this been substantiated recently? What are these foods? Sugar? Yeast? Food Dyes? I am very curious. Please help.
In the early 1970's Dr. Feingold proposed that much of the hyperactivity involved with learning disabilities could be attributed to food additives. This untested idea based on testimonials gained wide public acceptance. He believed that removing synthetic colors and flavors, as well as certain fruits and vegetables containing "salicylates" from the diet could treat behavioral disturbances. He also speculated that foods, such as sugar, caused behavior changes. Over the years, dozens of scientists put Dr. Feingold's theories to the test, but the evidence they gathered failed to support Dr Feingold's theory that additives, sugar or other substances in food, cause or contribute to hyperactivity.
Scientists studying hyperactivity found that sugar had a mildly quieting effect on some children. One theory is that eating sugar and other carbohydrate foods raises the level of brain neurotransmitters that are associated with feeling relaxed and calm.
FYI, the correct spelling of "FineGold" is Feingold. Many parents of ADD/ADHD children will testify to the benefits of this program. I encourage you to visit the Feingold Association web site to find out more.
If you re-read the question in this topic, you will see that the person asking the question misspelled Dr Feingold's name. In my answer, the spelling is correct.
I am familiar with the Feingold diet. While there may be many testimonials from parents of ADD / ADHD children for whom the diet "worked", there is no scientific evidence that sugar, artificial food colorings or sweeteners cause or increase behavior or learning problems in children as of 2005 with little research done on this diet since 1998.
Sorry, but I stand by my answer, which is based on nutrition science and research, not testimonials. Of the 47 human studies in English on the "Feingold diet" in the National Library of Medicine, none proved restricting any food additive or color, sugar or natural salicylates reduced symptoms of hyperactivity or attention deficit.
I was wondering if you had any information on what is called the "Fine Gold Diet"? It could be used, from what I understand, for patients (children) with Attention Deficit Disorders perhaps as a last resort for treatment. I do understand that it isn't proven to be of benefit, but may not be harmful either. If you have any information on this regarding - how to follow it and your advice regarding the diet, it would be most appreciated. Thanks.
I found your web page by doing a net search for "hyperactive children". Could you point me any tools (i.e. useful questionnaires) that may help a parent assess whether a 10-year old child is indeed "hyperactive" versus just being a typical boy at that age.
I am not aware of any nutritional tools for screening hyperactivity in children. However, why don't you ask you son's doctor for the name of a neurologist who is the appropriate person to perform testing. Also, a special education teacher or psychologist at your son's school could point you toward recent testing tools or questionnaires for parents. Most public schools perform testing free for students who may be in need of special educational services.
You are wise to question whether your child is just typical. After all, it is normal for children to be physically active and have shorter attention spans than parents.
Ironically, there has been some recent research that again states that sugar does not cause hyperactivity in children. It would be nice to put that nutritional misconception to rest finally. If anything sugar has a dulling or numbing effect and in large amounts can make people sleepy.
What do you think of Feingold's diet for hyperactive children? My friend told me to take my son off a lot of foods.
The Feingold diet for hyperkinetic children is based on removing all foods with sugar, preservatives, color dyes and salicylates from a child's diet. Specific foods are omitted.
Hyperactive children vary from three to 15% of all children depending on the studies I have reviewed. As psychologists, educators and parents have become more aware of hyperactivity, more children have become screened for this disorder. Symptoms are over activity, distractibility, restlessness and short attention span. Hyperactive children have more problems with their behavior especially relevant, goal directed, appropriate behaviors.
It was Feingold's theory that children are born with an inherited predisposition toward hyperactivity, which is triggered by certain food substances. Feingold based his 1973 studies in San Francisco with hyperactive children on a diet free of salicylates, artificial food colors and artificial flavors. Naturally occurring salicylates in apples, apricots, cherries, currants, grapes, raisins, nectarines, oranges and peaches that were once banned have been found to contain little or no salicylates. Feingold's basic theory was that 30 to 50% of hyperactive children can be taken off drugs and managed on a diet free of these food substances. Feingold himself considers the artificial colors and flavors to be the most toxic substances to hyperactive children.
A report by the National Advisory Commission on Hyperkinesis and Food Additives to the United States Department of Health, Education and Welfare agreed that "Feingold's hypothesis was based on clinical findings and not on rigorous clinical trials or experimental research". Furthermore, a series of experiments on the Feingold Diet's effect on hyperactive children produced mixed and inconsistent results. While Feingold's diet has limited success with all hyperactive children, some studies have indicated the diet seems to be more effective with younger children and that further testing of children sensitive to artificial colors show short term effects lasting one hour.
Stimulant medication has been the treatment of choice for hyperactive children. A stimulant for someone who is hyperactive actually does slow him or her down.
The important impact of what a child eats should be documented and evaluated. If a child eats food with little or no food value, I would expect a child's nervous irritability to increase.
The Feingold diet has increased a parent's concern about what their child eats and involved the parent more in monitoring their child's diet. I do have some concerns about the Feingold diet because, some of the dietary restrictions may cause a nutritional deficiency. The number of fruits and vegetables eliminated in the Feingold diet may prevent an adequate vitamin C intake. I have no problem with parents omitting artificial food colors and artificial food flavors because I do encourage diets using as few sugar and salted snacks foods as possible. A complete artificial color and flavor-free diet may be too time consuming or too expensive for most families to follow. Also, what about foods hyperactive children eat at schools, friend's or grandparent's houses? I would rather teach a child about a nutritious diet and encourage children to make appropriate food choices.
The best diet for a child includes a variety of the basics, such as meats, milk, grains, fruits and vegetables. The foods should be cooked using as little added salt and sugar as possible. The use of processed foods should be blended with basic foods depending on the time and money a parent has to spend.
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