WASHINGTON: Simply eating healthier may improve the behavior of children with attention deficit hyperactivity disorder if therapy and medication fail, said a study published Monday in the journal Pediatrics.
Researchers, however, said that their review of recent controlled scientific studies had shown conflicting evidence on the impact of supplements and restricted diets -- in some cases they were no better than the placebo effect.
Nutritional interventions should therefore be considered an alternative or secondary approach to treating ADHD, not a first-line attack, said the review by doctors at Northwestern University Medical School in Chicago.
"Supplemental diet therapy is simple, relatively inexpensive, and more acceptable to patient and parent," than strict additive-free diets that have been popular in the past, said the study.
"Public education regarding a healthy diet pattern and lifestyle to prevent or control ADHD may have greater long-term success."
The study reviewed research published on the sugar-restricted, additive-free Feingold Diet, megavitamin therapies, omega-3 fatty acid supplementation and the suspected link between ADHD and a "Western-style" high-fat, low-fiber diet.
Three to five percent of US schoolchildren, or nearly five million youths, are diagnosed with ADHD, which involves hyperactive behavior, inability to pay attention, and impulsivity. It is often treated with stimulant medications such as the controversial Ritalin drug.
The precise causes of ADHD are unknown, although studies have pointed to hereditary factors as well as social and environmental influences. Eating high-sugar and high-fat foods may exacerbate symptoms, some research has shown.
But while proposed interventions such as giving iron supplements or cutting out additives and food dyes have soared in popularity in recent years, the Pediatrics article said there is little solid science to back up those claims.
For instance, the much-hyped Feingold Diet which advocates no red or orange color dyes in food as well as no apples, grapes, deli, sausage or hot dogs, was highly touted in the 1970s and 80s for improving symptoms in more than half of ADHD children.
"Controlled studies failed to confirm the effectiveness of the diet to the extent claimed," said the Pediatrics review, also noting that the regimen was very difficult for many parents to follow.
Similarly, studies focused on getting rid of potential allergens in the diet such as wheat, eggs, chocolate, cheese and nuts, have shown limited success with some ADHD kids "but a placebo effect could not be excluded," said the study.
Even when it comes to sugar and diet soda, two elements which many parents believe can trigger hyperactivity in children, scientific studies have been unable to prove a definitive link.
"The majority of controlled studies fail to demonstrate a significant adverse effect of sucrose or aspartame," said the study.
The authors noted that avoiding high sugar foods in young children "may prevent diet-related exacerbations of ADHD."
But when parents restrict a child's sugar intake in order to ward off bad behavior, their inherent belief that it will work is likely to blur any objective assessment of whether it works or not.
"In practice, the link between sugar and hyperactive behavior is so universal in the opinion of parents of children with ADHD that no controlled study or physician counsel is likely to change this perception."
The suspected role of zinc and iron-deficiency deserves further study, while megavitamin therapy has not been proven to work and may even be dangerous in the long term, it said.
For many parents, simply paying more attention to feeding their kids a healthy diet, rich in fish, vegetables, fruit, legumes, and whole-grains, is likely to help.
"A greater attention to the education of parents and children in a healthy dietary pattern, omitting items shown to predispose to ADHD, is perhaps the most promising and practical complementary or alternative treatment of ADHD," said the study.
Andrew Adesman, chief of developmental and behavioral pediatrics at Steven and Alexandra Cohen Children's Medical Center of New York, who was not part of the study, said more research is needed into dietary treatments for ADHD.
"We have more questions than answers," he said. "It is unfortunate that more research is not being done to examine the role of dietary interventions for the treatment of ADHD.
"Since some of these nutritional interventions cannot be patented, drug companies are not willing to underwrite the costs of the needed research."
-AFP/vl
Taken from ChannelNewsAsia.com; source article is below:
ADHD kids helped by healthy diet
Read the labels. If they include words such as hydrogenated or 
Let kids learn where food comes from and how it is made or grown. An excursion to a farm can be very enriching. Explain why you have chosen particular foods over others at the supermarket. 
Apart from main meals, let your child nibble on nutritious snacks throughout the day. Grazing regulates their blood sugar as they get a steady supply of energy from frequent small meals. 
Junk food is one of the key culprits of 
In addition to yielding vitamins, minerals and other nutrients that keep children healthy, milk is important for building and maintaining strong bones. The Academy of Pediatrics advises 
Phytos, for short, are immune-boosting substances found only in fruits and vegetables. They prevent wear and tear on organs and help the body to repair itself. They also give fruits and vegetables their vibrant colours which kids are naturally attracted to. So, let your child choose his own phytos by asking him to select a rainbow to eat. 
Popeye loves it for a reason. A dose of spinach offers fibre, Vitamins C and E, calcium, folate, as well as the antioxidant lutein, which boosts retinal health. It is also high in iron, which aids growth and muscle development. Spinach is easily disguised for kids: Blend baby spinach, celery, carrots and tomatoes into a homemade pasta sauce. 
They're good for the body but children, especially finicky eaters, may not always get the vitamins from the foods they eat. Many parents give their children a daily multivitamin as an added nutritional precaution. 
High in protein and calcium, easier to digest than milk, yoghurt has live bacterial cultures that keep intestines healthy, aid digestion, and offer a boost to the immune system. Buy low-, or non-fat variants. You can also blend it into smoothies, make dips from it, or stir it into soups and sauces. 
