Hyperactivity/ ADHD

Hyperactivity is a descriptive term that refers to restless, distractible children who have a knack for disrupting order at home and at school. They have average or above-average intelligence. Hyperactive behavior and attention deficits are often connected so that the term attention deficit hyperactivity disorder (ADHD) has been popular. Normal boys and some girls tend to be hyperactive and when they are enclosed and constrained, they can be disruptive of an adult sense of order. The diagnosis of ADHD is tentative at best and often bright, energetic children are diagnosed when they do not adapt well to rigid classroom protocols. The trend toward drugging children so that they can attend school is to be deplored.

In the worst case, hyperactive children are not well. They have physical symptoms and  poor impulse control. They may display mood swings, inappropriate anger and sometimes are violent. Their schoolwork suffers from inattention, disorganization, poor memory, and behavior disruptive of orderly classrooms. ADHD may improve as children age, but some have a long-term handicap, limited by a combination of physical illness, poor achievement, low self-esteem, and antisocial behavior.

Several theories were advanced to explain ADHD. The theory of "minimal brain damage or dysfunction" had many advocates. The child is viewed as having a fixed disability, manifesting a structural problem of brain, acquired during prenatal development or at birth. Language disability or dyslexia has also been attributed to a fixed circuitry problem in the brain that impairs encoding and decoding of language symbols. These brain-damage theories ignore the living, dynamic properties of the brain; they seem to view the brain as a simple appliance or computer that comes hardwired to behave in a certain way. But what about the daily input of molecular substances to the brain? Can improper food-body-brain interactions, sustained by habitual food choices, produce the patterns of dysfunction commonly observed?

I believe that food chemistry and delayed patterns of food allergy play an important role in causing learning and behavioral problems in children. Whenever children are sick or influenced by food and/or airborne chemicals, their brain function is compromised and symptoms include disturbances of sensing, feeling, remembering and acting. Their learning is impaired and their behavior may be disturbed. The intention of compassionate biological management is to restore orderly, normal functioning of the child by careful revision of environmental conditions and food intake.

Caffeine is major problem. Hirsch reported a 252% increase in ADHD scores (using the Connor’s scale) when children drank less than one can of caffeinated colas. Coca cola contains 44 mg per 12 oz can and Pepsi Cola 38 mg per can. High caffeine drinks such as Jolt and Red Bull are available in supermarkets and may be consumed by children.

"Sugar" is often blamed for hyperactivity. Parents often observe that children's' behavior deteriorates after eating sugar-containing foods, such as chocolate chip cookies, cake, jello, kool-aid, pop, strawberry ice cream, or chocolate bars. They often blame sugar and do not think of other ingredients in the food as potential problems. The sugar-hyperactivity connection illustrates a mistake of attribution, blaming the results of the complex interaction of many food ingredients with the body on only one of the ingredients. When sugar (glucose and sucrose) alone is given to children, they tend to be sedated, with unchanged or even decreased physical activity.

Other food ingredients have been named as the culprits in children's behavioral problems such as food dyes, glutamate and aromatic substances. Amines in fruits, for example, are neuroactive chemicals that produce behavioral changes when given alone. Nutmeg is known to contain hallucinogenic substances, and cinnamon often triggers hyperactivity and/or headaches. Several naturally occurring polyphenolic compounds have been studied for their effects on behavior. Gallic acid, for example, suppresses food intake in animals. In rat studies, obese rats were more sensitive to appetite suppression by gallic acid than their lean litter mates. Gardner advanced the hypothesis that the whole range of aromatic compounds in the food supply are chemically active and also allergenic.

Psychopharmacology & Hyperactivity

The most researched neurochemical approach to hyperactivity is based on a drug-neurotransmitter model of brain function. The dopamine system is involved in reward-seeking behavior, sexual behavior, control of movement, regulation of pituitary-hormone secretion, and memory functions. A model of schizophrenia postulates increased or unregulated dopamine circuits and drugs which block dopamine activity reduce the schizophrenic syndrome. An interesting neurochemical relationship between hyperactivity and schizophrenia has been postulated, where the two conditions seem to have opposite features.

ADHD may be attributed to dopamine deficiency. Dopamine synthesis slowly increases as children grow and may not reach full capacity until late teens. This is one of the built-in maturation lags which prevents some children from assuming adult-like behavior in their early life. Dopamine in young animals exerts a protective influence against hyperactivity. Since schizophrenia is associated with increased dopaminergic activity and is improved by dopamine-blocking agents, there is a reciprocal relationship between psychosis and hyperactivity. A neurochemical relationship might look like:

   >>    increasing dopamine

Attention Deficit    ---------- -----> SCHIZOPHRENIA

(decreased focal attention)          (increased focal attention)

  Hyperkinetic  <--------------- STEREOTYPY

decreasing dopamine

Nutritional strategies may attempt to modify the amino acid profile of the diet to encourage dopamine synthesis by augmenting intake of phenylalanine and tyrosine and supplying extra cofactor, Vitamin.B6 (pyridoxine). A more direct drug approach is to utilize molecules that stimulate dopamine circuits or act as dopamine agonists - options have included pemoline, L-dopa, bromocriptine, amantadine, and lergotrile.

Ritalin and amphetamines increase dopaminergic activity and decrease hyperactivity while they increase stereotypy. Ritalin has become the "drug of choice" for children with ADHD. Ritalin therapy poses many risks, some obvious and others concealed. Any child treated with Ritalin is moved from the hyperactivity end of the spectrum toward a schizophrenia-like state.

The most obvious Ritalin effect is appetite suppression and retarded growth. Some parents complain that their Ritalin-treated child acts like a "zombie". They describe emotional blunting and detachment from family and friends, a mild schizophrenic attribute. Children on higher doses and chronic use may manifest paranoid features - withdrawal, anger, restless, suspicious behavior.

Adults who abuse amphetamines regularly develop a psychotic state with paranoid features. Ritalin may also produce disruption of movement control in a few unlucky children. Facial and head tics may appear, and, in the Tourette's syndrome progress to peculiar grunting and respiratory tics, associated with compulsive behaviors, manifesting stereotypy. No drug which works on the dopamine system is free of long term toxicity on the motor system.

Studies on the effects of long term Ritalin use show the mixed results expected from a symptomatic drug therapy which does nothing to remove the underlying cause of the disorder. In all drug-related studies of ADHD, there is no consideration of dietary variables, nor any thought that the learning and behavior problems are just symptoms of a more pervasive illness. The reviewers of drug studies discover that ADHD continues through adolescence into adult experience. The names for the disorder change as patients age and accumulate social and interpersonal problems. 

Hechtman reviewed the outcome of children treated with Ritalin. She stated: "Thus, stimulant treatment in childhood does not seem to secure a positive adolescent outcome for the hyperactive. However, studies that have combined stimulants with other multimodal interventions... do suggest more positive outcomes."

I propose a multimodal therapy which repairs the attention deficit disorder with effective, diet revision therapy; repairs academic deficits by appropriate remedial education; repairs lost self-esteem by family and child counseling; and maintains normal functioning by supporting the family effort to sustain proper diet, learning and social opportunities. A brief review of these concepts follows.

The Food Allergy Explanation of ADHD

Many physicians have described diet revision treatment for children's' behavioral and learning problems. Egger remarked: "A role for food allergy in the hyperkinetic syndrome has been postulated since early this century."  ADHD can be seen as a symptom of a food-driven hypersensitivity disease. Many children with ADHD will have symptoms and signs of delayed pattern food allergy. We are not talking about common allergy, diagnosed by skin tests. We are talking about delayed patterns of food allergy that cannot be detected by tests.

More on Food Allergy and ADHD

The Physical Symptoms

The most common symptoms are allergic shiners (dark circles under the eyes) and stuffy nose. ADHD kids tend to have histories of nose congestion, recurrent middle-ear infections, and sleep disturbances, starting in infancy. Some have more specific allergic problems such as eczema, hives, and asthma but most have non-specific symptoms that do not fit the familiar patterns of allergy. Digestive disturbances are common but may be episodic with long normal periods - bouts of gas, distention, pain lead the list - some children have bouts of diarrhea others tend to be constipated. Some have headaches and many have leg pains often at night. Often parents will state that the child has recurring colds or flus and are prescribed antibiotics too frequently.

Eating Behaviors

Often, the early ADHD child will show curious and difficult eating behaviors. Preschool infants with food problems tend to become fussy or picky eaters with strong food preferences and refusal to eat many healthy foods. These children may frustrate their mothers into accepting their idiosyncratic eating patterns. Children with food allergy typically become eating specialists - compulsively eating a small number of "favorite" foods and refusing the rest. Vegetable foods are the first foods refused, often in favor of compulsive eating of fruit juices, dairy or wheat products. 

When you see a four year girl in her pink dress with bows in her hair, allergic shiners and stuffy nose, screaming and writhing in the aisle of the supermarket because her mother will not let her keep the bag of candy she just snitched from the shelf, you can make the diagnosis of food allergy - ADHD and predict years of difficulty for this child and her parents unless they are successful in controlling her food supply. Their success is doubtful for many reasons - even if they are highly motivated and well informed, the little girl in the pink dress will not comply willingly and will show every behavior of a committed food addict for years to come.

Proper Diet Revision

ADHD symptoms may remit surprisingly and dramatically when food selection is changed. The details of a successful food plan vary from individual to individual. The most globally successful diet revision in all these illnesses involves complete revision of the problematic diet.

• Selective "elimination diets" tend not to work.
• There are no tests for this type of food allergy.
• The proper technique of diet revision therapy is designed to solve simultaneous problems in the child's food supply.

Consideration is given to

• minimizing exposure to food additives,
• choosing nourishing, primary, low allergenic foods as dietary staples,
• assuring nutrient adequacy by careful monitoring of the child's food intake.

Brief Note on Delayed Pattern Food Allergy

In this section we are discussing delayed food allergy, not the more obvious immediate food allergic reactions. Delayed patterns of food allergy are not so obvious and generally go unrecognized. Allergy skin tests do not show this problem nor do blood tests for antibodies  such as RAST or ELIZA.  Delayed patterns of food allergy are responsible for causing specific diseases such as asthma and eczema and also common but ill-defined illness patterns in children. 

The Alpha Nutrition Program is proposed to help solve learning and behavior problems in children. The Alpha Nutrition tends to solve food allergy problems, generates healthy eating practices, and encourages a return to adaptive self-regulation. In families, this is only possible if everyone cooperates and everyone succeeds at getting better. A tall order. A healthy mind requires correct, coherent, consistent molecular input to the brain.