Nutrition

...and some answers to the puzzles posed by ADD/ADHD.

Essential Fatty Acids

The integrity and function of cell membranes, especially those of the nervous system, are dependent upon adequate essential fatty acid (EFA) intake for normal growth and developments. These nutrients are also required for prostaglandin production. The most important prostaglandin for controlling biochemical processes in the brain appears to be PGE1. If there is inadequate EFA intake, poor absorption, or defective conversion of the EFA's to PGE1, the consequent deficiency may lead to attention deficit and hyperactive symptoms. Animal studies show deficiencies of EFA's result in learning and behavioural disorders and, interestingly, in a reduced resistance to the adverse effects of neurotoxic agents, including lead.

Typical Western diets provide an omega-6:omega-3 ratio which is too high. An optimal ratio may be 4:1. Currently, the average diet provides approximately 10-14:1. In some countries where there is a very high grain intake, there is a ratio of approximately 24:1 and these people demonstrate overt essential fatty acid deficiency signs.

When supplementing with essential fatty acids, especially evening primrose oil (omega 6), it is generally recommended to balance with an omega-3 oil, and it is also very important to provide lipid soluble antioxidant protection with vitamin E.

Zinc

Low levels of zinc in developing animals and humans produce a large variety of defects. These include immunological, neurological endocrine and hormonal abnormalities. Behavioural disorders, including hyperactivity, are certainly known to be associated with low zinc status. Research on ADHD children has shown them to be zinc deficient and this has been suggested as a potential causative, or at least contributing, factor of the conditions.

Selenium

The majority of the antioxidant protection of the body is provided by antioxidant enzymes in the cell. One of the most important of these antioxidant enzymes is glutathione peroxidase which can only be produced in sufficient quantitiy if selenium is freely available. When selenium levels are low, glutathione peroxidase levels fall and sensitive and vulnerable organs like the brain are left susceptible to oxidative stress.

Thyroid dysfunction can significantly affect brain function. Selenium is an important component of the enzyme 5' deiodinase. This enzyme plays an important part in the activation of T4 to T3. Low levels of selenium will reduce production of 5' deiodinase.

Chromium Deficiencies in chromium become more frequent where 'fast' or packaged foods are predominant in the diet. Chromium is a key component of glucose tolerance factor (GTF) which has strong insulin-enhancing properties. GTF works by helping insulin to bind with receptors within cells' membranes. If GTF levels are low, receptors in cells don't bind insulin and are consequently described as being 'insensitive' to insulin. These means that much higher levels of insulin must be released by the pancreas to control blood sugar levels following a meal.

These higher peaks of insulin can then later produce an excessive lowering of blood sugar. The resulting hypoglycaemia can then be responsible for irritability, moodiness, hyperactivity/lethargy and cognitive problems.

Food Additives and Allergies

There is a long history of concern about food additives and the possible involvement of these in an array of behavioural disorders. Dr Feingold proposed that they are significant contributors to ADD/ADHD and that removal of these substances will have a distinct benefit for these children. Unfortunately, research on Dr Feingold's and similar diets failed to show an obvious association. However, many parents see dramatic changes in children when they consume specific additives.

This indicates that some children may be sensitive to food chemicals, but research which treats ADD/ADHD patients as an homogenous population fails to recognise these children as a subgroup. Several studies have looked at the red food colouring tartrazine. Some findings were inconclusive and others showed a distinct effect.

Sensitivity to foods may predispose children and adults to behavioural disorders including ADD/ADHD. Despite limited research, there is supportive data showing elimination diets to be useful. By omitting the common allergens milk, wheat, egg, cocoa, corn, sugar and food colouring, researchers have found that approximately half of the ADD/ADHD children in the trial noticed improvement after seven days.

Allergy, digestive disturbance, dysbiosis and leaky gut syndrome are commonly linked with neurological disorders and resolution of these conditions produces positive results for ADD/ADHD patients. Practitioners implementing the Bowel Detoxification and Gut and Liver Detoxification Programs note improvements in epilepsy, headaches and migraines, aggressive behaviour, hyperactivity and ADD/ADHD. Interestingly Dr Thomas Borody of the Centre for Digestive Diseases in Sydney has recently made the connection between enteric clostridium infection and autism.


Heavy Metals

It is well known that elevated levels of hair lead concentration are associated with poor neurological development, behavioural disorders and also with ADD/ADHD. A recent study of school children found a striking dose-response relationship between levels of hair lead and negative teacher ratings. This showed that the higher the lead concentration, the more severe the child's disorder, as assessed by the teacher.

A physician's assessments of the child's behaviour showed an even stronger correlation. When considerations of other potential variables were made, the correlations were still evident. Other studies have similar findings in hair lead concentration and associated behavioural disorders and autism. The treatment of metal contamination with a chelating agent such as glutathione has led to significant improvement in these conditions.