Dr Alex Richardson from the Department of Physiology, at the University of Oxford opened the conference by describing the wide gap between scientific evidence on food and behaviour, and practice and policy.
The physical risks to children from a nutritionally poor diet are acknowledged but damage to learning abilities, behaviour and mood is not. The role of nutrition is largely ignored in standard assessment and management of ADHD (covering dyslexia, dyspraxia and autistic spectrum disorders). Appropriate nutrition is essential for the growth, development and maintenance of every cell in our brains and bodies. There are at least 39 essential nutrients that must be provided by food, many of which are lacking from the modern diet.
What is missing/added? Our diets are high in refined, processed foods, which are squeezing out fruit and vegetables, unrefined foods, and foods rich in omega 3 fatty acids. Additions include pesticides, synthetic chemicals, antibiotics, growth hormones, preservatives, flavouring, colours, sweeteners and texture-modifying agents. Although many have been tested for physical effects, behavioural effects have not been safety tested.
Food and mood
Depression has strong links to diet, and omega 3 fatty acids seem to be a protective factor.
Dr Richardson closed with a strong message to all who say that nutrition is ‘alternative’. It is not; it is ‘fundamental’.
Effects of dietary change
Dr Paul Clayton, a fellow of the Royal Society of Medicine, emphasised that public health problems are getting worse, and a realisation is beginning to dawn that these problems relate to diet not medication. Life expectancy has actually reduced since mid-Victorian times, when cancer rates were 10% of what they are today.
Improved agricultural output and the expansion of the railways to distribute fresh food around the country contributed to the good health of Victorians, who were physically active and burned large amounts of calories. Oysters and salmon were part of the diet of the poor who also ate more than 10 portions of fruit and vegetables a day. Bread and cheese was about as processed as food got. The Victorians died from infections (pre-antibiotics), childbirth, heart failure after rheumatic fever and industrial accidents but rarely cancers or heart disease.
Mass importation of salted meats and cheap sugar and the industrial production of cigarettes coincided with the introduction of motorised transport; we began to eat more meat and take less exercise.
The age of antibiotics is coming to an end. We need to use all nutritional tools available to improve natural immunity so as to avoid unnecessary early death and avoidable disease. Multiple micronutrient depletion is a global problem.
Trace and toxic minerals
Professor Neil Ward from the University of Surrey described how aggressive behaviour in ADHD is linked to melatonin, which is controlled by zinc. Food colours not only reduce zinc intake, but can leach zinc from the body. Aluminium can mimic iron where there is a deficiency of iron: and there is evidence of a direct relationship between levels of aluminium in children and their classroom behaviour.
Lead, still lurking in our environment, has been linked to a reduction in IQ. Alcohol and medicinal drugs compete with trace elements for absorption into the blood stream, and some non-steroidal anti-inflammatories actively deplete iron, melatonin, folic acid and zinc.
To treat ADHD, concentrate on essential fatty acids, vitamins and the minerals known to relate to ADHD: zinc, selenium, iron and chromium. ADHD sufferers also have raised blood serum levels of lead, cadmium and aluminium.
One study among juvenile offenders found that replacing high sugar food and drink with whole foods, fresh fruits and vegetables resulted in a 45% reduction in rule violations.
With the consent of the medical fraternity, Ritalin (which shares many properties with cocaine) is given to children without an understanding of its sedative, habit-forming long-term effects.
Proper hydration is also essential. In a classroom study a bottle of water was placed on each child’s table. After a few days of endless demands for loo breaks, teachers noticed an improvement in concentration – which dropped after lunch breaks full of fizzy drinks!
Nutritional management Dr Brian McDonogh, a specialist in nutritional medicine, explained that drugs fail to reverse the underlying causes of ADHD, merely masking the symptoms. We need to look at nutrition before resorting to drugs but, at the moment, no alternative to drugs is offered.
It is essential to take a detailed family history. Find out what the child is eating and drinking. Certain conditions may alert you to nutritional status and intolerances. Rule out the presence of heavy metal toxins. A simple sweat test can determine much about a child’s nutritional status. Remove all additives from the diet. Learn which ‘good’ foods to remove on the grouds of suspected allergy, and which ‘bad’ foods must not be consumed. Which supplements does the child really need? Address the gut health with L-glutamine and probiotics – a healthy gut is a healthy body. Within a couple of weeks of a diet and supplement change, a child comes back to life. The child also understands the effects that foods have, so is more likely to stick to the new diet plan. ADHD symptoms can be massively reduced after a successful diet change.
How essential fatty acids can affect learning behaviour
Dr Alex Richardson pointed out that ADHD is the only area in which proper trials of essential fatty acids have taken place.
Essential fatty acids (EFAs) include omega 7 (from olive oil) and omega 9 (from vegetables and fish) of which omega 3 and omega 6 are specific types.
EFAs are needed for the structure and maintenance of all cell membranes and optimal cell signalling. They affect brain growth and connectivity.
We need omega 6 (from seeds, nuts, grains, evening primrose oil, meat, eggs and dairy products) and omega 3 (from green leafy vegetables, seaweed, nuts, seeds, and seafood). The ratio should be 1:1, but is about 15-25:1.
The American Psychiatric Association now recommends EPA/DHA (omega 3 derivatives) as an add-on treatment for mood disorders. Other studies have shown benefits for children with depression. DHA is essential for retinal development and a deficiency has been linked to visual, spatial and attentional disorders – all symptoms of dyslexia.
Effective utilisation and absorption of EFAs is dependent on other nutrient intake. Due to declining fish stocks, research is being done into the efficacy of algae as a replacement for fish.
Practical guidance Martina Watts, a BANT registered nutritional therapist, showed us a case history of a two-year-old child, James,
displaying classic ADHD symptoms. With a thorough investigation of his environment, his health, his family's health, dietary changes and supplementation his health has improved significantly.
He was found to have very high levels of arsenic in his blood. The source was an old railway sleeper in his garden where he often played. This was thrown out along with the surrounding soil. He had intolerances to certain foods, and had been weaned at nursery on a
supermarket own-brand food range, as well as having been prescribed steroid creams and antibiotics for eczema, impetigo and viral infections.
Martina recommended a home-cooked diet, with exclusions and rotations of foods,
enzymes and probiotics to improve his digestion and absorption of foods, supplementation with vitamins, minerals and EFAs, a reduction in exposure to environmental toxins and an
antimicrobial protocol to tackle yeast, bacteria and parasites.
James’ behavioural problems have disappeared, he is no longer hyperactive, sleeps well and does not rock or head bang. His immunity has improved, as have his stamina, weight, skin and stools. His complexion has changed from a yellowish-grey to a rosy glow. Martina is now concentrating on his gut health, as he still reacts to foods.
Food and health in schools and at home Dave Rex is the child health lead dietitian for NHS Scottish highlands. He says that parents want to know what to feed their children so dietitians need guidelines for worried parents. Any intervention must be
affordable – and palatable
otherwise no child will comply.
It is important to understand the emotional and financial culture surrounding a family’s food choices. Look at the local environment: shops, catering outlets, school/nursery food policy, peer food culture, advertising and marketing. Remember that autistic children also find any change difficult.
Give young people the opportunity to think about what makes food 'good'. Education breeds familiarity and understanding. The sense of achievement in growing your own food – planting, waiting and watching – makes it more special.
Children need to be confident and sure of their food choices, unswayed by marketing and peer pressure, perceptive about the message on the pack.
Dos and Don'ts for parents and carers
• You govern what they eat, but do not give the impression that you are restricting.
• Ensure consistency of message between parents and carers.
• Make a food plan with rough guidelines as to which foods are appropriate and how much.
There is a clear gap between the depth of knowledge and how we practically, responsibly and
sustainably improve diets, especially in lower income areas.
The conference was supported in part by Efamol, producers of easy to swallow omega oils capsules. www.efamol.com
Also present were another company specialising in oils: Barleans organic oils: www.barleans.com. They also make flavoured oils for children.
