William W. Lee, Ed.D.

Licensed Clinical Psychologist

CAN A CHANGE IN DIET AVERT THE NEED FOR RITALIN?

For over twenty-five years, parent of hyperactive children have been told that various common foods, food additives and preservatives were the cause of the condition that is know as attention deficit/hyperactivity disorder or ADHD. However these claims have been disputed repeatedly by many health organizations. Children with ADHD are hard to manage, disruptive at tome and in the classroom and they often struggle with academic performance and socialization at school. The main symptoms are difficulty concentrating, short attention span, easily distractible, excessive activity and impulsiveness. the vast majority of the children with this diagnosis are given Ritalin, a stimulant drug which has the paradoxical effect of calming them down and helping them focus at the task at hand.

While Ritalin is highly effective, helping 70 to 90 percent of children with the disorder, there are concerns about its long term use and side effects such as appetite suppression, weight loss, insomnia, stomachaches and, in rare cases, tics.  Prompted by these concerns, the Center for Science in the Public Interest, a nutrition advocacy group took a new hard look at the studies that explored various dietary factors in ADHD. It concluded that the evidence strongly indicates that for some children, the behavioral disorders are caused or aggravated by certain food additives, artificial food colors, the foods themselves or a combination.

So... is a change in diet worth a try? although only a small percentage of children with the disorder are expected to benefit significantly from changes in their diets, the new report urges parents to try the changes before resorting to drugs. this requires first identifying the foods or chemicals that seem to cause the unwanted behaviors. the task is not easy, but it has been done successfully for many children with food allergies. One approach is to begin with a very basic diet of foods that are beyond suspicion and at back, one at a time, the possible culprits for a few days and carefully monitor the results. Another approach is to eliminate one suspect food or substance at a time from the child's usual diet and see if there is an improvement.

Food that have most often been linked to worsening ADHD symptoms include artificial colors and flavors; foods that naturally contain salicylates, like apricots, berries and tomatoes; and foods that sometimes cause allergic reactions, like milk, wheat, and corn. Some children may also react to chocolate. Parents, and children when they are old enough, will have to become compulsive label readers to avoid the offending foods. Of course, keeping a child away from problems foods can be an impossible task, especially when the child eats lunch in school, goes out to eat or eats in other's homes. Some children may be teased about their dietary restrictions, while others may rebel at being deprived of foods and treats they love. 

Managing children with attention deficit hyperactivity disorder requires multiple interventions which may include medication; diet changes; behavior management plans at home and school; use of structure, routine and consistency on the parts of parents, grandparents and teachers; and counseling and skills training for the child. Accommodations and modification of expectations both at home and at school can be developed cooperatively between parents and school personnel. Parents should maintain close communication with their child's pediatrician and the feedback provided by their child's school.