Food additive link to ADHD

[KeyT]

Anybody see this study?

http://nz.news.yahoo.com/070907/9/1la6.html

A controversial new report which links food additives to hyperactivity in children is being examined by the trans-Tasman food regulator.

Food Standards Australia New Zealand (FSANZ) says it is looking into claims published in a prestigious medical journal The Lancet that suggests artificial colours and flavours are affecting kids' behaviour.

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The findings come from Southampton University researchers in England who tested almost 300 children with different products and found additives had a "significantly adverse" effect on those who consumed the most.

UK experts say they now have clear evidence that mixtures of certain food colours and the commonly-used preservative sodium benzoate are detrimental to kids.

FSANZ spokeswoman Lydia Buchtmann welcomed the report and said the regulator was investigating the findings to consider any changes to the food code.

"At this stage we're examining the report to see if there's any further action we needs to be taken," Ms Buchtmann said.

"We have been working closely with the UK on this because it is an interesting study."

The last major review of food additives was carried out in 2000.

She said the findings could be a useful tool for parents of children with attention deficit hyperactivity disorder (ADHD) to help manage their child's condition.

But she warned people not to self-diagnose intolerances to additives but rather seek advice from their doctor on what they should avoid.

The study involved 153 three-year-olds and 144 children aged eight or nine who were given fruit juice, either with or without additives.

The "additive" group were also given sweets with different levels of artificial colours.

The stronger lolly mix had a "significantly adverse" effect on the three-year-olds, and both mixes were detrimental to the older kids.

"Overall, children who took the mix moved about 10 per cent closer to the definition of being hyperactive," said lead author Jim Stevenson.

He said parents would find the results helpful but warned them that simply removing these additives from the diet would not prevent all hyperactive disorders.

"We know that many other influences are at work, but this at least is one a child can avoid," Dr Stevenson said.

Sounds familiar? Dr. Feingold said the same 30 years ago and developed a diet with an almost 100% cure rate. Also Dr. Michael Weiner PhD (known by most as Michael Savage of radio fame, and he just re-released his 1982 book on this subject, Healing Children Naturally ) says the same thing.

Most Physicians who always want scientific proof for everything will probably describe studies like this (like the food additive companies did to Dr. Feingold) and go with the sound scientific answer, "We don't know what causes ADHD. It just happens."

Let me see, ADHD has can really only been scientifically proven (IMHO not so much a condition than a side effect, or misdiagnosis, or just plain childhood behavior) for the past 50 years. Food additives became more popular and used more starting 50 years ago. Sugar became in wider spread use with larger consumption of sugary drinks, foods and cereals after World War II. Coincidence?

More info on Feingold studies and research:

http://www.feingold.org/

http://www.feingold.org/pg-research.html

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[KeyT]

Nobody has any thoughts?

 

[socialcog]

First off let me just say that I know nothing about the etiology or epidemiology of ADHD. It is just not my field of interest. However, I do know a little about science and research. I think I speak for most of the contributors in this forum when I say that in order for science to convey strength, it needs to be heavily controlled. Otherwise, it's finding will carry little weight or simply tossed into the bucket labelled, "Dogma". The study that you shared in your post has left out huge pieces. I wouldn't be surprised if the funding behind it, or the PIs, are proponents of a biomedical approach to ADHD intervention.

Perhaps attach a link with the actual article so those of us interested can have a look at the design,methodology and results. "10% closer to the definition of hyperactive" really doesn't tell anyone anything.

Perhaps that is the reason nobody has any thoughts.

 

[Ollie123]

Yeah, frankly the Yahoo news article wasn't really informative enough for me to comment. If I can track down the full article I'd have a better sense of whether the study really means something. I wouldn't be surprised in the least if diet contributed to ADHD. Diet affects damn near everything we do in some way or another. Though I almost have to laugh though when people try and claim it is the SOLE cause of ADHD, or that ADHD is just due to bad parenting.

 

[KeyT]

First off let me just say that I know nothing about the etiology or epidemiology of ADHD. It is just not my field of interest. However, I do know a little about science and research. I think I speak for most of the contributors in this forum when I say that in order for science to convey strength, it needs to be heavily controlled. Otherwise, it's finding will carry little weight or simply tossed into the bucket labelled, "Dogma". The study that you shared in your post has left out huge pieces. I wouldn't be surprised if the funding behind it, or the PIs, are proponents of a biomedical approach to ADHD intervention.

Perhaps attach a link with the actual article so those of us interested can have a look at the design,methodology and results. "10% closer to the definition of hyperactive" really doesn't tell anyone anything.

Perhaps that is the reason nobody has any thoughts.

What about the Feingold studies?

http://www.feingold.org/pg-research.html

I would think that since ADHD is so over diagnosed, that people interested in psychology would be interested in new research. I think the Feingold studies are very valid. The Feingold Center still helps thousands of children.

 

[Ollie123]

You weren't asking about the Feingold studies, you were asking about a Yahoo news article that even a non-scientist should be able to tell is missing far too much information for anyone to draw conclusions from

Feingold has definitely done some very legitimate work (trytophan depletion, etc.), but in my limited experiences with the Feingold Center, they seem to have a strong following of uneducated "ADHD(or insert other disorder) doesn't really exist, its just the man keeping us down!" folks that sort of discredits them. I have no doubt whatsoever that changes in diet DO help many people, and I wish more research was done on that issue. Despite doing some legitimate work though, Feingold seems to push things a few steps too far for me to take them too seriously.

 

[KeyT]

You weren't asking about the Feingold studies, you were asking about a Yahoo news article that even a non-scientist should be able to tell is missing far too much information for anyone to draw conclusions from

Feingold has definitely done some very legitimate work (trytophan depletion, etc.), but in my limited experiences with the Feingold Center, they seem to have a strong following of uneducated "ADHD(or insert other disorder) doesn't really exist, its just the man keeping us down!" folks that sort of discredits them. I have no doubt whatsoever that changes in diet DO help many people, and I wish more research was done on that issue. Despite doing some legitimate work though, Feingold seems to push things a few steps too far for me to take them too seriously.

Students, students, students…always thinking that giving just a opinion about something that will etched in tablets like the Ten Commandments. I remember the days. Thinking that anytime I said something I should write it down to put in my Osler-style autobiography. My God, I didn’t ask you to write a paper for me, just some first-hand thoughts. There is no test and that end of this question.

I mentioned the Feingold studies several times in my OP. I think to say that people who believe that ADHD is not a developmental disorder that is genetic but possibly non-existent, a side effect of nutrition, or from environmental (natural & man-made) toxins and who have vast knowledge in the area as “uneducated” is a pretty ridiculous statement. Who do you think conducts these studies? You think that anyone who thinks ADHD doesn’t exist or is non-genetic is some sort of loon? Do you think those people came up with those thoughts on a whim, just pulled it out of the air? Do you think these people received their MD, DO, or PhD from a degree mill?

 

[Ollie123]

I don't necessarily consider earning a degree the same as being "educated'

As I said, I'm not going to argue that diet doesn't affect ADHD, because I believe it does. However, as someone who spent 2 years working in a top-ADHD lab, I have to say that yes, people who don't think it exists are either uneducated (by my definition of it) or some kind of loons. One can argue the basis for the disorder/diagnosis is heavily flawed (I think that's true of damn near every disorder). One can easily argue that we turn to drugs far too quickly, and I don't think anyone who doesn't have stock in a pharmaceutical company would disagree.

I have no problems with people making component arguments for nutrition or environmental causes of ADHD. I have a problem with people who believe that is the SOLE cause. Big difference. Particularly in this field, nearly every disorder comes from the interaction of numerous factors and there are exceptions to nearly every rule.

But yes, I feel quite comfortable calling anyone who doesn't believe it exists either a loon, or uneducated. The reality is that there are kids who don't respond to parenting styles that work well for nearly all other children, have parents who are health-nuts, etc. and are still clearly off-the-charts on ADHD scales. ADHD is, in my eyes, one of the most poorly handled disorders in psychology, but that's very different from denying its existence entirely. Even if it WAS due only to diet or bad parenting, why are some kids more susceptible to diet or bad parenting than others? To say ADHD doesn't exist because some kids "get it" from eating a certain preservative is like saying that cervical cancer doesn't exist because its caused by HPV.

 

[Therapist4Chnge]

I too have done ADHD research, and it is DEFINITELY a legitimate Dx, and though food plays a role, there are neurological, environmental, and other factors that contribute. Food is one small part, but I think of it like someone throwing a bucket of water on you....while you stand in a downpour.

-t

ps. ADHD is one of the most misunderstood Dx's in psych, along with all of the eating disorder dx's and borderline PD.

 

[PsyKardinal]

As a counselor with a practice focusing primarily on children and adolescents I definitly agree that ADHD is an extermly complex diagnosis. The treatment has to involve more then just a diet change. A multimodal approach is the key to treatment, a change in parenting style, a change in diet (less sugar and other items that get kids all hyped up), in older children/adolescents solid cognitive therapy, supportive family for the whole family, helping the family develop new family rules, developing built play times for the child, and yes medication if it is appropriate. I really good go on for quite a while about how to treat ADHD but I am not here to write treatment plans.

If we are going to discuss the latest and greatest research about treatment of a particular disorder, then lets actually have the research or a link posted to it. Yahoo articles are written for someone with an 8th grade or so education.

 

[Neuro-Dr]

There is at least one recent and pretty comprehensive meta-analysis on the issue. There are several others that were limited by age, sample sive and induction versus elimination designs. Ultimately, I think the article below is the most useful synopsis of the current state and the one from which my recommendations to parents comes from:

Title: Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials.
Author(s): David W. Schab and Nhi-ha T. Trinh.
Source: Journal of Developmental & Behavioral Pediatrics 25.6 (Dec 2004): p423(12). (9204 words)

 

[Therapist4Chnge]

Yay research!

As an aside, I've been looking to increase journal/research discussions on the forum, so I'd like to encourage anyone/everyone to bring interesting and pertinant research in for discussion.

-t

 

[PsyKardinal]

Neuro-Dr,

Thanks for the article lead, I will definitly seek it out later this evening when I am at home and have time to really digest it well. T4C, I would love to have a more research topics to discuss amongst us all, any ideas to start with.

Jeff

 

[Therapist4Chnge]

Neuro-Dr,

Thanks for the article lead, I will definitely seek it out later this evening when I am at home and have time to really digest it well. T4C, I would love to have a more research topics to discuss amongst us all, any ideas to start with.

Jeff

I'll check out the article later this week, and try to give my 2 cents.

As for research in general, being that much of our time is spent creating, analyzing, and applying research....we might as well talk about it more. I figure people can post anything they find interesting, and we can go from there. I'm always interested in what others are doing, specifically in regard to social/relational research, so even if I don't know the research area that well....I'm always up for stretching my brain a bit.

-t

 

[Neuro-Dr]

I can give you the highlights, 15 studies with a combined subject pool of 200+ found yielded an effect size of around 0.28. This means that each stdy had about 15 subjects on average although several contained double-blind data on elimination and challenge arms. All kids were hyperactive to begin with and those that previous showed increase hyperactivity to AFC, showed reduction during the triel at least as measured by parent rating scales (not teach or clinicians).

So, one could reasonably say that there is a subset of kids who appear to become more hyperactive in the presence of AFC challenge arms as measured by blinded parent, but not teachers or clinicians necessarily. These levels were measured using a 10 Conner's Rating Scale. the average increase was about 0.45 for parents and 0.28 overall (not Cohen's d, but SMD=standard mean difference).

KeyT- I'm not a student, so I'm not sure whether my thought are worth remembering or writing down.

So if asked whether AFC could exacerbate hyperactivity in an ADHD child the mythbusters answer would be "plausible". If asked if AFCs cause ADHD, the answer would be "busted". If asked why anyone hasn't gone out and conducted a double blind placebo controoled study of normal and ADHD kids with challenge and elimination arms in a sample size above a couple hundred, the answer is "I don't know".

 

[Duckygirl]

Let me see, ADHD has can really only been scientifically proven (IMHO not so much a condition than a side effect, or misdiagnosis, or just plain childhood behavior) for the past 50 years. Food additives became more popular and used more starting 50 years ago. Sugar became in wider spread use with larger consumption of sugary drinks, foods and cereals after World War II. Coincidence?

I just thought I would add that I don't think "sugar" in it's pure form is considered an "additive"...an additive is a preservative, which enhances the shelf life of a product or its color. Cane sugar, sugar, brown sugar, etc. do neither. They enhance flavor. High fructose corn syrup which is now in virtually every food that doesn't grow (and is most certainly an additive) is a trend you are more likely to be able to suggest as your "coincidence." I believe it's been increasingly used since the 1970s.

Sugar was used less before World War II ended because there simply wasn't enough produced to go around. High fructose corn syrup (and the other sugar-like additives we added increasingly to the food we eat), which is not made from Hawaiian grown sugar cane but one of country's most abundant vegetable crops -corn!- became more prevalent after that time period because food science advanced and people figured out how to make a sweetener that was extremely adaptive, acted as a preservative, and was extremely CHEAP.

Food scientists became so good at messing around with high fructose corn syrup that they even learned how to put it into things as a preservative alone. The bread on your Starbucks sandwich, for example, might even have high fructose corn syrup in it. Starbucks has recently adjusted the ingredients in some of their foods, however; I couldn't tell you if you walked down the street and picked up a sandwich in the Starbucks refrigerated section that you would still find HFCS in the ingredients list or not.
That is my non-psyhcology-but-still-thread-topic relevant point of the day.

P.S.
I love that you guys are pushing the discussion of research, it's been really interesting to see what articles you've suggested. I only apologize that don't have research to support my thoughts on high fructose corn syrup- I just only have so much time in my day to post!

 

[Therapist4Chnge]

I love that you guys are pushing the discussion of research, it's been really interesting to see what articles you've suggested. I only apologize that don't have research to support my thoughts on high fructose corn syrup- I just only have so much time in my day to post!

No worries!

I don't know everything (though my mom might argue that! ), but I think collectively we can probably cover a bunch of really interesting areas.

My personal opinion of high fructose corn syrup is that it is evil. I haven't done research to define "evil", but I'm pretty sure that is what we'd find.

-t

 

[Neuro-Dr]

There is very limited effects of ingested sucrose in hyperactivity in challenge or elimination studies I've seen.

Wolraich, M.L., Lindgren, S.D., Stumbo, P. J., et. al. (1994). Effects of diets high in sucrose or aspartame on the behavior and cognitive performance of children. New England Journal of Medicine, 330(5), 301-307.

Wolraich, M., Milich, R., Stumbo, P., & Schultz, F. (1985). The effects of sucrose ingestion on the behavior of hyperactive boys. Journal of Pediatrics, 106, 675-682

 

[Duckygirl]

I don't know everything (though my mom might argue that! )...My personal opinion of high fructose corn syrup is that it is evil. I haven't done research to define "evil", but I'm pretty sure that is what we'd find.

T4C- I am with you, I think high fructose corn syrup is pretty awful. I've managed to mostly cut it out of my diet. I just don't even go near foods processed with it. It's nice that you mom might say you knew everything, I'm sure my mom would [lovingly] say the opposite!

There is very limited effects of ingested sucrose in hyperactivity in challenge or elimination studies I've seen.

Thanks for the articles, Neuro-Dr. I'll be reading up!

By the way, I hope no one interpreted my little lesson on the difference between sugar and sugar-like additives to mean that I necessarily support the link of the increase of sugar products and hyperactivity (as the OP had). There is no doubt in my mind that a) hyperactivity most certainly exists and b) diet must play a part in hyperactivity, at least in some children, but beyond that, I claim nothing.

 

[Duckygirl]

All right, all right. I've had enough time now to dig up some background on high fructose corn syrup from the food science aficionado, Harold McGee:

"The 1960s brought the invention of fructose syrups. These start out as plain corn or potato syrups, but an additional enzyme process converts some of the glucose sugars into fructose, which is much sweeter and therefore gives the syrups a higher sweetening power. The solids in standard high-fructose corn syrup are around 53% glucose and 42% fructose, and provide the same sweetness as the syrup's equivalent weight in table sugar. Because high-fructose corn syrups are relatively cheap, soft-drink manufacturers began to replace cane and beet sugars with them in the 1980s, and Americans began to consumes more corn syrups than cane and beet sugar...

Among the usual sweetners available to the cook, corn syrups are alone in providing long carbohydrate molecules that get tangled up with each other and slow down the motion of all molecules in the syrup, thus giving it a thicker cosistency than any but the but the most concentrated sucrose syrups...

Another consequence of corn syrup's viscosity is that it imparts a thick, chewy texture to foods. And because it includes glucose, a water-binding sugar that is less sweet than table sugar, corn syrup helps prevent moisture loss and prolongs the storage life of various foods without the cloying sweetness that honey or sucrose imparts. Finally, all corn syrups are somewhat acid, with a pH balance between 3.5 and 5.5, so in baked foods they can react with baking soda to produce carbon dioxide and thus conrtibute to leavening" (On Food and Cooking: The Science and Lore of the Kitchen, p.677-678).

That's it for now.

 

[Therapist4Chnge]

Very cool, thanks!

-t