Attention deficit disorders and children

ABSTRACT: How do you know whether your child suffers from ADD/ADHD? Sometimes it can be difficult to tell. There is a general list of symptoms associated with inattention and hyperactivity-impulsivity.

Nutrition is highly important in children and often these symptoms may appear due to poor nutrition. High energy foods such as deep fried foods, and fluctuating sugar levels can cause mood swings and poor behaviour in some children. A balanced diet containing fish oil and other healthy fats, proteins (and amino acids), complex carbohydrates and adequate vitamins and minerals can be all that is required to turn a poorly behaved, difficult and unhappy child, into a happy and healthy child.

KEYWORDS: attention deficit disorder, ADD, ADHD, Kids Intelligent, IQShield


How do you know whether your child suffers from ADD/ADHD? Some children can just be very active and energetic, only slowing down as they grow. There are others however, that may be ‘wired’ differently.

If you think your child suffers from Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), you may be relieved to know that they are normal, however, some children may have a specific learning disability that prevents them from taking in information and sorting it out in the same way that other children do.

All is not lost however. In a healthy and loving environment, along with training and assistance, many learning disabilities can be overcome.

Does My Child Suffer from ADD/ADHD?
A diagnosis of ADD/ADHD is usually made using the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This is a reference source used by healthcare practitioners to assess the main symptoms. Genetic and behavioural risk factors are also taken into account, along with other criteria such as diet and exposure to chemicals including toxins and prescription medicines.

To be diagnosed as suffering from ADD/ADHD, a child needs to exhibit at least six of the symptoms for inattention or at least six of the symptoms of the combined hyperactivity-impulsivity list to a degree that interferes with daily life.

Symptoms of Inattention
• Often ignores details, makes careless mistakes 
• Often has trouble sustaining attention in work or play 
• Often does not seem to listen when directly addressed 
• Often does not follow through on instructions; fails to finish 
• Often has difficulty organising tasks and activities 
• Often avoids activities that require a sustained mental effort
• Often loses things he/she needs 
• Often gets distracted 
• Is often forgetful in daily activities

Symptoms of Hyperactivity-Impulsivity
Hyperactivity 

• Often fidgets or squirms 
• Often has to get up from seat 
• Often runs or climbs when he or she shouldn’t 
• Often has difficulty with quiet leisure activities 
• Often “on the go” as if driven by a motor 
• Often talks excessively

Impulsivity 
• Often blurts out answers before questions have been completed 
• Often has difficulty waiting his/her turn 
• Often interrupts or intrudes on others.

This is quite a generalised list, and everyone may be able to relate to some of these feelings at one time or another. When children are experiencing fast growth spurts, it is important to ensure that they are receiving enough minerals, in particular calcium, zinc, magnesium and possibly iron. As it is often a time when it may be difficult to provide children the nutrition they need, a nutritional supplement should be considered.

Nutritional Requirements
If a healthcare professional has diagnosed a child with ADD or ADHD, as mentioned earlier, there are ways to improve the situation and bring out the best in your child. The first thing to consider is the child’s diet.

Surprisingly, sugar is not considered to be a contributing factor to ADHD. Eliminating sugar from your child’s diet is unlikely to cause a significant improvement over time.

Some children however, have a propensity towards the condition. That is, these children have not been diagnosed with ADD/ADHD, however they have some symptoms of ADD/ADHD or in the least have a tendency towards to the condition. These children have been found to do better when dietary triggers are removed. These triggers may include artificial colourings, flavourings, preservatives, refined carbohydrates and “junk” food generally. Food sensitivities, allergies and intolerances may also act as a trigger. A common sensitivity is to wheat for instance, while some children may tolerate other types of grain such as spelt, kamut, millet and rice.

Any blood sugar irregularities can lead to mood swings, so this should be investigated. As food intolerances can be caused by reactive or inflammatory bowel states, it is essential to address any digestive problems which can lead to malabsorption of nutrients that have particular implications in ADD/ADHD. Simply giving a supplement of a probiotic containing Lactobacillus acidophilus and Bifidobacterium animalis for improved intestinal function can bring about an improvement in nutrient levels.

It is recommended however, that any dietary changes are done in consultation with a naturopath, dietician or other health professional experienced in ADD/ADHD who can give guidance so that any restrictions do not cause deficiencies in other areas.

Nutrients to consider
Studies have shown the benefits of the following nutrients, in particular DHA, acetyl-L-carnitine, zinc, folic acid and bacopa, in child mental development and behaviour – improving attention, concentration, learning, cognition, memory, emotional intelligence, and symptoms related to mood, anxiety and stress.

• Fish Oils: the increased need for the essential fatty acids in people with ADD/ADHD has been extensively studied. Research suggests that some hyperactive children have a deficiency of omega-3 essential fatty acids, in particular docosahexaenoic acid (DHA). DHA is found in fish oils, and is incorporated into neural and eye cell structure, making up to 60% of these structures. DHA is essential for mental development (cognition, learning, attention, concentration and memory; and emotional intelligence – mood and behaviour), as well as eye, cardiovascular, and immune system development and maintenance.
• Acetyl-L-Carnitine is an antioxidant, with neuroprotective and growth factor regulating properties. Involved in brain development, maintenance and function, benefits have been seen in attention, memory, anxiety and impulsive behaviour. 
• Zinc is required for cell health as well as for the metabolism of DHA and eicosapentaenoic acid (EPA) essential fatty acids. Children who have been diagnosed with ADD or ADHD have been observed to have lower levels of this vital mineral. 
• B complex vitamins, B1, B2, B3, B6, B9 (folic acid) and B12 are indicated for healthy metabolism and support of the nervous system, especially in growing children. 
• Bacopa monnieri / Brahmi is an antioxidant that enhances neurotranmission (neural cell communication), neuron repair, and supports new neuron growth. This assists learning, memory and concentration, while also reducing symptoms of depression and anxiety. 
• Iron deficiency can lead to anxiety, aggressiveness and poor attention span, and any deficiency should be investigated and addressed. The frequent occurrence of ‘restless legs syndrome’ in children with ADHD may be associated with iron deficiencies.
• Magnesium deficiency has implications for the nervous system. In children with ADHD and magnesium deficiency, magnesium has been shown to cause a decrease in hyperactivity. 
• Calcium is synergistic with magnesium and important for the nervous system. Children can easily become deficient in calcium at times of accelerated growth.

Therapies
Counseling, play therapy and behaviour modification therapy and information on educational intervention should be considered to provide strategies and tools for coping with, and understanding, some of the behaviours associated with ADD/ADHD. Support groups can provide invaluable information and assistance.

Summary of Recommendations:
• Address any digestive disturbances which may contribute to nutrient deficit 
• Address food intolerances 
• Supplement specific nutrients at an age-appropriate dosage, and ensure that medication, or combinations of medications, are not the cause of the condition (if in doubt, seek advice from your healthcare practitioner)
• Seek counseling and appropriate additional therapy (e.g. cognitive therapy, behaviour modification)

Following these tips may assist you and your child, particularly if you have any concerns regarding your child’s behaviour. If you have tried the above diet options and nutritional supplements, and find that they are inadequate, or if you have other concerns, then consult your healthcare practitioner.

Kidd, PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev. 2007 Sep;12(3):207-27. 
Helland IB, et al. Maternal Supplementation With Very-Long-Chain n-3 Fatty Acids During Pregnancy and Lactation Augments Children’s IQ at 4 Years of Age. Pediatrics 2003;111;e39-e44
Richardson, AJ, Montgomery P. The Oxford-Durham Study: A randomised, controlled trial of dietary supplementation with fatty acids in children with developmental coordination disorder. Pediatrics (2005) 115:1360-1366
Nemets H et al. Omega-3 treatment of childhood depression: A controlled, double-blind pilot study. American Journal of Psychiatry (2006) 163:1098-1100. 
Amminger GP et al. Omega-3 fatty acids supplementation in children with autism: A double-blind, randomized, placebo-controlled pilot study. Biological Psychiatry (2007) 61:551-553. 
Seddon JM, et al. Dietary fat and risk for advanced age-related macular degeneration. Arch Ophthalmol. 2001 Aug;119(8):1191-9.
Cho E et al. Prospective study of dietary fat and the risk of age-related macular degeneration. American Journal of Clinical Nutrition (2001) 73(2):209-218
Peat JK et al. Three-year outcomes of dietary fatty acid modification and house dust mite reduction in the Childhood Asthma Prevention Study. Journal of Allergy and Clinical Immunology (2004) 114:807-813.
Schiano V et al. Omega-3 polyunsaturated fatty acid in peripheral arterial disease: Effect on lipid pattern, disease severity, inflammation profile, and endothelial function. Clin Nutr. 2008 Jan 29 
Tziomalos K, Athyros VG, Mikhailidis DP. Fish oils and vascular disease prevention: an update. Curr Med Chem. 2007;14(24):2622-8.
Surette ME. The science behind dietary omega-3 fatty acids CMAJ. 2008 Jan 15;178(2):177-80.
Stough et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology. 156:481-484. 
Paulose CS, et al. Neuroprotective Role of Bacopa monnieri Extract in Epilepsy and Effect of Glucose Supplementation During Hypoxia: Glutamate Receptor Gene Expression. Neurochem Res. 2007 Oct 18 
Dhanasekaran M, et al. Neuroprotective mechanisms of ayurvedic antidementia botanical Bacopa monniera.
Phytother Res. 2007 Oct;21(10):965-9.
Khan R et al. Decreased glutamate receptor binding and NMDA R1 gene expression in hippocampus of pilocarpine-induced epileptic rats: Neuroprotective role of Bacopa monnieri extract. Epilepsy Behav. 2008 Jan;12(1):54-60.
Pawar RS et al. Glycosides of 20-deoxy derivatives of jujubogenin and pseudojujubogenin from Bacopa monniera.
Planta Med. 2007 Apr;73(4):380-3. 
Jyoti A, et al. Bacopa monniera prevents from aluminium neurotoxicity in the cerebral cortex of rat brain. J Ethnopharmacol. 2007 Apr 20;111(1):56-62.
Blumenthal M, etal. (eds) (2000) Herbal Medicine – Expanded Commission E monographs, American Botanical Council, Austin, Texas.
Roodenrys S, et al. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacology. 2002 Aug;27(2):279-81. 
Raghav S, etal. Randomized controlled trial of standardized Bacopa monniera extract in age-associated memory impairment. Indian J Psychiatry 2006;48:238-242 
Penland, J.G., Lukaski, H.C., Gray, J.S. Zinc fortification and cognitive and psychosocial function in young adolescents. Federation of American Societies for Experimental Biology Journal. 17:A1087.
Maylor EA, et al. Effects of zinc supplementation on cognitive function in healthy middle-aged and older adults: the ZENITH study. Br J Nutr. 2006 Oct;96(4):752-60. 
Bhatnagar S, Taneja S. Zinc and cognitive development. Br J Nutr. 2001 May;85 Suppl 2:S139-45. 
Tubek S Role of zinc in regulation of arterial blood pressure and in the etiopathogenesis of arterial hypertension. Biol Trace Elem Res. 2007 Summer;117(1-3):39-51.
Dey Sarkar P, et al. Study of oxidative stress and trace element levels in patients with alcoholic and non-alcoholic coronary artery disease. Indian J Physiol Pharmacol. 2007 Apr-Jun;51(2):141-6.
Block G et al. Usage patterns, health, and nutritional status of long-term multiple dietary supplement users: a cross-sectional study. Nutr J. 2007 Oct 24;6:30.
Kazemi-Bajestani SM, et al. Serum copper and zinc concentrations are lower in Iranian patients with angiographically defined coronary artery disease than in subjects with a normal angiogram. J Trace Elem Med Biol. 2007;21(1):22-8. 
Age-Related Eye Disease Study Research Group. A Randomized, Placebo-Controlled, Clinical Trial of High-Dose Supplementation With Vitamins C and E, Beta Carotene, and Zinc for Age-Related Macular Degeneration and Vision Loss: AREDS Report No. 8. Archives of Ophthalmology. 2001 October;119:1417-1436 
Mochizuki K, et al. Improvement of scotopic electroretinograms and night blindness with recovery of serum zinc levels. Jpn J Ophthalmol. 2006 Nov-Dec;50(6):532-6. 
Sazawal S, et al. Zinc supplementation reduces the incidence of acute lower respiratory infections in infants and preschool children: A double-blind, controlled trial. Pediatrics (1998) 102(1):1-5 
Prasad AS, et al. Antioxidant effect of zinc in humans. Free Radic Biol Med. 2004 Oct 15;37(8):1182-90. 
Duchateau J, et al. Influence of oral zinc supplementation on the lymphocyte response to mitogens of normal subjects. Am J Clin Nutr. 1981 Jan;34(1):88-93. 
Clarke, R., et al. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer's disease. Arch Neurol. 55(11):1449-1455. 
Corrada MM, et al. Reduced risk of Alzheimer’s disease with high folate intake: The Baltimore Longitudinal Study of Aging. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, July 2005 (Vol. 1, Issue 1, Pages 11-18. Malaguarnera M, et al. Homocysteine, vitamin B12 and folate in vascular dementia and in Alzheimer disease. Clin Chem Lab Med. 42(9):1032-1035. 
Ravaglia G, et al. Homocysteine and folate as risk factors for dementia and Alzheimer disease. Am J Clin Nutr. 82(3):636-643. 
Murakami K, et al. Dietary intake of folate, other B vitamins, and omega-3 polyunsaturated fatty acids in relation to depressive symptoms in Japanese adults. Nutrition. 2008 Feb;24(2):140-7. 
Tolmunen T, et al. Dietary Folate and the risk of depression in Finnish middle-aged men. A prospective follow-up study. Psychother Psychosom. 73(6):334-339 
Morris MS, et al. Depression and folate status in the US Population. Psychother Psychosom. 2003 Mar-Apr;72(2):80-7. 
Durga J, et al. Effect of 3-year folic acid supplementation on cognitive function in older adults in the FACIT trial: a randomised, double blind, controlled trial. Lancet. 2007 Jan 20;369(9557):208-16. 
Bryan J, Calvaresi E. Associations between dietary intake of folate and vitamins B-12 and B-6 and self-reported cognitive function and psychological well-being in Australian men and women in midlife.
J Nutr Health Aging. 2004;8(4):226-32. 
Hudson S and Tabet N. Acetyl-L-carnitine for dementia. Cochrane Database of Systematic Reviews (2003) Issue 2. Article No.: CD003158. 
Passeri, M, et al. Mental impairment in ageing: selection of patients, methods of evaluation and therapeutic possibilities of acetyl-L-carnitine. Int J Clin Pharmacol Res. 1988; 8(5): 367-76. 
Martindale: The Complete Drug Reference © 2005 The Pharmaceutical Press. 
Montgomery SA, et al. Meta-analysis of double blind randomized controlled clinical trials of acetyl-L-carnitine versus placebo in the treatment of mild cognitive impairment and mild Alzheimer's disease. Int Clin Psychopharmacol. 2003 Mar;18(2):61-71
Santina A, et al. Mechanisms of Ischemic Neuroprotection by Acetyl-L-carnitine. Ann N Y Acad Sci. 2005 Aug;1053:153-61.

Comments are closed.