
Study: Diet May Help ADHD Kids More Than Drugs - squarepeg
http://www.npr.org/2011/03/12/134456594/study-diet-may-help-adhd-kids-more-than-drugs?sc=fb&cc=fp
======
Zak
_altering your child's diet without a doctor's supervision is inadvisable._

WTF? I'm sure this is just a CYA, but the idea that most people need the
advice of a medical professional to make dietary decisions is absurd. Sure, be
careful about any radical fad diets, but adding or eliminating certain foods
is quite safe. People do that all the time due to price fluctuations,
availability and changing tastes with no ill effects.

~~~
pyre
There's also the possibility that there will be parents that severely restrict
their child's diet in a way that causes malnutrition too...

[edit] Not saying that it's a good reason to make that statement, but that's
what that CYA aspect probably is...

~~~
Vivtek
This shouldn't be downvoted. It's a real risk. It's _easy_ to over-restrict a
child's diet.

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zach
So they basically hypothesized ADHD is often a symptom of a food allergy,
tested that premise and found some strong evidence for it. Just the kind of
straightforward and useful study that somehow never seems to get funding.

Have a glance at the charts in the Lancet PDF (that erikpukinskis helpfully
linked) to see the improvements versus the control group and the way that
reintroducing high-sensitivity foods caused a regression:

[http://marrym.web-log.nl/files/adhd-and-elimination-diet-
rct...](http://marrym.web-log.nl/files/adhd-and-elimination-diet-rct---the-
lancet-2011.pdf)

Wow. If I was a NYTimes health reporter, I would start researching a story on
how up-and-coming young families are requesting food allergy tests for their
seemingly asymptomatic kids as a matter of course, because that's clearly
going to be the trend now.

~~~
gregburek
On page 500, under Discussion: "Blood tests assessing IgG levels against foods
did not predict which foods might have a deleterious behavioural effect. ...
We recorded no difference in behavioural effects after challenge with high-IgG
or low-IgG foods. These results suggest that use of IgG blood tests to
identify which foods are triggering ADHD is not advisable. However, IgG blood
tests might be useful in other diseases."

~~~
zach
I wonder if the IgG test they used is that reliable, though.

It might be that their results are limited by the accuracy of the ImuPro test,
which would be a shame.

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Dn_Ab
The article title is a bit misleading. It looks like they done a blind search
on foods the children ate and by process of elimination found foods whose
removal caused the reduction of ADHD like symptoms from 64% of kids in their
sample. The Two signal paragraphs are:

 _Pelsser compares ADHD to eczema. "The skin is affected, but a lot of people
get eczema because of a latex allergy or because they are eating a pineapple
or strawberries." According to Pelsser, 64 percent of children diagnosed with
ADHD are actually experiencing a hypersensitivity to food. Researchers
determined that by starting kids on a very elaborate diet, then restricting it
over a few weeks' time.

...

"In all children, we should start with diet research," she says. If a child's
behavior doesn't change, then drugs may still be necessary. "But now we are
giving them all drugs, and I think that's a huge mistake," she says._

My questions as someone ignorant of this area are 64% seems a confident
generalization, theres no real physiological basis with respect to
neurochemistry given for what causes these er mental allergies, what foods or
absence thereof created the best results, is this scalable - it seems very
trial&error so susceptible to misapplication and corner cutting and

I don't know how to read the following statement:

> _Also, Pelsser warns, altering your child's diet without a doctor's
> supervision is inadvisable._

~~~
Tichy
I think reaction to food can vary greatly from individual to individual, so
maybe a broad generalization doesn't make sense. Or rather it makes sense to
determine individual problems, rather than broad common problems.

Supposedly they could have created a similar study by just testing a single
problematic food item (I don't know, wheat or whatever), and they should also
have found an effect - only smaller.

It does not seem to outlandish that different things can trigger allergies,
yet all allergic reactions are somewhat similar.

------
squarepeg
Full study here: [http://www.adhdenvoeding.nl/cms/wp-
content/uploads/2011/02/P...](http://www.adhdenvoeding.nl/cms/wp-
content/uploads/2011/02/Pelsser-The-Lancet-2011-Publication-INCA-study.pdf)

~~~
chernevik
Here's a better summary article:

[http://www.theaustralian.com.au/news/health-science/diet-
cha...](http://www.theaustralian.com.au/news/health-science/diet-change-
improved-adhd-childrens-behaviour-lancet-reports/story-e6frg8y6-1226000212800)

~~~
tokenadult
Yes, that article draws attention to the important issue that the study was
not "blind" and thus subject to influence by observer-awareness effects.

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tygorius
After some supplemental reading, the hypothesis of ADD/ADHD symptoms as a
reaction to food allergies has been tested before[1], the authors had done a
previous experiment published back in 2009, and it appears this experiment was
designed to avoid criticisms[2] of past experiments in the field.

[1] <http://www.ncbi.nlm.nih.gov/pubmed/8257176> [2]
<http://www.ncbi.nlm.nih.gov/pubmed/17048717>

~~~
martincmartin
Cool!

Is the full text of [2] available anywhere? I can't seem to find it with web
searches.

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IvarTJ
ADHD has a long history of claims of diets supposedly helping kids with the
diagnosis. It began with the Feingold diet, went on to the Gluten-free/Casein-
free diet, and now apparently exclusion diets. I am rather sceptical.

~~~
zach
That's what makes this study interesting. Instead of a "hey, maybe this works"
regimen, the foods excluded from the diet in this study are individualized
according to the patients' measured allergic response.

It would be interesting to look at the data, even with this small sample, to
see how different the individual diets ended up being.

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juiceandjuice
Some doctors attribute ADHD, particularly the inattentive sort, to actually be
a manifestation of general allergic reactions which really just makes people
tired, and triggers symptoms that would classify a person as having ADHD
according to the DSM (Remember, the DSM generally makes no distinctions as to
what causes a condition, it only diagnoses it.) They often try to treat the
allergies first, which is generally a good start.

I have both ADHD and a mild latex allergy. Ironically, the latex allergy makes
eating almost any fruit shitty (
[http://en.wikipedia.org/wiki/Oral_allergy_syndrome#Cross_rea...](http://en.wikipedia.org/wiki/Oral_allergy_syndrome#Cross_reactions)
)

However, my diet has definitely kept clear of most of these foods when
possible for a long time now (although I really do love avocados), and even
did the fatty fish thing for a while, but symptoms haven't changed for me.

~~~
mshron
The conclusion of the original study is that it isn't an allergic reaction
that is causing the symptoms, but that somehow restricted diets still work.

Their "few-foods diet" was rice, meat, vegetables, pears and water. Then,
based on the needs of the individual kids, likes and dislikes (and maybe their
known susceptibility to various allergens?), etc, potatoes, fruit and wheat
were added.

You could try just sticking with the reduced few-foods diet for a month and
see if symptoms improve.

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elptacek
I read this article on the ketogenic diet and epilepsy a while back:

<http://www.nytimes.com/2010/11/21/magazine/21Epilepsy-t.html>

If I understand correctly, nobody completely understands why these dietary
changes effect such significant benefits. But the results are interesting, to
say the least.

About six years ago, I was forced to change my own diet quite radically. It
has been a huge adjustment, but the process has made me acutely aware of just
how much certain foods can effect me physically and mentally. And, too, how
the physical reaction to certain foods effects me, mentally. So my bias here
is obvious -- it's good to see investigation into possible causes. Especially
when the medications for ADHD are a bit scary.

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ScottWhigham
As a pretty strongly affected ADHD person and as the parent of an extremely
affected seven year old, my experience is that no, diet alone will not help
kids more than drugs. I'm a vegetarian, eat right, work out - all the right
things - and, although they help, they are no replacement for some type of
methylphenidate (i.e. Ritalin or Concerta). I don't need a study to tell me
that "One approach does not work for all people."

Sorry for the rant - I just think it's easy for non-ADHD people to dismiss
ADHD. I see hyper kids who get called "ADD" and then people make
comments/decisions about truly ADHD kids from these people ("Just don't feed
them red dye #10!" (or whatever)).

~~~
tygorius
Read the study, it's not dismissive at all. According to the authors, roughly
1 in 3 kids don't respond to changes in diet.

As someone who recently abandoned methylphenidate for my new BFF bupropion, I
understand the sensitivity to common claims that ADD/ADHD is primarily a lack
of will power or a lack of parental/teacher discipline. But I still believe in
science. Part of my early treatment involved vitamin supplements for serum
deficiencies in iron, B12, and D. Bringing those levels up did not alleviate
the symptoms for me, but I'm open to scientific investigation of reports that
such supplements were a crucial difference for other people.

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Mz
My kids are more ASD rather than ADHD but dietary changes and nutritional
supplements and generally treating previously unrecognized health issues did a
lot for them. While I was really, really sick, I got asked at times if I was
(or accused of being) ASD or ADHD. I have no reason to believe I am either,
though if I am feverish, in pain, throwing up, heavily medicated and so forth,
my attention span and social skills are definitely impaired. Getting healthier
has done a lot for my "social skills" (which I actually have, I just sometimes
am too screwed up to effectively execute) and attention span/ability to focus.

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xpaulbettsx
From an anecdotal perspective, I can tell you that diet has the most
significant effect (either in aggravating or helping) ADD, this is great
advice. With children, it's even worse since any effect that food would have
would be multiplied because they're smaller (just like drugs are dosed way
less)

~~~
xpaulbettsx
Downmod? Care to elaborate?

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TheCowboy
Is this relevant to Hacker News because a significant portion of us are ADD
and need to cut out the bahama mamas from our drink diet?

~~~
Psyonic
We've gotten to the point where damn near any article is argued to be relevant
to Hacker News. Keep fighting the good fight... I'm with you in spirit.

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mkramlich
The OA's theory does not surprise me. Food is just chemicals we put into our
body. Alter the chemicals, alter the effects on behavior and health. And I
wouldn't be surprised that, in addition to the cases where an allergy is
involved, a lot more kids today are getting too much sugar and too much
caffeine, and possibly trace elements from plastics and pesticides and
detergents, and none of the latter group should probably be going into our
bodies at all -- and weren't for the first few million years of our existence
because they didn't exist yet!

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swaits
Filed under "no shit Sherlock".

