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Reprinted from Food Insight Taking the Hype Out of Hyperactivity
Winter 1988
Its symptoms are often described as nervousness, aggressiveness, impulsive behavior, short attention span, "ants in the pants," and even "bouncing off the wall."
And next to child care, it seems to be the most popular topic of discussion whenever parents of toddlers and elementary school children get together. In reality, hyperactivity or attention deficit-hyperactivity disorder (ADHD) affects a small percentage of children in the United States. Medical authorities estimate about 5 million children are affected to varying degrees. It begins by the age of seven and is 10 times more common in boys than girls. Because the cause and cure for this condition continue to be elusive, it remains a frustration to parents, physicians, educators, and school counselors, as well as its young victims alike.
Childhood hyperactivity is not a new condition. Accounts of the disorder have been documented in the medical literature as far back as the 1880s. Today, scientists believe that ADHD is probably caused by a combination of certain genetic, environmental, neurological and biochemical factors. Because there is no known cure for this disorder, treatment usually involves multiple approaches, often a combination of medication, psychological intervention and modification of the child's environment.
Dietary modification has sometimes been recommended in treating hyperactivity. Although this approach has received much publicity, scientific evidence does not support a connection between diet and hyperactivity.
Feingold Elimination Diet
In the 1970s, Dr. Benjamin F. Feingold, a pediatric allergist in San Francisco, claimed that childhood hyperactivity was caused by food colors, artificial flavorings and preservatives. He prescribed a diet eliminating these ingredients, as well as other foods containing natural chemicals called salicylates, including almonds, cucumbers, tomatoes, apples and berries. Based on anecdotal reports, Feingold stated that up to 50 percent of children on such a restricted regimen improved during treatment. Needless to say, this created quite a stir as Feingold had singled out common everyday food substances that most every child consumed regularly.To test the Feingold hypothesis scientifically, the Nutrition Foundation supported a variety of research studies using experimental and control diets. After reviewing the results of seven independent studies involving approximately 200 subjects, the Foundation's National Advisory Committee on Hyperkinesis and Food Additives concluded in 1980 that there was no evidence linking artificial food colors, flavors, or preservatives to hyperactivity or learning. The committee reported that dietary restriction was sometimes beneficial because of the "placebo" effects of the treatment. In other words, it sometimes worked because people believed it would or because of increased involvement and attention of family members.
In January 1982, the National Institutes of Health also convened a panel of biomedical investigators, practicing physicians, consumers and advocacy groups to examine available evidence on hyperactivity. The 13-member consensus development panel concluded that controlled scientific studies do no support, the claim that food additives, colorings, or preservatives cause hyperactivity. The NIH panel also stated that special restriced diets should not be used universally to treat hyperactivity, since there is no evidence to predict which children may benefit.
Sweeteners
Other food ingredients sometimes suspected of causing childhood hyperactivity include nutritive and non-nutritive sweeteners. Many parents, for example, claim their children are "sugar responders," exhibiting uncontrollable behavior after eating foods containing sugar.In November 1984, the relationship between sugar consumption and hyperactivity was examined as part of the symposium, "Diet and Behavior: A Multidisciplinary Evaluation," sponsored by the American Medical Association and the International Life Sciences Institute. Studies reported at the meeting indicated that sugar does not aggravate hyperactivity or behavioral problems in children. Many behavioral researchers now believe that consuming sugary foods can, if anything, have a calming effect.
After examining all the available scientific data, the Food and Drug Administration's Sugars Task Force concluded in 1986 that there is no evidence that sugar consumption causes behavioral changes in normal children or adults.
Studies also have been conducted on the relationship between low-calorie sweetener consumption and childhood behavior. National Institutes of Health researcher Dr. Markus Kruesi and colleagues conducted a double-blind study in which 30 children, identified by their parents as sugar responders, were given large doses of sucrose, glucose, saccharin and aspartame.
Regardless of the substance given, no differences were noted by parents, trained observers or electronic monitoring in terms of hyperactivity, aggressive behavior or emotional reactions. Carefully controlled scientific studies such as these have failed to demonstrate a relationship between hyperactivity and artificial colors, artificial flavors, preservatives, sugar, aspartame or saccharin. Although special restricted diets may prove helpful to a small number of children, experts advise they should not be prescribed as standard therapy.
Study Shows Some Educators' Beliefs Not Based on Medical Evidence
A new study published in the August 1988 issue of the Annuals of Allergy reports that despite medical evidence to the contrary, many teachers continue to believe that sensitivity to certain foods can have a direct impact on learning and behavior in school.Because of increasing numbers of parents requesting food hypersensitivity testing for children having difficulty in school, two University of Louisville professors surveyed some 200 local teachers and student teachers to determine if their attitudes reflected this opinion.
"This survey of teachers indicates their strong conviction of the role of certain foods, especially those containing sugar, in influencing such behaviors as attention, alertness, motivation, concentration and activity level," the authors wrote. "These data suggest the need for improved communication between the medical and educational communities to prevent inappropriate responses to school-related problems and misreferrals to physicians for primarily educational problems."
The study was conducted by James A. McLoughlin, Ph.D., professor in special education and associate dean of the School of Education, and Michael Nall, M.D., clinical assistant professor in the Department of Pediatric Allergy. "The danger inherent in the food/school learning connection is that teachers and parents will overlook the more obvious reasons why children are not learning and are misbehaving: inappropriate instructional techniques, unmotivating teachers and parents, and inconsistent behavior management techniques. "Sometimes it is easier to blame the children for the problem and change their diet than examine and modify instructional and parenting strategies," they wrote.
Reprinted from the International Food Information Council Foundation, 1988
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