Prenatal Exposure to Mercury May Be Linked to ADHD

Mothers beware of your diet

We’re all concerned about contaminants in our environment. We worry about drinking clean water, breathing clean air, and eating non-toxic food. A recent study published online Oct. 8 in Archives of Pediatrics & Adolescent Medicine reveals another possible concern: mercury hidden in fish. The study links mercury exposure in expectant mothers to ADHD symptoms in their children at the age of 8. Mercury is known to affect the human nervous system.

As with other studies of mercury and its possible link to ADHD, the current study “adds to concerns about mercury consumption and to evidence about the benefits of fish consumption,” said Dr. Susan Korrick. Korrick is the study’s co-author and an assistant professor of medicine at Harvard Medical School and Brigham and Women’s Hospital in Boston.  Korrik’s team found that more mercury exposure leads to a higher incidence of ADHD symptoms. However, more fish consumption — the main source of mercury exposure — leads to a decreased risk.

“How much fish you eat is not equivalent to how much mercury you are exposed to,” said Dr. Korrick. “I think the public health conclusion that I would come to is that one can benefit from fish consumption, but it’s important to try to consume fish that are low in mercury.” Fish high in mercury include swordfish,shark, and fresh tuna. Fish with lower levels of mercury include salmon, haddock, shrimp, and cod.

Korrick and her reviewed data on children at age 8 from the New Bedford, Mass., area who were born between 1993 and 1998. New Bedford is on Massachusetts’ coast and is a fishing community where fish consumption is popular. Fish consumption is a primary source of mercury. Korrick’s team investigated whether greater mercury exposure before birth, prenatal exposure via mothers’ wombs, might lead to more behavioral problems in kids later in life.

The researchers tested the children and evaluated teacher reports. The researchers found that some children of mothers who had the highest levels of mercury before birth were 40 percent to 70 percent more likely to have the behavioral problems.

There are flaws to the research because of its design. It doesn’t prove that mercury is directly responsible for the behavioral problems or ADHD although prior studies have found links. Also, children in the study were not actually diagnosed with ADHD because the study only looked at ADHD symptoms. Better to be safe than sorry regarding mercury consumption.

Diet and ADHD Symptoms

The February 5, 2011 issue of The Lancet reports that researchers in the Netherlands and Belgium were able to significantly reduce ADHD symptoms through restrictive dietary measures.

This theory has long been advocated by such notable groups as The Feingold Association (http://www.feingold.org/). However, their studies have been limited to smaller groups and anecdotal evidence. While their findings have been compelling, medical doctors and adversarial attacks by the processed food industry quashed overall acceptance of dietary restriction. The NIMH give only limited credence to the theory.

Feingold and other advocates of the restrictive diet have suggested that the introduction of food additives can affect the human immune system sometimes causing reactions like hyperactivity, inattention, and even eczema, asthma and gastrointestinal problems. In light of research about food colorings and hyperactivity, the British have taken steps to eliminate certain preservatives and food dyes from their food supply.

The study published in the Lancet was funded by Foundation of Child and Behaviour, Foundation Nuts Ohra, Foundation for Children’s Welfare Stamps Netherlands, and the KF Hein Foundation.  The researchers placed  100 children from Belgium and the Netherlands into two groups: one that received the restrictive diet and the other that only received advice on healthy eating habits. The group that received only advice on healthy eating was the control group. All of the children had been diagnosed with ADHD and were between the ages of 4 and 8.

The children were placed on the restrictive diet for a period of five weeks. They were allowed to eat only rice, meat, vegetables, pears and water. Later, the children were allowed to additionally consume potatoes, fruits and wheat. The researchers assessed ADHD symptoms during this period.

Over the course of the next four weeks, researchers reintroduced processed foods into the restricted diet group. The researchers selected foods that were previously considered to negatively affect body or immune responses.

Nine children withdrew from the restrictive diet group. Attrition in all studies is common. Of the forty-one children who completed the restrictive diet program, 78 percent had a reduction in their ADHD symptoms, compared with no improvement in the controls. Assessment was performed using an ADHD symptom scale that ranges from 0 to 72 points. Higher scores in the scale indicate more severe symptoms. The average reduction was 24 points, a significant reduction.

Thirty children who demonstrated decreased ADHD symptoms resulting from the restrictive diet were selected for reintroduction of foods outside the restrictive diet. This was deemed the ‘challenge test.’ Nineteen of the thirty children had a relapse in symptoms on the challenge test. Sensitivity to foods thought to produce high immune response didn’t seem to produce any greater negative effects than foods thought to produce lower immune response.

Limitations of the study include restriction to ADHD; it cannot be discerned whether it would apply to ADD. Secondly, not all children responded to the restrictive diet. Of those who did respond, responses to foods seemed to be equal no matter what processed food was introduced back into the diet. Additionally, under this research design, it was not possible to have a blind control; parents knew what group their child was in. If they also knew the expected outcome of the study, it might have influenced the outcome.

On the practical side, the restrictive diet is very difficult to follow consistently. However, if your child seems to respond well when you remove certain processed foods, this research seems to support your observation although the certainty about diet and ADHD symptoms has not been clearly established by this study.

ADHD and the Western diet

A study published online in the international Journal of Attention Disorders examines the possible link between ADHD and a ‘Western-style’ diet in children.

The study was conducted by Perth’s Telethon Institute for Child Health Research in Australia. The researchers found that a diet typically consumed in the Western world consisting of ‘fast foods,’ sugar/corn syrup, processed meats and flour, fried, and refined foods nearly doubled the risk of an ADHD diagnosis. This Western diet is rich in total fat, saturated fat, refined sugar and sodium.

“We found a diet high in the Western pattern of foods was associated with more than double the risk of having an ADHD diagnosis
compared with a diet low in the Western pattern, after adjusting for numerous other social and family influences. We looked at the dietary patterns amongst the adolescents and compared the diet information against whether or not the adolescent had received a diagnosis of ADHD by the age of 14 years. In our research, 115 adolescents had been diagnosed with ADHD, 91 boys and 24 girls,” says Associate Professor Wendy Oddy.

The Perth researchers analyzed the dietary patterns of 1800 youth and separated them as having  ‘Healthy’ or ‘Western’ patterns. A diet rich in fresh fruits and vegetables, whole grains and fish was designated as a healthy pattern.

Dr. Oddy added, “When we looked at specific foods, having an ADHD diagnosis was associated with a diet high in takeaway foods, processed meats, red meat, high fat dairy products and confectionary. We suggest that a Western dietary pattern may indicate the adolescent has a less optimal fatty acid profile, whereas a diet higher in omega-3 fatty acids is thought to hold benefits for mental health and optimal brain function. It also may be that the Western dietary pattern doesn’t provide enough essential micronutrients that are needed for brain function, particularly attention and concentration, or that a Western diet might contain more colors, flavors and additives that have been linked to an increase in ADHD symptoms. It may also be that impulsivity, which is a characteristic of ADHD, leads to poor dietary choices such as quick snacks when hungry.”

Of note, the scientists were unable to determine if poor diet causes ADHD or ADHD leads to poor dietary choices and cravings – a problem of antecedence.  Furthermore, the researchers had to determine and adjust for social and family influences. This, in itself could greatly skew final data. 

The British have performed similar studies examining the role of refined or processed foods and ADHD.  Certain food colorings were found to influence hyperactivity.  Knowing this, in addition to research that indicates better cognitive function through better diet, it would be wise to greatly reduce or totally extinguish consumption of fast food, refined and processed foods, etc. if one wishes to maximize one’s cognitive potential.

Diet alone will not solve the ADHD riddle. Cognitive training, memory training, behavioral shaping, and attention training are key ingredients to the solution.

Omega 3 Fatty Acids (Fish Oils) and ADHD

While the topic of nutrition & ADHD is contentious, omega 3s have gained ground in the relief of ADHD symptoms.

Respectable studies from Goteborg University in Sweden, University of South Australia, and Oxford University in the United Kingdom have shown that omega 3 fatty acids have reduced symptoms by as much as 50%. A more recent Norwegian study produced similar results.

In the study performed at the University of South Australia, children were divided randomly into three groups for the first 15 weeks of the study. One group was given a fish oil & primrose oil combination; the second took the same combination plus a multivitamin/mineral supplement, and the third group took a placebo. During the second 15 weeks, the kids on the placebo were given the fish oil & primrose oil combination plus the multivitamin/mineral as well.

While the studies received little press, the results were quite good for the two 30-week fish-oil groups. They demonstrated 40%- 50% improvement in behavior while the 15-week group showed a 30% – 40% percent improvement.

Ritalin and Concerta are the drugs most often prescribed for ADHD. The results actually were far better for fish oil when compared with results of studies of Ritalin and Concerta. Fish oils were more effective.

Let me make it clear that fish oil will not cure ADHD. Could it possibly mitigate symptoms for you? Possibly. According to Dr. Andrew Weil  “Levels of omega-3s in the plasma and red blood cells of children with ADHD are lower than in kids who don’t have the disorder.”

As attention issues are only the tip of the ADHD iceberg, it’s not a good idea to use fish oils as your only intervention. I strongly recommend using Play Attention; a cognitive program to improve attention, memory, visual tracking, time on-task, motor skills, and discriminatory processing.

ADHD and Food Additives: European Food Standards Agency calls for ban on six artificial colors

For years, parents have complained that certain artificial additives to brightly colored cakes, soft drinks, and candies, had caused their children adverse reactions such as hyperactivity, skin problems, mood volatility, headaches, etc. after consumption.

The Food Standards Agency (“FSA”) recommended ministers call for manufacturers to remove six artificial colors by the end of 2009. The FSA also urged a European Union-wide ban. This reversed the FSA’s decision last month when it dismissed calls for action on the additives.

According to The Independent, “The FSA’s advice to parents will be strengthened to warn them about the dangers of the E-numbers tartrazine (E102), quinoline yellow (E104), sunset yellow (E110), carmoisine (E122), ponceau 4R (E124) and allura red (E129).”

The Independent further reports that, “These colors and the preservative sodium benzoate (E211) were linked to hyperactivity in a £750,000 study by Southampton University, which found they made primary school children become distracted and fail a computer attention test.

The researchers estimated that 30 per cent of cases of attention deficit hyperactivity disorder (ADHD) would be prevented if companies removed the colors used in the £13bn-a-year global additives industry.

If the ministers elect to have the dyes and additives banned, the UK’s biggest producers of confections, soft drinks, ice cream, and others will have to reformulate their products.

The Independent:

The Southampton researchers had warned the seven additives were as harmful as lead in petrol, which was banned after it proved to lower children’s IQ by five points. Their research, in The Lancet in September, was the evidence that artificial additives worsened the behavior of normal children as well as those diagnosed with ADHD.

Dame Deirdre Hutton, who chairs the Food Standards Agency, said: “It is the agency’s duty to put consumers first. These additives give color to foods but nothing else. It would therefore be sensible, in the light of the… study, to remove them.”

The board decided to take no action on sodium benzoate because it was “a preservative” rather than a color. E211, which is linked with other potential health problems, is found in many soft drinks including Diet Coke, Irn-Bru, Lucozade and Fanta, and its removal would pose a significant technological and financial challenge to drinks companies.

The FSA stressed that its decision “does not mean there is an immediate ban”.

Campaigners welcomed the first decisive move in the UK against additives, whose effect on hyperactive children were first identified in 1975. Richard Watts, of the Children’s Food Campaign, said: “This decision is good news for children and parents, who have known for many years that these additives affect children’s behavior.” Anna Glayzer, an Action on Additives campaigner, said the FSA had put the consumer first. “We will be keeping a close eye on the industry to see what effect the voluntary ban has.”

The Food and Drink Federation said the recommendation was “bizarre”, as manufacturers were already removing the additives. “[Most] products don’t contain these colors,” a statement said.

The six colorings facing a ban:

Tartrazine (E102)
Description:
Synthetic yellow dye found in sweets, biscuits, mushy peas
Products:
Disney Winnie the Pooh Cake Kit, Lidl orange jelly, Bacardi Breezer tropical lime, Asda mushy peas
Health effects:
causes hyperactivity, linked to allergic reactions and migraine.

Quinoline Yellow (E104)
Description: Synthetic dye in sweets, pickles, smoked fish
Products: Aero orange, Galaxy Minstrels, M&Ms, Bassett’s Sherbet Lemons
Health effects: Causes hyperactivity and is linked to rashes. Banned in US.

Sunset Yellow (E110)
Description: synthetic yellow dye found in sweets, ice cream, fizzy drinks
Products: Cadbury Creme Egg, Haribo Jelly Beans, Irn-Bru
Health effects: causes hyperactivity and linked to stomach upsets and swelling of skin.

Carmoisine (E122)
Description: Synthetic red dye found in ready meals, sweets
Products: Love Hearts, Galaxy Minstrels, Cadbury Mini Eggs, various lollipops
Health effects: causes hyperactivity and is alleged to cause water retention in those allergic to aspirin. Banned in US.

Ponceau 4R (E124)
Description: synthetic red dye found in sweets, biscuits, drinks
Products: Bassett’s Pear Drops, Halls Blackcurrant Soothers, Supercook Alphabet Icing
Health effects: causes hyperactivity and is believed to cause problems for asthmatics. Banned in US.

Allura red (E129)
Description: synthetic red dye found in sweets, soft drinks, Turkish delight
Products: Fry’s Turkish Delight, Cadbury Mini Eggs, Maynards Wine Gums
Health effects: causes hyperactivity and may bring on allergic reactions.