ADHD — It’s all in the hands

Posted by on April 5th, 2011 | Comments off

Can certain hand movements reveal ADHD?

Two studies, both funded by the U.S. National Institutes of Health and published in the Feb. 15 issue of the journal Neurology, reveal that ADHD children have a greater amount of unintentional hand movement than children not labeled ADHD.

Researchers from Cincinnati Children’s Hospital Medical Center and the Kennedy Krieger Institute in Baltimore performed joint research using sequential finger-tapping experiments on children with ADHD. The researchers found that ADHD children exhibited more than twice the amount of unintentional movements than typical children on one of the two tests used.

Additionally, the researchers measured cortical inhibition with magnetic pulses (transcranial magnetic stimulation or TMS) and compared the results to children without ADHD.

Let’s do a little brain anatomy here to make things clearer. The cortex is a layer or sheet of neural tissue that is outermost to the cerebrum. The cortex is responsible for attention, memory, consciousness, thinking, perceptual awareness, and language. The motor cortex is a term that describes regions of the cerebral cortex. The motor cortex plays a key role in the planning, control, and execution of voluntary motor functions (like hand movement).

Cortical inhibition is a term used to describe the cortex’s ability to control these functions.  By using magnetic pulses directed across the cortex, the researchers discovered that children with ADHD were less able to inhibit their hand movements than children without ADHD. ADHD children presented unintentional hand movements about 40 percent more of the time than children without ADHD.

“We now have a real, quantifiable measure of a problem with controlling behavior in these children,” said Dr. Stewart Mostofsky, primary author of the study performed at the Kennedy Krieger Institute.

“From a clinical standpoint, the critical issue is … they do have differences with these aspects of normal motor control,” Mostofsky said. “We have to recognize that and account for that in considering how to work with children with ADHD.”

Notably, ADHD children that presented the greatest inability to inhibit their hand movement usually received more severe parental reports of hyperactivity and impulsivity.

The question obviously missing is, “What is the significance of these two studies?” They do not provide any direct applications for either diagnosis or treatment of ADHD. Could any parent with an ADHD child tell the researchers that their ADHD child could not control himself like other children his age? The answer is likely a resounding, YES!

The studies do identify patterns of inhibition control. This has been documented in previous studies and is a known factor in ADHD. Could the researchers develop a diagnostic tool based on inhibition control? Yes. As a matter of fact, this type of measurement is commonly obtained in a Computerized Performance Test or “CPT.”

The CPT typically flashes a letter, number, or symbol on a computer screen. The student is tasked to press the space bar or mouse when a preselected number, letter, or symbol appears on the screen. The computer will measure how many times the student clicks correctly, incorrectly, unnecessarily, or impulsively. A wide variety of data are obtained from a CPT. Yet they can only be part of a comprehensive evaluation for evidence of ADHD as so many variables are involved that may mimic ADHD.

So, while studies like the finger tapping study are interesting, they do not provide significant insight into the field nor do they provide basis for a single method of diagnosis. One may wonder why we fund such studies given what is already known in the field.

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Creativity and ADHD

Posted by on March 3rd, 2011 | Comments off

For many years, pundits have declared that although ADHD causes many hardships, it does have a side benefit: creativity.

Previous research has suggested that adults with ADHD may be more creative than adults without ADHD (White & Shah, 2006).

A current study by professors Holly White (University of Memphis, TN) and Priti Shah (University of Michigan, MI) replicated these previous findings. The study was published in the Journal of Personality and Individual Differences (January 2011).

To the skeptic, “creativity” is a nebulous term. Like art, what is creative to one person is not creative to another. Thus, standardized tests were developed that focus on qualitative and quantitative areas of creativity called “divergent” and “convergent” thinking. Divergent thinking is the brain’s ability to produce out of the box, spontaneous, and frequently, original ideas or solutions. Convergent thinking, as the name implies, is the antithesis of divergent thinking. Convergent thinking is the brain’s ability to dispense with non-essential data, move to the heart of the problem and quickly parse options to find one correct solution. Convergent thinking is the type of skill needed for most standardized testing. It would not be helpful if you were a marketing specialist thinking of new ideas for your client.

White and Shah recruited  30 university students with ADHD and 30 without. They used a standardized measure of creativity called the Abbreviated Torrance Test for Adults (Goff & Torrance, 2002). In addition to the Abbreviated Torrance Test, the students completed the Creative Achievement Questionnaire ("CAQ"). This questionnaire asks highly specific questions about achievements in 10 creative domains among which include science, drama, writing, and humor, etc. The questions in the CAQ are designed to remove or limit subjective responses. For example, a question on the CAQ: Whether the subject’s “work has won a prize at a juried art show.” Thus, the answer reveals information from a more objective outside source.

Doctors White and Shah also wished to investigate whether these standardized measures actually extrapolated to real-world creative achievement among adults with ADHD. This would answer whether ADHD really does have side benefit.

When the researchers examined the data from all 10 domains combined, they found that the students with ADHD had significantly higher scores than those without the diagnosis. According to White, a distinctive pattern also emerged: ADHD subjects were more likely to excel at certain creative domains than at others — especially the performing arts. While the data were not statistically significant, a clear trend could be seen: domains where inhibition is not necessary seem to be the areas where these students excel, especially theater and drama. This makes sense because scientists have known that inhibitory control is lacking in most ADHD individuals. They are chastised for speaking out of turn at the office or school. They have difficulty controlling impulsive behaviors. It would make sense that they would thrive in an environment that necessitates they behave without inhibition.

Interestingly, White noted that she could find no significant differences between ADHD students on medication and ADHD students who were not. She had no answers for this riddle.

"ADHD," she says, “tends to just increase the amount of collisions between all of your ideas, so at any given time, you have more potential processes being activated and you’re less likely to rule out any options. It’s hard to know where this operates—like someone coming up with an idea and saying, ‘No, that’s not a good idea,’ and not even writing it down, versus, they don’t even think about it because they’re inhibiting it. But the key seems to be the inhibitory control—the same thing that allows somebody to not be distracted—which possibly could put a mental wall between what is right in front of them and other possibilities.”

There are limitations to a study like this. White and Shah specifically worked with students who had achieved or accomplished all requirements necessary to be admitted to university. Therefore, the trends she sees pertain specifically to them. ADHD students who flunked out of school, were incarcerated, etc. which prevented them from attending university were not included. That would make an interesting study because we’d know what affect family support, direction, and education play in success and creativity.

So, the bottom line here is: yes ADHD students can be more creative, but the research points only to a limited group of students. Is this an upside? For some yes. For others, we just don’t know yet.

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Diet and ADHD Symptoms

Posted by on February 5th, 2011 | Comments off

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.

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ADHD & The Fountain of Youth

Posted by on December 20th, 2010 | Comments off

A recent study published in the journal PLoS ONE reveals how we can all look younger and decrease cognitive deficits like ADHD. The secret:  exercise! That’s probably not what you want to hear, but it makes sense.

Scientists at Tel Aviv University found that "endurance exercises," aerobic exercise like running or cardio kickboxing not only help burn fat, but can also make us look younger and decrease symptoms of cognitive decline.

The team at Tel Aviv University’s Sackler School of Medicine led by
Prof. Dafna Benayahu propose that their data reveal why older people who have exercised throughout their lives age more gracefully.

"When we age, we experience sarcopenia, a decline in mass and function of muscles, and osteopenia referrers to bone loss," says Dr. Benayahu. So without daily exercise, the muscular and skeletal systems weaken and are more susceptible to injury. This may also play a role in the increased likelihood of falling as we age.

The key to staying young seems to lie in stem cells that get activated during endurance exercise. To determine this, Benayahu and her team studied rats. Basically, making the rats exercise actually increased the number of muscle stem cells that typically decrease as we age.

The results were quite compelling when contrasting rats that exercised against sedentary rats:
* The number of youth producing stem cells increased after rats ran on a treadmill for 20 minutes a day for a 13-week period.
* The younger rats showed a 20% to 35% increase in the average number of stem cells per muscle fiber retained.
* Older rats attained a 33% to 47% increase in stem cells meaning they benefited even more significantly than the younger rats!
* Endurance exercise prompted the older rats to get up and go more often!

Aging while embracing a sedentary lifestyle significantly contributes to the development of disease. Furthermore, it contributes to a decline in cognitive abilities.

In other previous studies, researchers have also found that exercise in outdoor or ‘green’ settings reduces the symptoms of ADHD.

What’s the future? Well, it’s likely that scientists will try to discover the chemical process behind  stem cell activation to produce more youthful bodies. It  can then be sold as a pill. It seems the world would rather do that than just get up and dance! And no side-effects except sore muscles that are getting stronger, more youthful, and defined!

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Does this ADHD make me look fat?

Posted by on November 8th, 2010 | Comments off

Ever think that your ADHD child likes to dip into the cookie jar more than the average child? You may be right according to research reported in the International Journal of Obesity (26 October 2010| doi:10.1038/ijo.2010.214) .

Researchers at Duke University Medical Center found an interesting correlation: the greater the number of ADHD symptoms, the greater risk of obesity later in life.

They examined data extracted from 15,197 respondents from the National Longitudinal Study of Adolescent Health in the US. The Duke researchers attempted to assess the association between ADHD symptoms and naturally occurring changes in body mass index (BMI) from adolescence to adulthood. The data were collected over the years 1995 until 2009.

"This is the first study to take this concept out of the clinic and into the population and show that it’s not just the diagnosis of ADHD that matters; it’s the symptoms," said study co-author Scott Kollins, adding, "The most exciting thing about this research is it gives us a thread to follow in determining why kids with ADHD symptoms might be at risk for developing obesity. It establishes the path for identifying these kids earlier and focusing on intervention methods."

It’s well established that ADHD kids have impulse control issues. We also know that foods high in fat, sugar, and calories have the same reaction on the brain’s reward systems as stimulant drugs. This combination could likely cause higher BMI as a child ages.

To be forewarned is to be forearmed. It’s likely good parenting to closely observe your child’s impulse control and assist your child to control food intake as he ages. It’s also a healthy idea to limit consumption of high fat, high sodium, and sugary foods.

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So Is My ADHD Child Covered by Section 504?

Posted by on October 26th, 2010 | Comments off

Your child may qualify to receive accommodations under Section 504 of the Rehabilitation Act. Section 504 states that:

“No otherwise qualified individual with a disability in the United States, as defined in section 706(8) of this title, shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance….” [29 U.S.C. §794(a), 34 C.F.R. §104.4(a)].

Under Section 504, students qualify if they are between ages 3 and 22 and have a disability [34 C.F.R. §104.3(k)(2)].

So, the next question is, does ADHD qualify as a disability? The federal law states that:

“An individual with a disability means any person who:

i. has a mental or physical impairment which substantially limits one or more major life activity;

ii. has a record of such an impairment; or

iii. is regarded as having such an impairment” [34 C.F.R. §104.3(j)(1)].

Does ADHD qualify as an “impairment?” This is the gray area in which ADHD seems to fit well but allows wriggle room for schools. Under Section 504, impairment may include any disorder or disability that “substantially” reduces a student’s ability to access learning in the educational environment because of a learning or behavior related condition.

The wriggle room for schools is that the law is always subject to interpretation. So, every school interprets and implements Section 504 differently. Since ADHD has no physical manifestation like epilepsy or cerebral palsy, it is a hidden problem. Compounding this is the fact that many educators still believe the myth that poor parenting causes the problem or that by giving the child medication, all will be solved without need for accommodation at school. Therefore, under these circumstances, the onus is not on the school, they believe, it is on the parent.

Unfortunately, Section 504 does not define a list of specific disorders (again wriggle room). Obviously, that list would have to be highly comprehensive and definitive.

Also, ADHD would have to affect “major life activities” Major life activities do include, among a variety of other things, concentrating (ADHD), learning, sitting, working, thinking, and interacting/cooperating with others. Many of these major life activities are often affected by ADHD. So, your ADHD child may be included, but the school must agree that some of these “major life activities” substantially limit your child’s education.

So, does your ADHD child qualify for section 504? The answer is, yes – most likely. It should be apparent to you that the law has left a large gray area for interpretation in some cases. 

Remember this: The squeaky wheel gets the grease. Squeak loud, know your rights, and document everything. You should be able to make good headway with this approach.

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ADHD’s Genetic Link

Posted by on October 11th, 2010 | Comments off

What causes attention-deficit hyperactivity disorder – ADHD? Research in the English medical journal, The Lancet, says it’s not too much sugar, bad diet, or poor parenting. Professor Anita Thapar, lead author of the study, says it’s likely genetic.

Thapar and her group of scientists at Cardiff University in Wales compared 366 children with ADHD to 1,047 kids without ADHD. In particular, the researchers examined differences in the children’s DNA. They found that kids with ADHD were more likely to have small segments of DNA that were duplicates or missing (copy number variants or CNVs — either a deletion or duplication of genetic material).

"We hope that these findings will help overcome the stigma associated with ADHD," Professor Anita Thapar, the study’s lead author, said in a written statement. "Too often, people dismiss ADHD as being down to bad parenting or poor diet. As a clinician, it was clear to me that this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to those of other children."

While being media friendly, Thapar’s last statement is a stretch in relation to her research. People and the media love statements that provide seemingly conclusive answers.

Let’s go beyond the media hype that says this research concludes there is a definite genetic link. The researchers really only say there seems to be a possible “genetic link.”  However, their research did not conclude that it is purely or even primarily genetic. What they truly are saying is that this study is evidence that ADHD is not purely social.

The authors conclude:

    “Our findings provide genetic evidence of an increased rate of large CNVs in individuals with ADHD and suggest that ADHD is not purely a social construct.”

This is logical because only 15% of the research subjects with ADHD demonstrated increased CNVs. So is it safe to conclude that genetic makeup may contribute, at least in some particular cases, to ADHD? Yes, but to be clear,  this research did not conclude that it is entirely genetically based and was only partially genetically based in a small segment of their study population. This is very similar to other genetic research.

Why is it, if ADHD is genetically based, at least in part, that 30% don’t have it as adults when diagnosed as a child? What happened? Where did it go? This is what is most  important to parents and professionals.

Epigenetic theory, now being widely embraced by the scientific community, maintains that human development  includes both genetic origins of behavior and the direct influence that environmental forces have on the expression of those genes (nature/nurture). Epigenetic theory regards human development as a dynamic interaction between these two influences.

Simply put, how our genes express themselves is greatly impacted by environment. This is likely why, over time, 30% of children don’t display symptoms as adults. The brain changes, rewires, or (a radical version of epigenetic theory) their genes change.

Do tools exist to do this? Yes. See www.playattention.com.

If I may quote Dr. Theodore Dalrymple, “What seems to have happened is that parents have lost the awareness that they had for decades – if not for centuries – that concentration and self-discipline do not come naturally to children, and have to be taught (as well, sometimes, as enforced).”

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Training the ADHD Brain

Posted by on September 27th, 2010 | Comments off

For years, we at Play Attention, have trained thousands and thousands of people to better pay attention, learn the cognitive skills they need to succeed, and change their behavior. Our results have spoken clearly for us since 1994. Now science is catching up.

Two recent distinct studies validate the brain’s ability to change. While a vast plethora of research confirms these studies’ findings, they are noteworthy. The first study demonstrates the efficacy of skill training, and the second demonstrates how teaching skills rewires the living brain.

The first study, published in the August 25 Journal of the American Medical Association, was performed by researchers from Massachusetts General Hospital (MGH). They utilized cognitive behavioral therapy as a direct intervention for ADHD adults. Cognitive therapy teaches skills for managing life challenges.

The researchers at  MGH found that while medications were the first line of treatment, many patients still persist with underlying symptoms.  While previous studies on cognitive behavioral therapy for ADHD were small and short term, the researchers at MGH claim their study to be the first to conduct full-scale randomized, controlled trial of the efficiency of an individually-delivered, non-medication treatment of ADHD among adults.

“Medications are very effective in ‘turning down the volume’ on ADHD symptoms, but they do not teach people skills,” commented Steven Safren, PhD, ABPP, director of Behavioral Medicine in the MGH Department of Psychiatry, who led the study. “This study shows that a skills-based approach can help patients learn how to cope with their attention problems and better manage this significant and impairing disorder.”

“Sessions were designed specifically to meet the needs of ADHD patients and included things like starting and maintaining calendar and task list systems, breaking large tasks into manageable steps, and shaping tasks to be as long as your attention span will permit,” commented Safren, an associate professor of Psychology in the Harvard Medical School Department of Psychiatry. “The treatment is half like taking a course and half like being in traditional psychotherapy.”

Like Play Attention has been doing since 1994, the researchers provided training sessions mainly that included skills training in filtering of distractions, organization, problem solving, and planning.

Safren’s group receiving cognitive and behavioral training demonstrated advanced control of their symptoms over their control group.  This benefit had persisted when measured three and nine months after the training.

The second study, published in The Journal of Neuroscience (August 25, 2010, 30 34 11493-11500 doi 10.1523 JNEUROSCI.1550-10.2010), examined the brains of rats when they learned to control their impulses.  The researchers documented synaptic changes in the medial prefrontal cortex. They concluded that the rat’s brains rewired themselves to produce the impulse controls necessary to be successful in the tasks the scientists had established for them.

Other past studies have confirmed that the brain will rewire to make changes for skills, impulse control, organization, etc. We’re glad that science is catching up to an learning process that we’ve done at Play Attention for sixteen years now.  That’s beyond cutting edge; it’s leading the way for others.

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Misdiagnosing ADHD

Posted by on September 13th, 2010 | Comments off

According to a study released by the University of Michigan, nearly 1 million children in the United States are potentially misdiagnosed with ADHD.

The research was conducted, not by a medical group, but by economist Todd Elder  in the Journal of Health Economics (Elder et al. The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates. Journal of Health Economics, 2010; DOI: 10.1016/j.jhealeco.2010.06.003).

Elder found that the youngest or often the most immature children are misdiagnosed with the ADHD label simply because of their age and exhibited maturity. Elder also found that these children are significantly more likely than their older classmates to be prescribed medications like Ritalin to control their behavior. Using a sample of 12,000 children, Elder examined the difference in ADHD diagnosis and medication rates between the youngest and oldest children in a grade. He found that the youngest kindergartners were 60 percent more likely to be diagnosed with ADHD than the oldest kindergarten children. Elder followed that group of children and found that they were more than twice as likely to be prescribed stimulant medication by the time they reached the fifth and eighth grades.

Currently, about  4.5 million children are diagnosed with ADHD. Elder concludes that about 20 percent  or about 900,000 children have likely been misdiagnosed.

In a press release from the University of Michigan, Elder said that such inappropriate treatment is particularly worrisome because of the unknown impacts of long-term stimulant use on children’s health. Elder is also concerned that misdiagnosis wastes an estimated $320 million-$500 million a year on unnecessary medication. He estimates that between $80 million-$90 million of it is paid by Medicaid.

"If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s 5 and the other kids are 6," said Elder. "There’s a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD."

ADHD has no pathology, no biological marker in the brain that clearly demonstrates its existence. Thus, its diagnosis is always subjective. While teachers are not permitted to make this diagnosis, their perceptions and opinions serve as the initial step to a diagnosis made by a doctor.

"Many ADHD diagnoses may be driven by teachers’ perceptions of poor behavior among the youngest children in a kindergarten classroom," he said. "But these ‘symptoms’ may merely reflect emotional or intellectual immaturity among the youngest students."

According to Science Daily, Elder’s paper will be published in the Journal of Health Economics in conjunction with a related paper by researchers at North Carolina State University, Notre Dame and the University of Minnesota that arrives at similar conclusions as the result of a separate study.

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ADHD and the Western diet

Posted by on August 23rd, 2010 | Comments off

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.

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