(Part 1 of 3 blogs focussing on ADHD and diet for both children and adults)
In the USA
Up to 16 percent of high school-age children have been diagnosed with ADHD (1). Sales of prescription stimulants more than quintupled in 10 years as shown from the fascinating article: The Selling of Attention Deficit Disorder: the number of diagnoses soared amid a 20-year drug-marketing campaign by Alan Schwarz, New York Times, 2013 (2)
At the time, Dr C. Keith Conners who had worked to raise awareness of ADHD in children for 50 years, described what was happening as “preposterous … giving out of medication at unprecedented and unjustifiable levels”.
In Australia
From 2019-2021, prescription rates for some ADHD medications have gone up an astounding 45x! (3). It is not clear where the impetus has come from but there seems to have been a concerted and successful campaign, mainly by psychologists and psychiatrists, to make ADHD more visible. Given their scope of knowledge, diet is very rarely mentioned (4). This has raised the following concerns:
- possible harms of over-diagnosis for children
Luise Kazda, a researcher from the University of Sydney, writes that rising diagnoses of ADHD may be unnecessary or even harmful:
“During my daughter’s challenging first year of school … she was the youngest in her class, placing her at higher risk of being diagnosed with ADHD … Our study concluded these children are unlikely to benefit from being labelled with ADHD and may, in fact, be harmed by it .” (5).
- long waiting times and costs
ADHD clinics charging up to $3000 a visit for adults (6).
- serious long term risks of ADHD medications for adults
These can include (7)
- Heart disease
- High blood pressure
- Seizure
- Irregular heartbeat
- Abuse and addiction
- Skin discolorations
A new study shows that non-ADHD people who use ADHD medications such as Ritalin can actually reduce their mental performance. These medications are not recommended for mild ADHD, only moderate to severe symptoms (8).
So … Why not try diet first???
Recent European studies show that diet works well for the majority of children with ADHD who do it properly (9). This is a critical finding and confirms many previous studies.
According to Dr Lidy Pelsser, senior researcher at the ADHD Research Centre in Eindhoven, Netherlands:
“In all children, we should start with diet research. If a child's behaviour 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." (10)
But consumers are very unlikely to get useful information about diet from any support organisations (11).
Brief reader reports from facebook threads “Did diet work for ADHD?”
Children
”Omg yes!!! This diet is a lifesaver!! We were on the school speed dial list before term finished, anger issues, couldn't control emotions, discipline of all degrees made no difference. 3 weeks on the diet and I have a different kid!! The days when I mess up accidentally I can tell and so can the school.” – Madonna [1420]
Adults
“I have ADHD and while FS doesn’t completely ‘cure’ it, my symptoms are much better and more manageable...amines make my ADHD, emotions, etc. much worse” - Jenny [1558]
READ Diet first for ADHD (blog 2 of 3)
READ How to do diet for ADHD (blog 3 of 3)
References
1. CDC Data and statistics for ADHD. ADHD diagnosis among children aged 3–17 years: State estimates vary from 6% to 16%. https://www.cdc.gov/ncbddd/adhd/data.html
2.The Selling of Attention Deficit Disorder: the number of diagnoses soared amid a 20-year drug-marketing campaign, by Alan Schwarz, New York Times, 2013 https://c2-preview.prosites.com/226351/wy/docs/The%20selling%20of%20ADD2.pdfs/The%20selling%20of%20ADD2.pdf and https://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html
3. Is the soaring use of ADHD stimulants a cause for concern? NewsGP, November 2022. https://www1.racgp.org.au/newsgp/clinical/is-the-soaring-use-of-adhd-stimulants-a-cause-for
4. My child has been diagnosed with ADHD. How do I make a decision about medication and what are the side effects? The Conversation May 2021. https://theconversation.com/my-child-has-been-diagnosed-with-adhd-how-do-i-make-a-decision-about-medication-and-what-are-the-side-effects-161411
5. Rising diagnoses of child ADHD may be unnecessary or harmful. Luise Kazda, University of Sydney, Opinion. https://www.sydney.edu.au/news-opinion/news/2021/04/13/rising-diagnoses-of-child-adhd-may-be-unnecessary-or-harmful.html
6. Long waiting times and ADHD clinics charging up to $3000 a visit for adults. https://www.abc.net.au/news/2023-05-24/adhd-clinics-diagnosis-explosion-3000-a-visit/102380452
7. Serious long term risks of adult ADHD medications. https://www.webmd.com/add-adhd/long-term-risks-adhd-medications and https://www.webmd.com/add-adhd/adhd-medication-chart
8. ADHD medications for non-ADHD people can reduce mental performance. https://www.theguardian.com/australia-news/2023/jun/15/people-who-use-smart-drugs-worse-at-complex-tasks-study-finds?CMP=share_btn_link
9. Dr Lidy Pelsser, senior researcher at the ADHD Research Centre in Eindhoven, Netherlands. Pelsser LM et al, Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. Lancet. 2011;377(9764):494-503. https://pubmed.ncbi.nlm.nih.gov/21296237/ and other Netherlands studies https://www.adhdenvoeding.nl/literatuur-downloads/
10. Dr Pelsser’s quotes from “Study: diet may help ADHD kids more than drugs”, NPR Research News. http://www.npr.org/2011/03/12/134456594/study-diet-may-help-adhd-kids-more-than-drugs
11. Advice from support organisations, examples:
CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), the major USA-based organisation at https://chadd.org/ , provides information funded by the Centers for Disease Control and Prevention (CDC). They say “use fresh and healthy ingredients that are low in fat, sugar, and salt without artificial ingredients and additives that can make ADHD symptoms worse for some people. Eating healthy foods can make ADHD symptoms easier to manage”. And “Research ... does not support the view that ADHD is caused by food additives or coloring. The research does show that these ingredients can make symptoms worse for some people affected by ADHD.” See more Arnold LE, Lofthouse N, Hurt E. Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for. Neurotherapeutics. 2012 Jul;9(3):599-609. doi: 10.1007/s13311-012-0133-x. PMID: 22864801; PMCID: PMC3441937. https://pubmed.ncbi.nlm.nih.gov/22864801/
ADHD Support Australia at https://www.adhdsupportaustralia.com.au/ is self-funded and has taken no funds from pharmaceutical companies. They support diet among other interventions https://www.adhdsupportaustralia.com.au/does-diet-affect-adhd/ and are rightly concerned about coeliac disease as a unrecognised cause. However they also promote and test without evidence for Pyrroles, Pyrroluria, Kryptopyrroles or Mauve factor and treat on that basis with high dose zinc and B6, supplements to remove excess copper, as well as other supplements. See detailed evidence about this issue https://www.fedup.com.au/information/frequently-asked-questions/symptom-questions#pyroluria
ADHD Foundation at https://adhdfoundation.org.au/ is an Australian national consumer not-for-profit organization registered as a charity. They support the use of the stimulant medications and say that ADHD “is not caused by diet, foot additives, refined sugar”. Further that “treatments with little or no evidence for their effectiveness include dietary management, such as removal of sugar from the diet, high doses of vitamins, minerals, trace elements, or other popular health food remedies, long-term psychotherapy or psychoanalysis, biofeedback, play therapy, chiropractic treatment, or sensory-integration training, despite the widespread popularity of some of these treatment approaches”. Evidence is provided by retired psychologist Dr Russell Barkley at https://www.russellbarkley.org/ , most recently 18 years ago. While they are a “wholly volunteer run organisation” revenue from donations and bequests (over $20,000 last year) is not otherwise detailed.
World Federation of ADHD at https://www.adhd-federation.org provides an ADHD Guide funded in part by pharmaceutical companies. The words ‘food’, ‘diet’ and ‘additive’ do not appear in this guide, in common with the focus on psychology and psychiatry in many other umbrella organisations lacking any knowledge of diet.