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ADHD Alternative Therapies and the Links between Diet and Behaviour

Behaviour, Infant and Children | August 1, 2014 | Author: The Super Pharmacist

Children, behaviour

ADHD Alternative Therapies and the Links between Diet and Behaviour

Attention deficit/hyperactivity disorder (ADHD) is the most frequently diagnosed psychiatric disorder in children, although it can also begin in adulthood. The hallmark symptoms of ADHD are hyperactivity, impaired response inhibition and an inability to sustain attention (as the name suggests). A patient may exhibit some or all of these symptoms. Estimates suggest that approximately 10% of children from seven to twelve years of age suffer from ADHD, and to 60% of these may experience symptoms as they grow up.

ADHD is strongly associated with the male gender. This condition is acknowledged as a neuropsychiatric disorder, as certain changes in brain structure and chemistry are consistently shown to be associated with ADHD symptoms.

These may include:

  • Persistent deficits in impulse control‚Äč
     
  • Hyperactivity; i.e. restlessness, difficulty in remaining stationary, compulsive or excessive talking, impatience, often interrupting or intruding on the activities of others
    Risk factors for ADHD
  • Inattention; i.e. frequent carelessness which leads to errors, poor focus when performing tasks, forgetfulness, distractibility and disorganisation
     
  • Poor academic performance: this is common in children with ADHD
     
  • Inconsistent task completion or performance
     
  • Decreased motivation
     
  • Drowsiness and/or sleep disturbances: this is most common in adult patients

Risk factors for ADHD

  • Genetics: A parent with ADHD has a high probability of passing it to their offspring. In addition, mutations in several genes are associated with the condition. Many of these concern neural activity controlled by the neurotransmitter dopamine. Genes concerning the actions of other neurotransmitters, particularly serotonin and norephinephrine, may also be implicated in ADHD.
     
  • Traumatic brain injury: This may be associated with the exacerbation of symptoms, most often in teenagers. Acquired brain damage may also be associated with the onset of ADHD. These cases are termed secondary ADHD (S-ADHD).
     
  • Obstructive sleep apnea: This condition restricts breathing, and thus oxygen intake, during sleep. OSA is strongly associated with adult ADHD, although it is not clear if this indicates a causative effect or a coincidence. Some reports indicate that OSA may result in attention deficits and mild hyperactivity, however.
     
  • Psychosocial factors: Some researchers conclude that some environmental factors may influence ADHD development in children. These include parent/child interaction and the levels of early social interaction.
     
  • Diet: There is some evidence that deficiencies in certain minerals and nutrients may be associated with ADHD. Some researchers believe that a high intake of foods with chemical additives is associated with a higher risk of hyperactivity in children. One study found that up to 89% of child subjects reacted "with ADHD-like symptoms" when given 100mg of artificial food colourings.

The Effects of Diet on ADHD-like Behaviours

There is a possibility that certain foods, or rather the lack of certain nutrients, may affect ADHD development. Some researchers in this field have concluded that dietary changes can affect the severity of symptoms.

The Effects of Diet on ADHD-like BehavioursAs mentioned above, artificial colourings may influence development of the condition for certain patients. Some other foods, including chocolate, tomatoes, soy and citrus fruits, are also associated with ADHD symptoms in children. There may also be a link between sugar intake and ADHD, but this is mainly based on parent reports. Deficiency in the amino acid tryptophan may be associated with attention deficit in adults. This may be related to the fact that this molecule is converted to some neurotransmitters, including serotonin, when ingested.

Some studies indicate a protective effect of omega-3 fatty acids against ADHD symptoms. A study of 95 children with ADHD also demonstrated a correlation between omega-3 intake and improvements in working memory.

ADHD Alternative Therapies

Conventional treatment for ADHD is mainly based on drug therapy. Methylphenidate (i.e. Ritalin® or Concerta®) is a typical pharmacological ADHD treatment. Others include dexamphetamine and combinations of amphetamine and dexamphetamine. These options act by increasing the availability of dopamine. These drugs are associated with side-effects (and high abuse potential, though not necessarily in ADHD patients themselves), and many parents may not wish to expose their child to "stimulant drugs".

Non-drug options available to manage ADHD.

Exercise

Exercise may ameliorate ADHD symptoms in both adults and children. A study including young ADHD patients demonstrated a decrease in inattention as a result of 20 minutes of moderate exercise. Practising yoga may be associated with improved ADHD symptoms. Exercise also appears to enhance the efficacy of methylphenidate, which may be useful for patients in need of combination therapy.

Neurofeedback

This is a technique that helps patients to control their symptoms through familiarity with visual representations of their physiological effects. For example, ADHD patients may observe the brain activity associated with their symptoms via electroencephalogram (EEG). They are then trained to employ "self-regulation" techniques in response to this, which may result in the easing of symptoms such as inattention.

Cognitive training

This is a type of training, based on task completion, designed to improve working memory and attention. This promising alternative therapy appears to be particularly effective in children and teenagers with ADHD. Cognitive training has an advantage of possible delivery through portable technological interfaces - i.e. smartphones and tablet PCs.

Parent training and education

This is a system of training and/or educating the parents of children with ADHD in appropriately and effectively managing the patient's behavioural symptoms. This may be provided in the form of parent support structures, parenting skill improvements, targeting child behaviour or a combination of these. This training appears to have positive outcomes, and may also have psychological benefits for the parents in question, but scientific review of this option can produce inconclusive results.

Melatonin supplementation

ADHD is associated with circadian rhythm (i.e. the sleep/wake cycle) disturbances. Parts of the brain that regulate sleep patterns have been found to function differently in ADHD patients in comparison with healthy controls. These are controlled to a degree by a molecule called melatonin, which acts as a neurotransmitter and a hormone. A recent trial demonstrated that the altered melatonin release associated with ADHD resulted in a significant sleep deficit in the patients studied. Melatonin supplementation may correct sleep disturbances in ADHD, which may improve attention and performance deficits.
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