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Our Nation's Kids on Uppers

Our Nations’ Kids on Uppers

Stimulants, commonly referred to in street terms as “uppers,” are used by approximately 3.5 million children.  The stimulants, such as Ritalin, Adderall and Dexedrine, are being prescribed in record numbers to control the symptoms associated with attention deficit hyperactivity disorder.   Stimulants are used to temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness, and the more powerful variants are therefore often prescriptions or illegal drugs.   Children as young as 3 years of age are being started on these prescription medicines.   Is it possible that the number of children taking prescription stimulants to control the symptoms of ADHD could be reduced by making simple dietary changes?   

Attention deficit hyperactivity disorder (ADHD), previously known as attention deficit disorder (ADD), is a common behavior disorder that affects an estimated 10% of school-age children.  Symptoms of ADHD include acting without thinking, hyperactivity and difficulty focusing.  These symptoms impair a child’s ability to function socially, academically and at home.   One of the biggest effects ADHD can have on a child is in the area of academic development.   Research shows that the majority of children with ADHD fail to achieve at a level that is consistent with their academic ability. What are the options for helping a child who is showing signs of, or who has been diagnosed with ADHD, to ensure their success? 

Currently, the two popular choices of treatment for ADHD are prescription medications and behavior therapy.  The use of medications is certainly a well-known and widely accepted form of treatment.   Behavior therapy is often combined with medication because children learn certain patterns of behavior before treatment is received and these patterns need to be dealt with.  Another lesser-known option for treatment is diet change.  

Let’s first take a look at the most common choice for treatment of attention deficit hyperactivity disorder—prescription medications.  The most commonly prescribed medications, also known as stimulants, are Methylphenidate (Ritalin), Dextroamphetamine (Dexedrine) and Amphetamine (Adderall).   Taking a stimulant seems to actually help someone with ADHD calm down.  Science does not really know why.  It could be that an ADHD brain is lacking in certain chemicals that turn off stimulation, resulting in a brain that is unable to "calm down," and perhaps the addition of an external stimulant somehow lets the brain know it can "relax." This is all just educated guessing and supposition. What is known is that methylphenidate, a stimulant with a similar chemical structure to cocaine and whose effects are described as somewhere between those of a  cup of coffee and those of amphetamine (a.k.a. "speed"), appears to alleviate the symptoms of ADHD. 

Taking medications can start as early as three years of age.   In order to achieve the optimum effect with stimulants, it is sometimes necessary to take several doses per day, oftentimes a combination of two different medications.  Since the drugs are only effective while in the blood stream, and the underlying cause is never corrected, the medications must be taken for life.   Unfortunately, the costs of the medications can be very high and unmanageable for some families.  According to Consumer Report 2008, a monthly supply of Ritalin can be around $83 a month.  Adderall can run between $120 a month for the twice-a-day dosage and $188 a month for the once-a-day time-release form. 

Because of concerns with drug abuses by young people after World War II, in 1970 the Food and Drug Administration made a decision to restrict the use of amphetamines with children.  Japan totally banned the use of amphetamines.  England restricted their use and Sweden categorized amphetamines as narcotics.  In 1972, the Food and Drug Administration placed Ritalin, along with other amphetamines, on the Schedule II list, the same category as opium, codeine and morphine.

Possible side effects of taking stimulants include decreased appetite, stomachache, irritability, headaches, dry mouth, blurry vision, nausea, tics and insomnia.    More severe side effects include jaundice, heart palpitations, anorexia, and anemia.  According to the Nutrition Help Center, rare but possible side effects include abnormal liver function, cerebral arteritis, leucopenia and death.  There is also a potential for Ritalin abuse and addiction.  It has been shown that long-term use of Ritalin can slow a child’s growth.   After all of the side effects, concerns and costs, stimulants work for about 70% of those who take them. 

Another treatment choice for ADHD is behavior therapy.  The goal of behavior therapy is to increase the frequency of the desired behavior from the child by increasing the child’s interest in pleasing the parents and providing positive consequences when the child behaves.  Inappropriate behavior is reduced by consistently providing negative consequences when such behavior occurs.   Patricia Quinn, co-author of Understanding Women with AD/HD and When Moms and Kids Have ADD, suggests that the longer a parent interacts negatively with her child, the greater the chances he will develop secondary behaviors, like oppositional defiant disorder, anxiety and/or depression, and low self-esteem. 

 

Now, let’s take a look at the third, lesser-known option of diet changes.  How could diet have an affect on behavior?   In 1974, Dr. Ben Feingold published his book “Why Your Child is Hyperactive” addressing concerns of artificial colors and preservatives having an affect on children’s behavior.   On September 6, 2007, ABC Science reported, “Certain artificial food colourings and other additives can worsen hyperactive behaviours in children aged 3 to 9, UK researchers report.”  The Lancet, one of the world’s leading medical journals founded in 1823, reported that “Artificial colours or a sodium benzoate preservative (or both) in the diet result in increased hyperactivity in 3-year-old and 8/9-year-old children in the general population.”  

Let’s dig a little deeper.  Sodium benzoate is a preservative used in foods such as salad dressing, carbonated drinks, jams, fruit juices and condiments.  It is also used in fireworks as a fuel to make the "whistle" sound.  Sodiuim benzoate can damage and inactivate vital parts of DNA.  Research published in 2007 for the UK's equivalent of the Food and Drug Administration suggests that certain artificial colours, when paired with sodium benzoate (E211) may be linked to behaviors associated with ADHD and ADD.  The results suggest that consumption of certain mixtures of artificial food colours and sodium benzoate preservative are associated with increases in hyperactive behaviour in children. 

 Artificial food colors are derived from coal tar.  Coal tar is defined as a viscous black liquid containing numerous organic compounds that is obtained by the destructive distillation of coal and used as a roofing, waterproofing, and insulating compound and as a raw material for many dyes, drugs, and paints.   Because people associate certain colors with certain flavors, food manufacturers add artificial food colors to their products.  Frozen waffles can become more yellow and the “strawberry” in Nutri-grain bars can become the color of real strawberries by adding artificial food coloring.   Artificial dyes are particularly prevalent in the sugary cereals, candies, sodas, and snack foods geared towards kids.  The list of artificial food colors to avoid include Yellow 5, Red 40, Blue 1, Blue 2, Green 3, Orange B, Red 3, and Yellow 6.   These artificial food dyes can be found in foods such as Twinkies, Honeycombs, Cheetohs, Jell-O, Kool Aid, Kids Cuisine lunches, Lunchables, Go-Gurt yogurts, and many more popular foods.  In the United Kingdom, the Food Standards Agency (FSA) decided to push for a national voluntary removal of the additives, as well as advising the European Food Safety Authority (EFSA) to implement a ban.   Companies such as Cadbury Schweppes have pledged to remove all artificial colourings from its products by the end of the year 2008 in response to concerns over their possible effects on behaviour. 

 If a parent is dealing with a child who shows signs of attention deficit hyperactivity disorder and they are hesitant to start their child on a lifetime of prescription medications and behavior therapy is not working, changes in diet could be an option.   Specifically, avoiding artificial food coloring and the preservative sodium benzoate could help reduce the symptoms of ADHD--acting without thinking, hyperactivity and difficulty focusing. 

 ADDitude, Living Well with ADD and Learning Disabilities, published an article about Susan, the mother of six-year-old Jimmy who was diagnosed with ADHD.  Susan had also heard about the article published in The Lancet reporting the affects of sodium benzoate and artificial colourings on children’s behaviour.  She decided to take the findings seriously, and had Jimmy avoid foods containing sodium benzoate and artificial colouring.  “Within three days, she saw an improvement in his ADD symptoms. He sat down to eat, stood still long enough to get his hair combed and his teeth brushed, put his coat on by himself, and had plenty of hugs and kisses for his family. His teacher called to say how well Jimmy did in class, and asked if a new medication was responsible for his improved behavior.” 

What is the first step in finding out if dietary changes can reduce the symptoms associated with ADHD?  First, to see if food additives affect your child’s behavior, conduct a simple test at home.  For one week, avoid foods and drinks that list on their labels U.S. certified color Red #40, Blue #2, Blue #1, Yellow #5 (Tartrazine), Yellow #6 (Sunset Yellow), Orange B, and Green 3, as well as sodium benzoate.  Is your child less fidgety?  After seven days, reintroduce food additives into his diet by squeezing a few drops of artificial food coloring into a glass of water, and have your child drink it. Observe his behavior for two or three hours.  If you don’t see a change, have him drink a second glass. Does he become more hyperactive?  If so, it may be the time to start weaning your child from the products that contain artificial colors and the preservative sodium benzoate.

Buying foods free of artificial colors and sodium benzoate may seem like a daunting task.  However, it is possible.  As a consumer, it will become necessary for you to read the labels.  Oftentimes, food packages will have statements on the front stating, “Natural Fruit Flavors,” or “All Natural Ingredients,” or ‘No Preservatives Added.”  It is still necessary to read the label.   Start by purchasing 100% fruit juice instead of soda pop, fruit drinks and fruit punch, which are artificially colored and flavored.  Next, make muffins, cookies and cakes from scratch.  Cake mixes contain red and yellow coloring.  When purchasing cereal for your child, keep in mind the more colorful the cereal, the more food dyes it contains.   Cap’n Crunch, Trix, Fruit Loops, Lucky Charms, and Apple Jacks are full of food coloring. Look for breakfast cereals that are free of dyes — like Cheerios, which doesn’t contain artificial colors, flavors, or preservatives.   That small container of barbecue sauce that accompanies your child’s favorite chicken nuggets could also include artificial colors.  Many brands are loaded with Red #40.   However, Hunt’s Original is free of food coloring. Does your child enjoy popsicles?  Buy Welch’s Fruit Juice Bars, one of the few brands without dyes or preservatives. 

Dyes and preservatives can also be found in personal care products, such as toothpaste and mouthwashes, some of which, as many parents know, may be swallowed by young children. Again, read the labels carefully before buying them. Crest toothpaste, for instance, contains blue dye; Colgate’s Original is free of it. 

Unfortunately, most pediatric medicines contain food coloring as well (including those prescribed stimulants).  Ask your doctor if there is an additive-free substitute that would work just as well.  For over-the-counter medicines, choose Motrin or Tylenol, which come in dye-free white tablets.  Benadryl is artificially colored with red dye, but the medication also comes in clear liquid capsules.  (Stevens)

Eliminating artificial colors and preservatives could feel like too great of an undertaking.  Fortunately, the Internet offers an abundance of resources and recipes for parents in search of healthy alternatives for their child.  A great resource is Foodb.com.  Users select certain criteria based on food preferences, such as eliminating artificial colors and preservatives, and receive their personal list of foods.   From this list, a personal grocery list can be created.  There are over 11,000 food products to choose from.  This is just one of the websites available to help families research the foods they are providing for their family.

 At first, going to the grocery store may be a bit more work.  However, a change in diet can have a significant affect on your child’s behavior.  Change of diet will not help all of the 3.5 million children taking medications; however, eliminating sodium benzoate and artificial colors could significantly reduce this number.  Plus, avoiding foods with artificial colors and preservatives has another big benefit: Your family will probably be eating healthier, since the “junk” foods on supermarket shelves tend to be the most heavily colored and flavored.

 

 

 

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