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Attention Deficit Risks Raised by American Diet
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by Craig Weatherby

Attention deficit hyperactivity disorder (ADHD) is the subject of considerable controversy.
Many observers decry the now-routine use of stimulant drugs like Ritalin to control symptoms.
Meanwhile, others say that ADHD diagnoses represent the "medicalization" of behaviors that fall at one end of the normal scale... which may be signs of an unusally creative, intelligent mind.

Key Points
  • American-style diets are linked to higher risk of ADHD in teens.
  • Lower risk seen in teens who ate healthier, whole-foods-oriented diets featuring veggies, fruits, whole grains, and fish.
  • Results show an association that remains to be proven, but one that fits with basic brain research.
Claims that ADHD is an imaginary disease were undermined by a recent UC Davis study showing that two brain areas failed to connect when children with ADHD attempted a task that measures attention (Mazaheri A et al. 2010).

Those results may support the reality of ADHD, but they don't explain how the condition is caused or pinpoint lifestyle factors that might promote it.
Now, a new study from Australia lends support to the idea that nutritionally inferior diets may play a role in elicting the disorder.
American diet pattern eyed as ADHD factor
The term “standard American diet” is used by nutrition researchers to describe the most common eating pattern in this country.
And that semi-official appellation yields an acronymSADthat’s all too fitting in light of the clearly adverse health impacts of the nation’s dominant eating pattern.
The standard American diet is high in sugars, refined starches (white flour products), pro-inflammatory omega-6 fats, saturated fats, and sodium… but low in fruits and vegetables, whole grains, and fish.
As it happens, the standard Australian diet closely resembles the standard American diet, and has equally adverse health effects.
So Americans should be concerned by new research that links the standard Australian diet to increased risk of attention deficit hyperactivity disorder (ADHD) among adolescents.
The new findings suggests that risk of ADHD in Australian adolescents could be linked to Western diets, which tend to be high in total fat, saturated fat, refined sugar, and sodium.
Before we examine the Aussie study, let’s quickly review the evidence concerning diet and food additives as an ADHD risk factor.
ADHD risk factors: A look at the evidence
Some studies have found links between food additives and ADHD, but the evidence is mixed and points to greater susceptibility in some children than others.
Evidence of a link between sugar alone and higher ADHD risk or transitory behavior problems is considerably weaker.
On the prevention side, some research suggests a potential role for omega-3 fatty acids in reducing the risks of ADHD and improving behavior and learning among children with ADHD. (See “Kids’ Attention Deficits Curbed by Omega-3s” and “New Findings Support Omega-3s’ Ability to Aid Kids with Attention Disorders” and “Attention Spans Improve when Moms Eat Fish”.)
And last year, a Spanish scientific team that reviewed all of the available evidence noted the factors most closely linked to ADHD risk or prevention, including a possible role of the omega-3/omega-6 fat intake imbalance characteristic of Western diets.
It is worth quoting from their paper… which we’ve edited to clarify a very clumsy translation (Quintero J et al. 2009):
  • “[ADHD] has been related to many factors such as diet, additives, toxic substances from the environment, low protein diets with a high carbohydrate content, unbalanced minerals intake, deficits in intake of essential fatty acids, phospholipids, and amino acids, thyroid disorders, and vitamin B complex disorders...”
  • “The way Western lifestyles have changed in general, and diet in particular, is considered a possible factor in many disorders and health problems, but what about ADHD?”
  • “One of the changes that we want to emphasize is related to the omega-6-rich vegetable oils that dominate human consumption and the reduction in fatty acids from the omega-3 family. The effect of an omega-3 intake deficit is even worse when the amount of dietary omega-6 fat increases...”
Eaten in excess, omega-6 fatty acids tend to promote inflammation and are associated with higher risk of depression and cancer, while omega-3s tend to have opposite effects.
Omega-6 fats compete with dietary omega-3s for absorption, and omega-6s abound in processed and prepared foods and the cheap vegetable oils most commonly used in them and in American kitchens (corn, soy, safflower, cottonseed, and sunflower).
Aussie study links fishy “whole food” diets to reduced risk of ADHD
The authors of the new study analyzed the dietary patterns of 1,799 adolescents and classified their diets as “Healthy” or “Western” (Howard AL et al. 2010).
The teens were participants in the Raine Study from Perth, Australia. Researchers have been tracking this group of children since their birth in 1989.

Saturated fat seen as
scapegoat and distraction
Some common saturated fats (e.g., the stearic acid in meats and cocoa butter) show little statistical relationship to higher risk of cardiovascular disease and dementia.
Yet, diets high in total saturated fats are statistically associated with higher risk of both disorders.
But a close look at the evidence suggests that for most people, the statistical link between saturated fats and higher heart and brain risks probably doesn’t stem from a cause-effect relationship.
Instead, it is the overall SAD patternwhich is high in saturated fats but also features loads of sugars, white starch, and omega-6 fatsthat appears to raise heart and brain risks, rather than high saturated fat intake alone.
In fact, traditional, “whole food” diets that are high in saturated fatsbut low in sugars, refined starches, and omega-6 fatsdo not produce high rates of cardiovascular disease and dementia.
Young teens were defined as eating a “Healthy” diet pattern if they consumed relatively high amounts of fresh fruit and vegetables, whole grains, and fish. This diet pattern also tended to deliver more omega-3 fatty acids, folate (a B vitamin involved in brain health), and fiber.
The “Western” diet pattern was defined as one in which teens tended to eat more takeout foods, sweets, pastries, and processed, fried, or refined foods. This diet pattern delivered less omega-3s but more total fat, saturated fat, omega-6 fats, refined sugar, and sodium.
A team led by child nutrition specialist Wendy Oddy, Ph.D., compared the teens’ diet patterns to their health records, looking for any diagnoses of ADHD by the age of 14 years.
Out of the total of 1,799 teens, 115 (91 boys and 24 girls) had been diagnosed with ADHD by age 14.
After adjusting the results to account for various known social and family influences on ADHD risk, the Aussie team found that, compared with kids eating the “Healthy” diet, the kids who ate a “Western” style diet were more than twice as likely to have received an ADHD diagnosis.
When they looked at specific foods, an ADHD diagnosis was associated with diets especially high in takeout foods, processed meats, red meat, high-fat dairy products, sweets, and pastries.
Scientists attribute some of “Healthy” diet’s protection to omega-3s
Professor Oddy attributed some of the risk reduction of the Health diet pattern to fish fats: “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.” (TICHR 2010)
She also proposed that the Western dietary pattern doesn’t provide enough of certain other essential micronutrients needed for optimal attention and concentration.
The Aussies did not deny the possible influence of artificial additives, nor the possibility that kids susceptible to ADHD tend to make bad, impulsive eating choices: “…we cannot be sure whether a poor diet leads to ADHD or whether ADHD leads to poor dietary choices and cravings” (TICHR 2010).
Needless to say, we need more studies to confirm the link seen in this study, and to pinpoint the food choices most responsible for raising the risk of ADHD.
But we have plenty of data showing that the standard American diet is unhealthful, even deadly, in many ways.
  • Ambrosini GL, Oddy WH, Robinson M, O'Sullivan TA, Hands BP, de Klerk NH, Silburn SR, Zubrick SR, Kendall GE, Stanley FJ, Beilin LJ. Adolescent dietary patterns are associated with lifestyle and family psycho-social factors. Public Health Nutr. 2009 Oct;12(10):1807-15. Epub 2009 Jan 23.
  • Boris M, Mandel FS. Foods and additives are common causes of the attention deficit hyperactive disorder in children. Ann Allergy. 1994 May;72(5):462-8. Review.
  • Carter CM, Urbanowicz M, Hemsley R, Mantilla L, Strobel S, Graham PJ, Taylor E. Effects of a few food diet in attention deficit disorder. Arch Dis Child. 1993 Nov;69(5):564-8.PMID: 8257176
  • Cruz NV, Bahna SL. Do food or additives cause behavior disorders? Pediatr Ann. 2006 Oct;35(10):744-5, 748-54. Review.
  • Howard AL, Robinson M, Smith GJ, Ambrosini GL, Piek JP, Oddy WH. ADHD Is Associated With a 'Western' Dietary Pattern in Adolescents. J Atten Disord. 2010 Jul 14. [Epub ahead of print]
  • Krummel DA, Seligson FH, Guthrie HA. Hyperactivity: is candy causal? Crit Rev Food Sci Nutr. 1996 Jan;36(1-2):31-47. Review.
  • Mattes JA, Gittelman R. Effects of artificial food colorings in children with hyperactive symptoms. A critical review and results of a controlled study. Arch Gen Psychiatry. 1981 Jun;38(6):714-8.
  • Mazaheri A, Coffey-Corina S, Mangun GR, Bekker EM, Berry AS, Corbett BA. Functional disconnection of frontal cortex and visual cortex in attention-deficit/hyperactivity disorder. Biol Psychiatry. 2010 Apr 1;67(7):617-23. Epub 2010 Jan 8.
  • Quintero J, Rodríguez-Quirós J, Correas-Lauffer J, Pérez-Templado J. [Nutritional aspects of attention-deficit/hyperactive disorder] Rev Neurol. 2009 Sep 16-30;49(6):307-12. Review. Spanish.
  • Rojas NL, Chan E. Old and new controversies in the alternative treatment of attention-deficit hyperactivity disorder. Ment Retard Dev Disabil Res Rev. 2005;11(2):116-30. Review.
  • Telethon Institute for Child Health Research (TICHR). Western diet link to ADHD. July 29, 2010. Accessed at 

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