Saturday, November 21, 2009

17. My Recommendations for Treating ADHD

In this section, I will present my own ideas on how children with ADHD can, with time, improve their brain function and reduce their dependence on Ritalin. First of all, I want to remind you that I am not an M.D. My doctorate from MIT is in electrical engineering. However, my PhD thesis concerned an auditory model for human speech processing, and thus required extensive reading on neural mechanisms in the brain. My Bachelor's degree from MIT is in biology, with a minor in food and nutrition. I benefit strongly from having been exposed to ideas about nutrition before the low-fat diet craze got its firm grip on our nation's population.

The first step towards healing is to discard the idea that fats are unhealthy. I recommend reading any of the following books, which have covered the subject extensively, Good Calories Bad Calories by the New York Times reporter, Gary Taubes [35], Fat and Cholesterol are Good For You, by Uffe Ravnskov, a Swedish M.D., Ph.D. [28], and Trick and Treat: How 'Healthy Eating' is Making us Ill, by the British researcher and writer, Barry Groves [11].

We have been led by the American medical community to believe that a high-fat diet leads to heart disease, and that increased dietary consumption of fruits and vegetables is a heart-healthy choice. However, a recent (2009) long-term population-based study in Sweden has concluded that fruits and vegetables provide no heart-health benefit at all unless they are consistently eaten with fats [14]. The researchers conducted extensive interviews with several thousand men in rural Sweden about their food practices, and also carefully monitored their heart health status over a 12-year period. Surprisingly, they found no association between coronary disease and the consumption of fish or wholemeal bread, and no association with the consumption of fruits and vegetables, for those who also chose low fat dairy, or consumed little dairy. The only clear benefit they could find was with a combination of lots of fruits and vegetables and high-fat dairy consumption. They hypothesized that the high fat dairy was required to promote the absorption of the vitamins and minerals contained in the fruits and vegetables. However, if they are eating both lots of fat and lots of fruits and vegetables, they are probably also eating few empty carbs. A corollary of this result is that a person who avoids fat is likely deficient in vitamins and minerals, even if they consume a lot of fruits and vegetables.

Once a mother no longer fears fats, she can begin to change her child's diet, with the goal of over-correcting the fatty acid deficit through a high fat, very low carb, diet. An increase in the consumption of meat, fish, and eggs should be balanced with a decrease in the consumption of sugar and starch. Foods containing trans fats should be carefully avoided. Improvements will probably not be dramatic, as it will take a long time for the child to repair all the poorly insulated nerve fibers that are suffering from insufficient fat supply. I can not predict how quickly or how completely a child who has suffered from dietary fat deficiency throughout its life can recover, once the dietary correction is in place.

Of course, the best action would be to avoid the problem in the first place, and this begins with the pregnant mother. It is especially important for her to consume an abundance of omega-3 and omega-6 fats while she is carrying the baby, and to continue to do so once the baby is born, to assure a high-quality milk supply to her child. A recent analysis of data from the Nurses' Health Study, an ambitious long-term study involving over 18,000 nurses, showed that fat in dairy consumption was associated with high fertility. Women who said they ate low-fat diary increased their risk of infertility by 85%, whereas women who consistently ate high-fat dairy decreased their risk by 27% [7]. Fertility is an indicator of the degree to which the body perceives that it is prepared to support a fetus. Breast milk has an extremely high fat content, significantly higher than that of cow's milk. It then seems logical that, once mother's milk is replaced with table foods, these foods should continue to be high in fat content.

I find Ritalin to be a very disturbing drug, particularly because it is a synthetic drug and because it has been on the market for a relatively short time. We have no idea what will happen to children currently taking Ritalin 40 or 50 years hence. Alarm bells have already been raised regarding possible addiction and abuse, appetite loss and subsequent malnutrition and stunted growth, and adverse effects to the heart.

Other stimulants that occur in nature have been used by humans for hundreds of years, and they would likely be safer than Ritalin if they can achieve the same goals. I am thinking of caffeine, chocolate, and even nicotine. It's possible that nicotine is no better than Ritalin, with its known issues regarding the potential for addiction and increased risk for heart disease and lung cancer. But a nicotine patch, which avoids the issue of tar exposure in the lungs leading to lung cancer, is at least an alternative that should be considered instead of Ritalin.

Coffee is a particularly attractive choice -- it has been extremely well studied and appears to have very few if any adverse side effects. It has been shown to improve memory, and it works in part because, in addition to increasing adrenaline levels, it acts directly to disable insulin's suppression of fat release [23], which I consider to be one of the most important goals of an ADHD drug. Chocolate is a stimulant that children will find especially appealing, and chocolate milk (made from whole milk) would be a great way to introduce it.


forrest said...

Umm, the rather old observation that adding chocolate to milk interferes with adsorbing the calcium [if I've got this right?]

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