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ADHD, a behavioral syndrome in children that displays symptoms such as inattention, distractibility, inability to sit still and difficulty concentrating, is the most commonly cited behavioral problem in children today. An industry of claims and counter-claims has emerged in its wake, all vying for the attention and dollars of parents in search of some remedy.
Local naturopathic doctor Glen Nagel believes that diet and diet therapy should be considered as a first course of treatment. "Our goal is to get kids on a natural source diet, low in allergens, and high in complex carbohydrates, with adequate proteins and adequate fats," says Nagel. What he encounters with most children in his practice is the opposite -- a diet high in refined carbohydrates, low in protein, and low in essential fats.
Nagel is keenly aware that dietary recommendations pit parents against an array of forces -- namely the pervasive marketing of junk food in school, at the mall and on the TV -- that make a difficult situation even harder. "If you look in a store, the lower shelves are the high-sugar foods for kids," notes Nagel. "And you know kids are impulse buyers like adults. The colorful, friendly kids' cereals on the bottom shelf are going to be very high in sugar, colorings and additives. Some of these have chemical effects on brain chemistry."
When confronted with government studies that state sugar is not an indicator for hyperactivity and dismiss the effect of food ingredients on behavior, Nagel asks that parents look at their own experiences. "Any parent can tell you that food affects behavior in their kids," he says. "And most parents know that refined sugars will stimulate the metabolism and can lead to hyperactivity."
In addition to refined sugars, Nagel recommends a trial elimination of wheat and dairy from a child's diet. "I look to the evolutionary concept that man was a hunter and gatherer," says Nagel. "Native Americans are a great example. Their diet essentially centered on protein in wild game and fish, nuts, berries and fruits. There were really no diary products and no grains."
"I also look, as a naturopath, at other mammals," says Nagel in reference to the milk question. "Nature is a great model for what we should be doing as a mammal. No mammals drink milk past weaning. That says to me that milk is really for babies."
"Another area we look at is toxicity in our environment," says Nagel. "It is always important to screen kids for exposure to lead or mercury. If we see significant burdens with these toxins, there may be ways to address how to get those out of the child."
Nagel also believes in looking for problems like anemia and low thyroid, which can lead to attention deficit problems. "It is very routine to see kids come to us from their physician on Ritalin without these common screenings done. So these doctors are not practicing good medicine and trying to find the nature of the problem -- instead they're going for the quick solution."
A central concern of Nagel's is fat. "Partially hydrogenated fats are like a plastic food," he says. "Your body can't make brain and membranes out of it. The brain is 60 percent fat. And the fats that are in the brain are essential fats that aren't partially hydrogenated. These bad fats can actually block the intake of many of the essential fats."
To address the essential fat deficiency, Nagel recommends fish in the diet. Short of that, the naturopath often suggests supplement sources of either fish oil or flaxseed oil, which is a vegetable source of essential fats.
"I believe that diet changes are a trial, just like giving a drug is a trial," says Nagel of his experimental approach. "If you take someone off the allergens, you're not doing it because it is going to work, but to see if it is going to work. The term we use is that of a therapeutic trial, meaning these dietary changes may not be forever. Foods may be carefully reintroduced into the diet."
"The unfortunate reality is that drugs are easy and parents have to really understand that the right thing is not always the easiest thing," says Nagel. "Most parents who come into our office realize that we are going to make diet and nutritional suggestions."
And what about Ritalin? "I think every parent has to make that decision," says Nagel of the oft-prescribed stimulant. "My call is not to say, Don't take Ritalin -- but to say, "Here are the alternatives." If these can be tried and be successful, they're much safer."
Doris Rapp, Is This Your Child's World?
William Crook, Help for the Hyperactive Child
Michael Schmidt, Smart Fats
Judyth Reichenberg-Ullman and Robert Ullman, Ritalin-free Kids