Drastic increase of ADHD requires increased knowledge and research

This column is written by Stig Bengmark – Professor Emeritus, scientist, lecturer and writer. Read more of Stig Bengmark’s columns here.

According to the WHO, the number of patients with chronic diseases has increased very rapidly in the last 40-50 years, especially among those without a history of infections. This also applies to young people aged 3 to 17 – it’s estimated that about 15% of this age group already have some form of chronic disease.

This is considered to be due, in large part, to all the chemicals used in our foods (currently more than 300). It’s really striking to read that in just over ten years (between 1997 and 2008) the incidence of autism in the United States increased by 290% and ADHD by 33%. The trend is the same in the rest of the world, including Sweden – the number of ADHD diagnoses in children has been reported to have increased by about 700% in the last ten years (e.g. from Västmanland County, and the same trend can be seen all over Sweden). Possibly the increase is even larger – a lot of things are being hidden.

It affects those who are already exposed

ADHD is associated with low birth weight (less than 2.5 kg), among other things. According to one study of about 20,000 individuals in the UK, the prevalence of ADHD, though with many exceptions, is greatly overrepresented in groups with socio-economic problems: low income, poverty, young mother, low parental education, single parenthood, and so on. Poor knowledge of food and health has been particularly noted among this group. ADHD in adolescence is described as causing both socio-economic problems and major health problems later in life, and especially often drug abuse.

Pre-cooked food is the number one suspect – why not give it up?

Although the underlying causes of ADHD are still largely unclear, researchers today often associate the disease with lifestyle-related factors, especially chemical additives found in industrially-prepared foods. Although there are laws in both the EU and Sweden that stipulate that additives of chemicals must be declared on the packaging, they’ve unfortunately not had the desired impact. They’re often found in hidden places, written in small print and consisting of a number. Busy people, not least parents of small children (those who most enjoy ready-made food), don’t have enough energy to make the effort to find it. Refraining from buying ready-made food seems to be the best option and this is now what most researchers recommend.

Our intestinal flora hates chemicals of various kinds – also medicines

Take care of your gut flora – it decides whether you stay healthy. A strong link has been found between a lot of diseases and the mother’s lifestyle, especially during pregnancy or breastfeeding. The mother’s lifestyle before, during and after the birth (when she’s breastfeeding) plays a significant role in the baby’s health, also much later in life – even in old age – because it’s during the period around birth that the baby’s immune system is developed and ‘fine-tuned’.

In the early 1990’s, the English researcher, David Barker, showed a strong connection between the mother’s lifestyle during this period and how the child’s health would be in old age – he found a statistical connection between ‘bad’ lifestyles and the occurrence of diseases such as diabetes and Alzheimer’s later in life. Recent studies show that a large proportion of western mothers have very poorly functioning intestinal flora – dysbiosis – which leaks toxins into the foetus, for example, chemicals, medicines and the bacterial toxin endotoxin, even whole bacteria and remnants of bacteria. According to a US study, about half of babies in the United States are already infected at birth – even if they were born by caesarean section – and this is clearly not what we want. If the mother has ADHD, the foetus may also receive some of her eventual amphetamines or other medication as early as during her gestation, and during her breastfeeding period.

The picture below illustrates how health is affected by external factors in different periods of life. However, the individual’s own decisions about lifestyle still have the greatest significance.

The chemicals are found in processed western food – that’s what you should be cutting out

One thing’s for sure – ADHD is clearly overrepresented among those who eat a traditional western diet. 1,799 fourteen-year-olds were followed for 14 years from birth, and they showed a strong association between the prevalence of ADHD and consumption of western food (Howard AL et al J Atten Disord 2011; 15: 403-411). Another study of 4,000 children showed that intake of ‘junk food’ from as early as 4 years old could be associated with significantly increased hyperactivity as early as age 7 (Wiles NJ et al) Eur J Clin Nutr. 2009;63:491-498). A third study from 2012 shows a no less than threefold increased risk of ADHD when consuming ‘fast food’ (Azadbakht L, Esmaillzadeh A. Nutrition. 2012;28:242-249).

Use only clean, fresh, and raw ingredients

In the desperate situation we currently find ourselves in, there’s no other solution than to give up all food connected with industrial production. Instead of wasting time and effort in identifying the effects of all additives, researchers are increasingly investing in something called exclusion studies – i.e. excluding anything that may contain chemicals and only focusing on pure, raw ingredients. A number of such studies have already been published and more are on the way. These have actually had an unexpected amount of success – a reduction in symptoms of about 50% is a common result

A group of 15 children with ADHD aged from 3.8 to 8.5 years were allowed to eat only the following ‘pure ingredients’ for nine weeks: turkey, lamb, vegetables, fruit, margarine, vegetable oils, teas, pear juice and water (among others, bread and dairy products were excluded). These children were compared with 12 other children who were allowed to eat what they liked during the same period. When the results were assessed by teachers and parents, they were very positive – 11/15 (73%) of the children had, according to the parents, significantly improved, something that was not the case with those who were allowed to eat what they wanted, 0/12 (0%). The teachers’ assessment matched that of the parents – 11/15 (70%) of the treated children had significantly improved compared to none in the group that served as a control – 0/7 (0%). It could be suspected that the results were even better than the numbers show because in studies like these it’s difficult to motivate people suffering from ADHD to participate fully – many of them cheat, in some studies actually up to half, which can drag down the positive result.

In fact, ADHD children are among the most difficult to motivate among all disease groups, nor is there any organisation for organising permanent programs of this kind in schools – it currently seems hopeless regarding implementing programs like this on a larger scale. Unfortunately, it will probably remain that way since the studies have ended.

In selective studies, children with ADHD improved in all parameters after a five-week exclusion diet

The same research group continued working, and in 2011 published a major study in one of the world’s most respected medical journals – The Lancet. 100 children aged 4 to 8.5 were ‘randomly selected’ to either eat a so-called ‘restricted’ diet, which was put together to be healthy. The participants in the ‘restricted’ group returned to their normal diet after 5 weeks and their developments were recorded using a number of parameters that proved to be useful in contexts such as these. As can be seen from the picture below, all parameters in the so-called diet-restricted group (red in the picture) improved and deteriorated again when they returned to their ‘normal diet’.

Gluten and dairy-free are promising

There’s a lot to suggest that gluten and probably also dairy products have a negative effect. 67 individuals with hyperactivity aged from 7 to 42 years were followed between 2004 and 2008, of whom 10 had classic ADHD. Following the introduction of a gluten-free diet, the parents and/or patients themselves reported a significant improvement.

A happy message – a breakthrough on the way?

A Finnish study that’s just now being updated (March 2015), provides a new and fascinating perspective. The researchers monitored 65 children who participated in a study more than 13 years ago, in which mothers were randomly selected to take probiotics during the last 2-4 weeks at the end of their pregnancy and give their babies probiotics for the first six months of life, which were then compared with those who received the same regimen but with a placebo, i.e. an ineffective drug. The idea was to see if it could reduce the incidence of allergies, which it actually did – the children showed about a 50% reduction in the incidence of allergies.

I want to praise the researchers because now, 13 years later, they’re examining the children again – this time to see if this treatment may have had an influence on the later onset of ADHD, which, surprisingly, turned out to be the case.

Probiotics during the neonatal period completely eliminated ADHD in adolescence – it really is true!

The children were post-examined at the age of 13 by child neurologists or child psychiatrists, and the completely surprising finding was that those who had their intestinal flora strengthened during the neonatal period had apparently become ‘immune’ to the development of ADHD later in life. In fact, this group did not contain a single individual with hyperactivity disorder (ADHD) nor Asperger’s syndrome (AS) (0/40 = 0%), while the group that did not receive probiotics in the neonatal period actually showed symptoms of these diseases in no less than 6/35 cases (17.1%) – almost every seventh child. (Pärtty A et al Pediatr Res. 2015 E-pub Mar 11).

These observations offer great hope for the future.

Nobody wants to take medicines – but still they’re growing like there’s no tomorrow

According to a fairly large circle of experts, it’s important not to place too much hope on the drugs that are currently available, but nevertheless the prescription of ADHD medicines is increasing like there’s no tomorrow. At present, doctors probably see no other way than to treat those who have ADHD with medicines – their only real resource. Diet treatment requires twice as many resources, even if parents are often reported to be very much involved. It also requires participation from society – something that so far seems to be missing!

Thankfully, new research initiatives are likely to confirm what has already begun to be seen, namely that the supply of probiotics could break the trend.


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