Issues - ADHD and food additives

Almost 30 years ago, in 1973, Benjamin Feingold M.D. presented extensive research to the American Medical Association linking food additives to learning and behaviour disorders. His extensive research was based on over 1,200 cases and included over 3,000 different food additives.

His pioneering work has been ridiculed and studies done to disprove his statements. However, in spite of these "negative Feingold studies" about 50% of those who have tried the Feingold diet (even subjects in published studies that went against Feingold's Hypothesis) had significant decreases in symptoms of hyperactivity. [J. Harley, R. Ray, L. Tomasi, et al. Hyperkinesis and food additives: Testing the Feingold hypothesis. Pediatrics 1978; 61: 811-817. and also F. Levy, S. Dumbrell, G. Hobbes et al. Hyperkinesis and diet. A double-blind crossover trial with tartrazine challenge. Medical Journal of Australia. 1978; 1: pgs 61-64.]

Interestingly, "negative study" researchers focused on only 10 food dyes versus the 3,000 food additives that Feingold had considered. (NOTE: The term Food Additives in the USA actually covers over 5,000 chemicals added to food products for various reasons—anti-caking, bleaching, coloring, flavoring, emulsifying, preserving, thickening.)

In spite of several studies attempting to disprove Feingold's "Food Additives Cause Hyperactivity" hypothesis, the doors have been reopened as it has become evident that food additives DO play a major role in the the hyperactivity of children. Recently, the US National Institutes of Health Consensus Conference on Defined Diets and Childhood Hyperactivity agreed to reconsider the Feingold diet due to the fact that the many studies disproving Feingold's hypothesis used inadequate guidelines in their study and testing process, making their results invalid.

For example:
C. Keith Conners, author of "Food Additives and Hyperactive Children," has been the main researcher refuting the Feingold hypothesis. Schauss and Rippere have done studies of their own on the correlation of food additives and hyperactivity in children, and have come up with some criticisms of Conners' Research that are detailed below. [C. Goyette, C. Conners, T. Petti, L. Curtis. Effects of Artificial Colors on Hyperkinetic Children: A Double-blind Challenge Study. Psychopharmacology Bulletin 1978; 14: 39-40 and also, V. Rippere. Food Additives and Hyperactive Children: A Critique of Conners. Britain Journal of Clinical Psychology 1983; 22: 19-32]

• Conners' used chocolate chip cookies as the placebo in his studies, which can hardly be considered an appropriate control substance. In studies of reactions to food in hyperkinetics, chocolate produced a reaction in 33% in one study and 59% in another.
• The amount of food dye dosages used in Conners' studies was way below the average daily intake based on FDA data. On the average, most children, between the ages of 5 to 12, take in a daily dose of 150 mg of mixed food dyes. Conners used a dose of 26 mg a day in his studies, which doesn't even compare to the real amount of intake by children.
• Low levels of food dye doses mixed with the long intervals at which they were given falls short of the real life scenario of most school-aged children.
• The type of blood test for allergy determination is irrelevant in determining the result of food additive studies.
• The scales used for behavior reactions was an inadequate measure of the true outcomes. The rating scale was subjective and did not test on daily intervals.
• Conners was biased going into his studies which skewed his results. He did not take into account the affect of other environmental factors such as lighting, and he discounted evidence supporting Feingold's diet.

If Feingold's hypothesis becomes more widely accepted, the food industry will be greatly pressured into making costly changes in food processing that will erode their profits. This is thought to be the main reason why Feingold's studies have been discounted. In other words, there is a conflict of interest on the part of the Nutrition Foundation, an organization supported by the major food manufacturers--Coca Cola, Nabisco, General Foods, etc. With this organization sponsoring most of the negative studies it's no wonder these studies are trying to disprove Feingold's study. The major food manufacturers will fight with everything they have to keep researchers mouths shut regarding the harmful effects of artificial food additives because wide acceptance of Feingold's Research would economically hurt these companies. [Mattes J. The Feingold diet: A current reappraisal. Journal of Learning Disabilities 1983; 16: 319-323]

ADD Facts and Statistics
For a term that was hardly known before the 1960's, learning disability has come to include everything from unexplained behaviour patterns to clinical autism and everything in between. Learning disabilities have emerged as one of the most wide-ranging medical problems of children who live in developed countries where communicable disease is no longer a major threat.
A learning disability is defined as a condition that effects one or more of the elementary processes involved in understanding and applying language skills—either spoken or written. Specific problem areas might include combinations of an inability to listen, to think, speak, write, read, spell or engage in mathematics. There might be dyslexia (the impaired ability to read or write causing the individual to reverse words or letters); or aphasia (a difficulty in speech or in understanding the spoken word).
Frequently, children with ADD/ADHD characteristics also have emotional instability. They display outbursts ranging from excitement to extreme anger, and are an enormous challenge for parents and educators who are not equipped to handle such situations. In distress, parents seek the advice of family physicians. The doctor, because of a lack of expertise in this field, frequently prescribes drugs in an attempt to corral the explosive behavior and decrease the learning handicap. children, but a conservative 5% figure is more widely accepted since the study that published that figure followed "improved diagnostic criteria." Boys show a 10 times higher incidence of ADD/ADHD than do girls. The drug "Ritalin" is the most common medical treatment with over 2 million American children (mostly boys) taking the drug. "Ritalin" prescriptions to children are controversial and the possible dangerous side effects are hotly debated.
The following excerpt from the Physician's Desk Reference makes it easy to see why Ritalin is so controversial:
RITALIN DRUG WARNINGS: "Sufficient data on safety and efficacy of long-term use (greater than 24 months) of Ritalin in children are not yet available ... suppression of growth (ie weight gain, and/or height) has been reported with the long-term use of stimulants in children. Therefore, patients requiring long-term therapy should be carefully monitored."
The frequency of just "accepting the drug Ritalin as a solution for children" is alarming for the following reasons:

1. Adults are making a decision and a choice that will affect each day of a child's life. A "choice" for the child to take a drug that has severe adverse reactions associated to it.

2. This decision will affect the child each day he is on the drug and possibly even for years after he no longer takes the drug.

Methylphenidate (Ritalin®)

U.S. Brand Names: Ritalin®

Use: Used to treat attention deficit disorder and hyperactivity.

Contraindications: Do not use in children under six years of age since safety and efficacy in this age group has not been established.

Warnings/Precautions: Use with caution with emotionally unstable patients, especially if these patients have a history of abuse. In psychotic children Ritalin may worsen symptoms of behavior disturbance and thought disorder. Abuse of this drug can lead to tolerance and psychic dependence with varying degrees of abnormal behavior, severe depression can occur with withdrawal.

Growth retardation (suppression of height and/or weight gain) has been reported in children using this drug. Long-term therapy (greater than 24 months) is especially dangerous.

Adverse Reactions:
Common: Trouble sleeping, nervousness, loss of appetite (anorexia or nausea), fast heartbeat (tachycardia), increased blood pressure.

Less Common: Dizziness, drowsiness, headache, nausea, stomach pain, black stools, blood in urine or stools, chest pain, fever, joint inflammation and pain, pinpoint red spots on skin, skin rash or hives, uncontrolled twitching or jerking of muscles, unusual bleeding or bruising

Rare (have been reported): Blurred vision or any changes in vision; abnormal liver function from minor to hepatic coma; narrowing and sometimes blockage of arteries in the head; transient depressed mood; a few instances of scalp hair loss; Tourette's syndrome--defined as repetitive grimaces and tics of head, neck, arms, legs, and trunk, also, involuntary barks, grunts, or other noises, in about half the cases the sufferer has episodes of coprolalia (using foul language).

Long-Term Use: Mood or mental changes, weight loss, stunted growth problems.

Methamphetamine

U.S. Brand Names: Desoxyn®; Dexedrine®

Use: Used to treat hyperactivity in children.

Contraindications: Do not use if you haven't tried other antidepressants and psychotherapy first, if you have high blood pressure, if you are very nervous or have severe insomnia, if you have a history of addiction to drugs or alcohol, or if you have Tourette's syndrome.

Adverse Reactions:
Common side effects include nervousness, insomnia, loss of appetite, and addiction. Less common side effects include high blood pressure, rapid pulse rate, tolerance, and feelings of suspicion and paranoia. This drug has a high potential for abuse, and studies have shown that in psychotic children, administration of amphetamines may exacerbate symptoms of behavior disturbance and thought disorder and may also exacerbate motor and phonic tics and Tourette's Syndrome.

Central Nervous System: Psychotic episodes at recommended doses (rare), overstimulation, restlessness, dizziness, insomnia, euphoria, dyskinesia, dysphoria, tremor, headache, exacerbation of motor and phonic tics and Tourette's syndrome.

Gastrointestinal: Dry mouth, unpleasant taste, diarrhea, constipation, other GI disturbances, anorexia and weight loss.

Allergic: Urticaria.

Endocrine: Impotence, changes in libido

Mixed Amphetamine Salts

U.S. Brand Names: Adderall®

Adverse Reactions:
Common Side Effects: Restlessness, dizziness, insomnia, headache, dry mouth, weight loss.

Less Common Side Effects: Euphoria, unpleasant taste, diarrhea, constipation, gastrointestinal disturbances.

Rare Side Effects: Palpitations, tachycardia, elevation of blood pressure, psychotic episodes at recommended doses, overstimulation, dyskinesia, dysphoria, tremor, exacerbation of motor and phonetic tics and Tourette's syndrome.

Other Side Effects: Uticaria, impotence, changes in libido.

Pemoline

U.S. Brand Names: Cylert®

Use: Used to treat ADD/ADHD.

Warnings/Precautions: Stimulant drugs are addictive, they produce a short-term mood elevation even in people who are not depressed and when the effect wears off the user crashes and feels very depressed, sleepy, and sluggish. Stimulants can stunt growth in children with long term use. In psychotic children these drugs may exacerbate symptoms of behavior disturbance and thought disorder, administer with caution to patients with significantly impaired renal function, CNS stimulants have been reported to precipitate motor and phonic tics and Tourette's syndrome.

Adverse Reactions:
Hepatic: Hepatic dysfunction including elevated liver enzymes, hepatitis and jaundice

Hematopoietic: Rare aplastic anemia

Miscellanous: Suppression of growth, skin rash

Central nervous system: Convulsive seizures, may precipitate attacks of Gilles de la Tourette syndrome, hallucinations, dyskinetic movements of the tongue, lips, face and extremities, abnormal oculomotor function including nystagmus and oculogyric crisis, mild depression, dizziness, increased irritability, headache, and drowsiness

Common side effect: Insomnia,

Gastrointestinal: Anorexia, weight loss, nausea, stomach ache

Venlafixine

U.S. Brand Names: Effexor®.

Use: Used to treat ADD/ADHD..

Contraindications: Do not take with MAOIs since interactions could be lethal.

Warnings/Precautions: Use with caution if you are taking cimetidine or if you have high blood pressure or liver disease or are elderly.

Adverse Reactions:
Body as a whole: Headache, asthenia, infection, chills, chest pain, trauma,

Cardiovascular: Vasodilatation, increased blood pressure, tachycardia, postural hypotension,

Dermatological: Sweating, rash, pruritus,

Gastrointestinal: Nausea, constipation, anorexia, diarrhea, vomiting, dyspepsia, flatulence

Metabolic: Weight loss

Nervous system: Somnolence, dry mouth, dizziness, insomnia, nervousness, anxiety, remora, abnormal dreams, hypertonia, paresthesia, libido decreased, agitation, confusion, thinking abnormal, depersonalization, depression, urinary retention, twitching

Respiration: Yawn

Special Senses: Blurred vision, taste perversion, tinnitus, mydriasis

Urogenital: Abnormal ejaculation/orgasm, impotence, urinary frequency, urination impaired, orgasm disturbance, menstrual disorder

Paroxetine

U.S. Brand Names: Paxil®

Contraindications: Do not use with MAOIs or in patients with a hypersensitivity to paroxetine or to any of the inactive ingredients in paroxetine HC1 formulations.

Pregnancy Risk: Do not use during pregnancy unless you absolutely need to. This drug is secreted in human milk, use caution when nursing.

Adverse Reactions:

10% experienced:

CNS: Somnolence, insomnia, agitation, tremor, anxiety, dizziness

Gastrointestinal: Constipation, nausea, diarrhea, dry mouth, vomiting, flatulence

Other: Asthenia, abnormal ejaculation, sweating, impotence, libido decreased

1% to 10% experienced:

Body as a whole: Infection, trauma, allergic reaction, headache, asthenia, abdominal pain, chest pain, back pain, chills, trauma

Cardiovascular: Vasodilation, palpitation, vasodilation

Dermatologic: Photosensitivity, sweating, rash

Gastrointestinal: Nausea, dry mouth, constipation, diarrhea, decreased appetite, dyspepsia, flatulence, increased appetite, oropharynx disorder, vomiting

Musculoskeletal: Myopathy, myalgia, myasthenia

Nervous system: Hypertonia, somnolence, dizziness, insomnia, tremor, nervousness, anxiety, paresthesia, libido decreased, drugged feeling, confusion, agitation, abnormal dreams, concentration impaired, depersonalization, myoclonus, amnesia

Respiratory: Cough increased, bronchitis, rhinitis, yawn, pharyngitis

Special Senses: Abnormal vision, blurred vision, taste perversion

Urogenital System: Ejaculatory disturbance, other male genital disorders, urinary frequency, urination disorder, female genital disorders, dysmenorrhea, impotence, menstrual disorder, vaginitis

Fluxetine

U.S. Brand Names:Prozac®

Contraindications: Do not use with MAOI inhibitor.

Pregnancy Risks: C; is excreted in human milk, nursing or being pregnant while on fluxetine is not recommended.

Adverse Reactions:

10% experienced:

Body as a whole: Asthenia, flu syndrome, fever, headache

Cardiovascular: Vasodilation, palpitation

Digestive: Nausea, anorexia, dry mouth, dyspepsia, diarrhea, flatulence, vomiting

Nervous: Insomnia, abnormal dreams, anxiety, nervousness, somnolence, tremor, libido decreased

Respiratory: Pharyngitis, sinusitus, yawn

Skin: Sweating, rash, pruritus

Urogenital: Impotence, abnormal ejaculation

Metabolic & nutritional disorders: Weight loss

Special senses: Abnormal vision

Bupropion

U.S. Brand Names:Welbutrin®

Contraindications: Patients with a seizure disorder, patients using other medications containing bupropion, patients with a current or prior diagnosis of bulimia or anorexia nervosa, patients using a MAO inhibitor, and patients who are allergic to bupropion should not use bupropion.

Warnings/Precautions: Do not use Wellbutrin with Zyban or with any other medications containing bupropion.

Pregnancy Risk: B; is secreted in human milk, potential for serious adverse reactions in nursing infants, do not use when nursing or pregnant.

Adverse Reactions:

10% experience: rash, nausea, agitation, migraines>

1% to 10% experience:

Body (General): Headache, infection, abdominal pain, asthenia, chest pain, pain, fever

Cardiovascular: Palpitation, flushing, migraine hot flashes

Digestive: Dry mouth, nausea, constipation, diarrhea, anorexia, vomiting, dysphagia

Musculoskeletal: Myalgia, arthralgia, arthritis, twitch

Nervous system: Insomnia, dizziness, agitation, anxiety, tremor, nervousness, somnolence, irritability, memory decreased, paresthesia, CNS stimulation

Respiratory: Pharyngitis, sinsusitis, increased cough

Skin: Sweating, rash, pruritus, urticaria

Special Senses: Tinnitus, taste perversion, amblyopia

Urogenital: Urinary frequency, urinary urgency, vaginal hemorrhage, urinary tract infection,

Valproic Acid

U.S. Brand Names: Depakote® Depacon®; Depakene®

Use: Management of simple and complex absence seizures; mixed seizure types; myoclonic and generalized tonic-clonic (grand mal) seizures; may be effective in partial seizures, infantile spasms, bipolar disorder; prevention of migraine headaches.

Contraindications: Hypersensitivity to valproic acid or derivatives or any component; hepatic dysfunction.

Dietary Considerations:

Alcohol: Additive CNS depression, avoid or limit alcohol

Food: Valproic acid may cause gastrointestinal upset; take with large amounts of water or food to decrease gastrointestinal upset. May need to split doses to avoid gastrointestinal upset. Food may delay but does not affect the extent of absorption. Coated particles of divalproex sodium may be mixed with semisolid food (eg, applesauce or pudding) in patients having difficulty swallowing; particles should be swallowed and not chewed. Valproate sodium oral solution will generate valproic acid in carbonated beverages and may cause mouth and throat irritation; do not mix valproate sodium oral solution with carbonated beverages.

Milk: No effect on absorption; may take with milk.

Sodium: SIADH and water intoxication; monitor fluid status. May need to restrict fluid.

Warnings/Precautions: Hepatic failure resulting in fatalities has occurred in patients; children under two years of age are at considerable risk; monitor patients closely for appearance of malaise, weakness, facial edema, anorexia, jaundice, and vomiting; may cause severe thrombocytopenia, bleeding; hepatotoxicity has been reported after 3 days to 6 months of therapy; tremors may indicate overdosage; use with caution in patients receiving other anticonvulsants.

Adverse Reactions:

1% to 10% experience:

Endocrine & Metabolic: Change in menstrual cycle

Gastrointestinal: Abdominal cramps, anorexia, diarrhea, nausea, vomiting, weight gain.

Less than 1% experience: Drowsiness, ataxia, irritability, confusion, restlessness, hyperactivity, headache, malaise, alopecia, erythema multiforme, hyperammonemia, pancreatitis, thrombocytopenia, prolongation of bleeding time, transient increased liver enzymes, liver failure, tremor, nystagmus, spots before eyes.

Overdose/Toxicology: Symptoms of overdose include coma, deep sleep, motor restlessness, and visual hallucinations. Supportive treatment is necessary. Naloxone has been used to reverse CNS depressant effects, but may block the action of other anticonvulsants.

3. Drug therapy has never cured a single case of learning deficit. Mask, cover, temporarily take away symptoms? Yes. But cure? No! Our society is filled with adults who were drugged as children. They still have the same learning problems. Some may have learned to hide, or otherwise compensate for their deficit over time, but for most the problems remain because the cause of the problems remain.

4. Research shows that many children who have taken drugs for ADD/ADHD continually have drug addiction problems with either legal drugs and/or illegal drugs for the remainder of their lives. The reason for this could be that they are convinced they can solve life's problems and difficulties by taking a pill.

ADHD and Children's Environment
by Peter Montague
Attention deficit hyperactivity disorder (ADHD) affects somewhere between 10% and 15% of all school children in the U.S. (1.8 million to 2.7 million children). The estimate is uncertain because the behavior of children can be erratic under the best of circumstances and therefore the disorder is not simple to diagnose. Indeed, many cases are thought to go undiagnosed.[1,2]

According to recent estimates, as many as 1.5 to 2 million children in the U.S. diagnosed with ADHD are currently taking Ritalin (methylphenidate hydrochloride), a prescription drug with cocaine-like characteristics, to calm them down and/or help them focus their attention.[1,pg.1;2,pg.3] In 1997, more than 10 tons of Ritalin were ingested by U.S. children to control ADHD. It was recently found that Ritalin causes liver cancer in mice (though not in rats), so the long-term consequences of Ritalin use by millions of children need to be considered.[2,pgs.13-14]

Much evidence suggests that the ADHD problem is growing. Last month, at a medical conference devoted to the disorder, the organizers of the conference estimated that occurrence of ADHD among children in the U.S. is doubling every 3 to 4 years.[3] The use of Ritalin quadrupled between 1990 and 1997.[1,pg.1]
Children with ADHD often continue the symptoms into adulthood, with unhappy consequences for job performance. According to one 1997 estimate, somewhere between 6.5 million and 9 million adults in the U.S. have ADHD -- making it as large a problem as clinical depression or drug abuse. In 1997, about 730,000 adults in the U.S. were taking Ritalin by prescription for ADHD.[4]

The causes of ADHD are not known, but they are thought to be a combination of hereditary predisposition and environmental factors. Research in recent years has focused on prenatal exposures to agents such as lead, cigarette byproducts, and alcohol. Since the 1970s, researchers have been studying the effects of certain foods and food additives such as dyes and colorings; over the past 25 years, 16 out of 23 studies have found that food additives exacerbate the symptoms of ADHD in some children.[2] Poor diet (malnutrition) undoubtedly contributes to ADHD.[2,pgs.23,37] Most recently, research has implicated pesticides and exposure to low levels of industrial chemicals that may interfere with hormones, especially thyroid.[2,pgs.53,59] Obviously, combinations of all these factors could be important.

ADHD was first identified as a specific disorder in 1902. The definition of the disorder has changed over time. In 1902, George Still described 43 children with aggression, defiance, emotionality, limited sustained attention, and deficient rule-governed behavior. From the 1930s to the 1950s, the term "minimal brain damage" was used to describe the syndrome, even though there was no evidence of brain damage in most of the children so labeled. During the late 1950s, hyperactivity began to dominate the description of the disorder and the official name was changed to "hyperkinetic reaction of childhood" or hyperkinesis. The use of stimulant drugs, like Ritalin and amphetamines, to treat ADHD began in the 1960s. (Some drugs that act as stimulants or "speed" in most adults can have a calming effect in children and even in some adults.) In the 1970s, researchers considered inatten- tion as central to the syndrome, and it became officially known as attention deficit disorder or ADD. In the 1980s and 1990s, the combination of attention deficits and hyperactivity have both been highlighted, thus the current name, Attention Deficit Hyperactivity Disorder (ADHD).5
The DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS IV, published by the American Psychiatric Association, describes 3 patterns of behavior that may indicate ADHD: consistent inattention, hyperactivity, and impulsive behavior, or combinations of these three behaviors.

Signs of inattention include:
1. the person fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities;
2. the person has difficulty sustaining attention in tasks or play activities;
3. the person often does not seem to listen when spoken to;
4. the person often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace;
5. the person often has trouble organizing tasks and activities;
6. the person avoids or dislikes or is reluctant to engage in tasks that require sustained mental effort;
7. the person often loses things necessary for tasks or activities, such as pencils or tools;
8. the person is easily distracted by extraneous stimuli -- the honk of a car's horn, or a bird flying by.
A person with 6 or more of these inattention symptoms for more than six months might be a candidate for an ADHD diagnosis.
Signs of hyperactivity and impulsiveness include:
1. feeling restless, often fidgeting with hands or feet, or squirming in a seat;
2. running or climbing excessively at inappropriate times;
3. leaving a seat early in the classroom or in other situations;
4. the person has difficulty engaging in leisure activities quietly;
5. the person is often "on the go" or acting as if driven by a motor;
6. the person often talks excessively;
7. the person blurts out answers before hearing the whole question;
8. the person has difficulty waiting in line or for a turn;
9. the person often interrupts or intrudes on others.
A person with 6 or more of these hyperactivity symptoms for more than six months might be a candidate for an ADHD diagnosis.
Because everyone exhibits some of these behaviors from time to time, the DIAGNOSTIC AND STATISTICAL MANUAL specifies additional guidelines for determining when they indicate ADHD:
1. Some of the behaviors must have begun early in life, before age 7;
2. In children the behaviors must be more pronounced than in others the same age;
3. Above all, the behaviors must create a real handicap in at least two areas of a person's life, such as school, home, work, or social settings. So, for example, a child would not be diagnosed with ADHD if he or she seems overly active at school but functions well elsewhere.
Studies of identical twins reveal that environmental factors contribute significantly to ADHD. It is not known whether environmental factors can cause ADHD in an otherwise normal person, or whether environmental factors only exacerbate ADHD among those who are genetically predisposed. In either case, people with ADHD often do poorly in school (many drop out early), have low self-esteem, and have difficulty making connections with other people. People with ADHD are often described as messy, disorganized, inattentive, irritable, and aggressive. Because their lives can be frustrating and unrewarding, some ADHD sufferers may become hostile and even violent. In May of this year, T.J. Solomon, 15, shot six of his schoolmates at Heritage High School in Conyers, Georgia, a suburb of Atlanta.[6] At the time, the Solomon boy was taking prescription Ritalin for ADHD.

Malnutrition can trigger ADHD, and large numbers of U.S. children are malnourished. The U.S. Department of Agriculture (USDA) publishes "recommended daily allowances" (or RDAs) for various nutrients. USDA considers that RDAs exceed the average nutritional requirements of average people; a person is assumed to be malnourished if he or she receives less than 60% of an RDA for a particular nutrient. Notably, the number of U.S. children consuming less than 50% of RDAs has been reported as follows: vitamin A (9%); vitamin E (15%); vitamin C (6%); calcium (7%); and zinc (6%).[7] There are roughly 18 million children in the U.S., so these percentages represent large numbers of malnourished individuals. These percentages may even be somewhat optimistic; many scientists consider RDAs inadequate measures of nutritional status because nutritional requirements vary considerably from one individual to the next, so averages may be misleading. Furthermore, the chemical form of a nutrient is important but is often not considered in typical assessments of nutrient status.[8]

There is considerable evidence that food dyes can worsen the symptoms of ADHD in some children, but government authorities deny the evidence. The U.S. Food and Drug Administration (FDA) has published a pamphlet called FOOD COLOR FACTS which states that "there is no evidence that food color additives cause hyperactivity or learning disabilities in children." The pamphlet, though published by the FDA, was actually written by the International Food Information Council, a trade association representing many makers of food additives including General Mills, Kraft, Procter and Gamble, Pepsi-Cola, Coca Cola, Monsanto (maker of aspartame), and Ajinomoto (maker of monosodium glutamate).[2,pg.25] To make the statement that there is no evidence that food dyes cause hyperactivity or learning disabilities in children, the FDA had to ignore 16 double-blinded studies that have shown that food dyes do worsen the symptoms of ADHD in some children.[2] (A double-blinded study is one in which neither the participants, nor those observing and recording the children's behavior, know which children have been exposed to food dyes and which have not, the purpose being to avoid bias.)

In 1976, a study of U.S. children between the ages of 6 and 11 found they ingested an average of 76 milligrams of food dyes per day (mg/day). Ten percent of those studied ingested twice that amount, or 146 mg each day. Since that time, the quantity of food dyes manufactured per person in the U.S. has increased 50%.[2,pg.11]

At a time when Americans are searching for causes of aggression and violence among children, it would make sense to consider malnutrition, food additives, tobacco additives, toxic metals, pesticides and other endocrine-disrupting industrial toxicants -- all of which many U.S. children are exposed to from the moment of conception onward.

Resources
[1] Joseph A. Bellanti, William G. Crook, and Richard E. Layton, editors, ADHD ATTENTION DEFICIT HYPERACTIVITY DISORDER, CAUSES AND POSSIBLE SOLUTIONS, CONFERENCE SYLLABUS OF PRESENTATION PAPERS NOVEMBER 4-7, 1999, KEY BRIDGE MARRIOTT HOTEL, ARLINGTON, VIRGINIA (Alexandria, Virginia: International Research Consultants, November, 1999). Available for $25 from: International Research Consultants, Suite 2J, 4600 King Street, Alexandria, Virginia 22302. Telephone (703) 998-6091; fax: (301) 320-4688; E-mail: irconsult@aol.com. The conference was sponsored by the Georgetown University Medical Center (Washington, D.C.) and the International Health Foundation (Jackson, Tennessee).
[2] Michael F. Jacobson and David Schardt, DIET, ADHD & BEHAVIOR; A QUARTER-CENTURY REVIEW (Washington, D.C.: Center for Science in the Public Interest, November, 1999). Available for $8.00 from the Center, No. 300, 1875 Connecticut Avenue, N.W., Washington, D.C. 20009; telephone (202) 332-9110; fax: (202) 265-4954; E-mail: cspi@cspinet.org. Also available free at www.cspinet.org.
[3] Joseph A. Bellanti and William G. Crook, "Introductory Remarks" in the syllabus cited above in note 1, pg. 1.
[4] David J. Morrow, "Attention Disorder Is Found In Growing Number of Adults," NEW YORK TIMES September 2, 1997, pgs. A1, D4.
[5] Marianne Mercugliano Glanzman, "What is ADHD," in the syllabus cited above in note 1, pgs. 3-16.
[6] Associated Press, "Boy's Mother Apologizes Over Shooting in Georgia," New York Times May 25, 1999, pg. A19.
[7] Donald R. Davis, "Nutritional Deficiencies in American Children," in the syllabus cited above in note 1, pgs. 17-21.
[8] For example, see Roger J. Williams, NUTRITION IN A NUTSHELL (Garden City, New York: Doubleday, 1962).

Descriptor terms: adhd; attention deficit disorder; hyperactivity; children; ritalin; cancer; carcinogens