Special Advice: Prescribing the right diet

Do not stare or turn away when you meet a child or person with special needs. Respond to them as you would to anyone else. Every fortnight, we bring you general information on special conditions, backed by expert knowledge, to help you understand the people with these conditions better. We hope it benefits you or someone you know


Hyperactive people must have foods that balance deficiencies and moods

For many years pediatricians and pediatric allergists have reported a higher incidence of allergies amongst children with hyperactivity. Though data pertaining to the cause of hyperactivity is incomplete, various factors have been linked to it. These include the well-known genetic factors, smoking during pregnancy, artificial additives in food and environmental pollutants.

Most of us may not be familiar with 'neurotransmitters' and their functioning. But for all those who have heard the word but don't know what it actually means, here it is.

Neurotransmitters are chemical substances that are released from the nerve fibre and are effective in the transfer of an impulse to another nerve or muscle. We know scientifically that neurotransmitters require essential fatty acids (EFAs) for optimal functioning. EFAs are converted in the body by the enzyme delta-6 desaturase, which then further converts it to other substances. Research concludes that hyperactive children have a deficiency of EFAs either due to an inability to absorb EFAs from the gastrointestinal tract or because their EFA requirements are higher.

The source of the problem also seems to be that the enzyme necessary for the conversion process does not seem to work efficiently enough in the hyperactive child and adult. Hence a diet that positively influences and increases the level of EFAs is highly recommended for an Attention Deficit Hyperactivity Disorder (ADHD) affected person. A deficiency of EFA normally causes a constant thirst, which is one of the symptoms of hyperactive children including sweaty hands as well as 'head sweats' at night.

Two-thirds of hyperactive children studied were deficient in zinc, magnesium and vitamin B6, which block the conversion process of EFAs. The B-group vitamins are particularly vital to the hyperactive child as one of their main functions is to regulate the central nervous system. A deficiency of Vitamin B2 and riboflavin may lead to symptoms such as headache, irritability and fatigue. Vitamins B6 and C are involved in neurotransmitter synthesis.

Foods affect moods

Komal Singh, a nutritionist with the Unicare Medical Centre, says, "Foods do affect the moods of people affected with behavioural problems. While care must be taken to rectify any deficiencies, it is also important to identify and eliminate foods that aggravate any behavioural problems or cause infractions.

"The way to do this is to start with a very basic diet that is beyond any suspicion and add other foods one by one until the culprit food has been found. Or, one can even eliminate foods one by one until the infractions stop. Sometimes the reaction is for a whole group of foods but sometimes it is for just one particular food.

"Usually such dietary changes are more effective when tailor-made to suit a particular case. In some case dietary changes may adequately reduce behavioural problems but one must not expect miracles. Generally, putting the affected person on a restrictive diet is not recommended. Knowing which foods do not pose a problem allows the person to eat a wider range of foods."

Komal adds, "Problem foods usually are milk, wheat, artificial colouring agents, additives, flavourings, antioxidant preservatives and some nuts. Store-bought cakes, pies, burger, patties, fish fingers, packet soups and sauces, processed meats, cordials, fruit squashes, fizzy drinks and more such foods, usually contain the above artificial ingredients. Replace these foods with unprocessed and natural foods."

Overuse of antibiotics

Komal warns, "Another common problem is a yeast overgrowth in the gut and intestinal lining due to an overuse of antibiotics. The yeast overgrowth prevents the absorption of certain food in the intestine and also contributes to the behavioural problems. Probiotics or friendly bacteria, must be used to counter and remove this yeast growth. Some of suggested supplements for ADHD affected person are vitamin B6, magnesium, and calcium. Also Blue-Green algae, which is a rich source of vitamins, minerals, fatty acids and amino acids. Highly recommended are fish oils and evening primrose oil that provide the beneficial Omega-3 and Omega-6 fatty acids."

Some hyperactive children are even known to be sensitive to sugar. While we know that sugar doesn't cause ADHD, there is a possibility that certain sugars like glucose influence brain neurotransmitter levels and, therefore, the activity levels in ADHD affected children, thereby adding to their problem. Recent studies on the use of artificial sweeteners suggest that some hyperactive children become more aggressive when given large doses of aspartame.

Hunger causes the 'good-mood tank' to be empty and this needs to be filled up as soon as possible. Certain foods have shown to break a negative mood. Identify these foods for the ADHD affected person under your care and make sure these foods are available in a snack form at all times - especially the difficult hour of the day when hunger gets the better of the affected person.

Many ADHD affected people are simply not hungry at set meal times and while the medication is in their system. It is important for these individuals to have snacks available that are high in protein and complex carbohydrates. They will rarely sit down and eat a complete meal, but rather will need to eat several small servings throughout the day. Research shows that all students have increased performance after a meal high in protein and complex carbohydrates such as peanut butter on wheat toast. Making these snacks available for teens and for students with ADHD is even more important because of their often irregular or poor eating habits.

l This concludes advice on Attention Deficit Hyperactivity Disorder. The information in this article and all the Special Advice articles preceeding this one has been provide by Ayesha Saeed Hussaini. An educationl psychologist and practising at the Comprehensive Medical Centre, Dubai, Ayesha is currently completing her PhD. from Sheffield, UK. She also heads SFS, a Dubai-based special families suport group.

The right approach

- We must avoid forcing a programme on a child - getting the child to co-operate is more important.

- The whole family should be involved. Don't expect the child to co-operate if he has to watch the rest of the family eat foods that he is not allowed.

- Read labels and join a support group that investigates artificial ingredients and take comfort in the fact that you are not alone.

- Breakfast is vital. One protein and complex carbohydrate is equal to three hours or the child's best concentration. A lesser breakfast might only help for one hour.

- ADHD affected children need regular snacks, every two-three hours. This helps maintain the concentration.