Medical Is fish really brain food for developing children?

[baywax]

Here's a site with links to studies on Nutrition and ADD showing detrimental and beneficial effects of diet as related to the disorder.

http://www.feingold.org/Research/adhd.html

This one specifically compared Ritalin to Food Supplements with regard to benefits. Both treatments faired well.

Outcome-based comparison of Ritalin versus food-supplement treated children with AD/HD. Harding KL, Judah RD, Gant C. Altern Med Rev. 2003 Aug; 8(3): 319-30.
" Twenty children with attention deficit/hyperactivity disorder (AD/HD) were treated with either Ritalin (10 children) or dietary supplements (10 children) . . . Subjects in both groups showed significant gains . . . . . .Numerous studies suggest that biochemical heterogeneous etiologies for AD/HD cluster around at least eight risk factors: food and additive allergies, heavy metal toxicity and other environmental toxins, low-protein/high-carbohydrate diets, mineral imbalances, essential fatty acid and phospholipid deficiencies, amino acid deficiencies, thyroid disorders, and B-vitamin deficiencies. . . . These findings support the effectiveness of food supplement treatment in improving attention and self-control in children with AD/HD and suggest food supplement treatment of AD/HD may be of equal efficacy to Ritalin treatment. "

If someone is going to try the smoothie mix, here's the effective Smoothie receipt:

1 ounce of Apple Juice around the blades of the blender

4 ounces of 6 to 18 percent milk fat Yogurt Plain on top

add 2 servings of Learning Factors supplement

Run blender until powder and yogurt and juice are mixed up

add bio-active type yogurt, raspberry or blueberry or mixed...

to the near the top... leave room for 2 or 3 bananas and half an apple... unpeeled.

Turn blender on high until completely blended.

serves about four cups...

(edit: apple unpeeled not the bananas;)

 

[Moonbear]

Here's a site with links to studies on Nutrition and ADD showing detrimental and beneficial effects of diet as related to the disorder.

http://www.feingold.org/Research/adhd.html

This one specifically compared Ritalin to Food Supplements with regard to benefits. Both treatments faired well.

There were only 10 kids per treatment group in that study. That's not a large enough sample size to have any power to detect differences. They probably fared equally well because they had no statistical power to detect differences even if they existed.

That journal is rather light on scientists (lots of doctors of naturopathic medicine, some MDs...MDs are not trained to evaluate research studies...and a couple PhDs) in their editorial review board, which suggests to me they are not a particularly reputable journal.

 

[Astronuc]

How did they test you for ADD or ADHD? With me, they just went by the complaints from my teacher about my behavior. No tests involved, IIRC.

My son and I were interviewed by a psychologist, and we took a computer based test that has some kind of a repetitive test. At this stage of my life, I'm borderline, i.e. I've managed to compensate for the most part. My son on the other hand is ADD (borderline ADHD). He takes Concerta, and that makes all the difference. Without Concerta, he has a hard time functioning 'normally'.

 

[baywax]

There were only 10 kids per treatment group in that study. That's not a large enough sample size to have any power to detect differences. They probably fared equally well because they had no statistical power to detect differences even if they existed.

That journal is rather light on scientists (lots of doctors of naturopathic medicine, some MDs...MDs are not trained to evaluate research studies...and a couple PhDs) in their editorial review board, which suggests to me they are not a particularly reputable journal.

Here's a broader study from the Global Neuroscience Initiative Foundation, Los Angeles, CA, USA. slakhan@gnif.org.

And here's an excerpt related to the topic of this thread...

Studies have shown that daily supplements of vital nutrients often effectively reduce patients' symptoms. Supplements that contain amino acids also reduce symptoms, because they are converted to neurotransmitters that alleviate depression and other mental disorders. Based on emerging scientific evidence, this form of nutritional supplement treatment may be appropriate for controlling major depression, bipolar disorder, schizophrenia and anxiety disorders, eating disorders, attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD), addiction, and autism.

Thank you : - )


http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

 

[Moonbear]

Here's a broader study from the Global Neuroscience Initiative Foundation, Los Angeles, CA, USA.

Broader in what way? It's not even a study, but a review article, and doesn't address ADD or ADHD at all. Did you read the article? It's not supporting your claim at all, but rather suggesting some nutrient supplements can help alleviate symptoms, but do not eliminate the disorder.

For example, they say:

Double-blind, placebo controlled studies, randomized, placebo controlled studies, and open-label clinical studies have all shown that approximately 2 g of EPA taken daily in addition to one's existing medication effectively decreases symptoms in schizophrenic patients [59,60,65].

Regarding the above statement, reference 59 is another review article. Reference 60 is a randomized, double-blind, placebo-controlled study, but only enrolled 40 patients (20 per group). Again, this is a very weak design for a clinical trial.

http://ajp.psychiatryonline.org/cgi/content/full/159/9/1596

And, conveniently, the ONLY OTHER clinical trial testing the same thing with a larger enrollment was left out of the references...the one that says there's NO effect:
http://ajp.psychiatryonline.org/cgi/content/full/158/12/2071

Reference 65 is an open-label clinical trial with only 12 patients enrolled! That's about as good as worthless. And, it wasn't even measuring schizophrenia symptoms, but merely serotonin binding to platelets.
http://www.ncbi.nlm.nih.gov/pubmed/15253886There are also some glaring errors in this paper.
As an example, they state:

Two double-blind, placebo-controlled studies were recently performed that compared the affects of a 900 mg daily dose of St. John's wort extract to 20 mg daily doses of Paroxetine (Paxil) or Fluoxetine; which are both SSRIs used to treat OCD. In comparison to patients taking Paxil, those who took the St. John's wort supplement showed a 57% decrease in OCD symptoms and were 47% less likely to exhibit side effects [69].

Except, when you look up the reference they cited, once you sort out that their citation in the reference list is for the erratum, not the original study and backtrack to the original study, you find out that the cited paper did NOT study OCD, but depression, and didn't find that St. John's wort was better than Paxil, but that it was equally effective (this is really no surprise...St. John's wort has been known for some time to have real pharmacological efficacy for depression with the only major concern regarding herbal supplements containing it being 1) that patients are self-medicating rather than getting a proper diagnosis before taking a pharmacological agent, and 2) that doses are not consistent in herbal supplements and not regulated to ensure consistency. The percent decrease in symptoms was from baseline, not relative to Paxil, so the above cited article grossly misleads the reader to think there is a greater effect than actually described (this is why it's important to read critically and not take one single author's word...dig up the articles they are citing and see if you come to the same conclusions or if they are being accurately cited).

More importantly, regarding the argument you're trying to make, that's not addressing a nutrient deficiency, but using an herbal supplement to provide a pharmacologically active compound.

http://www.bmj.com/cgi/content/abstract/330/7490/503
and the erratum
http://www.bmj.com/cgi/content/full/330/7494/759-a

In fact, each of their major conclusions is riddled with errors.

Randomized, controlled trials that involve folate and B12 suggest that patients treated with 0.8 mg of folic acid/day or 0.4 mg of vitamin B12/day will exhibit decreased depression symptoms [9].

Tracking down reference 9, it is NOT a randomized, controlled trial, it is an EDITORIAL!

And what was reference 9 ACTUALLY commenting about? This:

A recent metaanalysis looked at the results of 25 randomized controlled trials of folate supplements in people who were not selected because of low folate levels. The conclusion was that daily dosages of 0.8 mg folic acid or more, in addition to dietary intake, are typically required to achieve the maximal reduction in plasma homocysteine concentrations (about 25%).17 Vitamin B12 (0.4 mg/day) produced a further 7% reduction.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17353937

Not a dang thing about depression there, they're talking about homocysteine levels.
And why were the homocysteine levels being compared in the meta-analysis (note that you have to dig back three levels of references from the one cited to even get to a randomized clinical trial...one is an editorial, the next a meta-analysis, and finally one will get to the actual clinical trials).

Background: Dietary supplementation with B vitamins that lower blood homocysteine concentrations is expected to reduce cardiovascular disease risk, but there has been uncertainty about the optimum regimen to use for this purpose.

http://www.ajcn.org/cgi/content/full/82/4/806

Wow, the more I check their references, the more shockingly incorrect I find each and every statement I follow up! If this is indicative of the usual articles within this journal, it cannot be very reputable.

 

[baywax]

Broader in what way? It's not even a study, but a review article, and doesn't address ADD or ADHD at all. Did you read the article? It's not supporting your claim at all, but rather suggesting some nutrient supplements can help alleviate symptoms, but do not eliminate the disorder.

For example, they say:


Regarding the above statement, reference 59 is another review article. Reference 60 is a randomized, double-blind, placebo-controlled study, but only enrolled 40 patients (20 per group). Again, this is a very weak design for a clinical trial.

http://ajp.psychiatryonline.org/cgi/content/full/159/9/1596

And, conveniently, the ONLY OTHER clinical trial testing the same thing with a larger enrollment was left out of the references...the one that says there's NO effect:
http://ajp.psychiatryonline.org/cgi/content/full/158/12/2071

Reference 65 is an open-label clinical trial with only 12 patients enrolled! That's about as good as worthless. And, it wasn't even measuring schizophrenia symptoms, but merely serotonin binding to platelets.
http://www.ncbi.nlm.nih.gov/pubmed/15253886


There are also some glaring errors in this paper.
As an example, they state:


Except, when you look up the reference they cited, once you sort out that their citation in the reference list is for the erratum, not the original study and backtrack to the original study, you find out that the cited paper did NOT study OCD, but depression, and didn't find that St. John's wort was better than Paxil, but that it was equally effective (this is really no surprise...St. John's wort has been known for some time to have real pharmacological efficacy for depression with the only major concern regarding herbal supplements containing it being 1) that patients are self-medicating rather than getting a proper diagnosis before taking a pharmacological agent, and 2) that doses are not consistent in herbal supplements and not regulated to ensure consistency. The percent decrease in symptoms was from baseline, not relative to Paxil, so the above cited article grossly misleads the reader to think there is a greater effect than actually described (this is why it's important to read critically and not take one single author's word...dig up the articles they are citing and see if you come to the same conclusions or if they are being accurately cited).

More importantly, regarding the argument you're trying to make, that's not addressing a nutrient deficiency, but using an herbal supplement to provide a pharmacologically active compound.

http://www.bmj.com/cgi/content/abstract/330/7490/503
and the erratum
http://www.bmj.com/cgi/content/full/330/7494/759-a

In fact, each of their major conclusions is riddled with errors.


Tracking down reference 9, it is NOT a randomized, controlled trial, it is an EDITORIAL!

And what was reference 9 ACTUALLY commenting about? This:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17353937

Not a dang thing about depression there, they're talking about homocysteine levels.
And why were the homocysteine levels being compared in the meta-analysis (note that you have to dig back three levels of references from the one cited to even get to a randomized clinical trial...one is an editorial, the next a meta-analysis, and finally one will get to the actual clinical trials).

http://www.ajcn.org/cgi/content/full/82/4/806

Wow, the more I check their references, the more shockingly incorrect I find each and every statement I follow up! If this is indicative of the usual articles within this journal, it cannot be very reputable.

Thanks moonbear... I had no idea... good checking.

 

[baywax]

I am continuing my search, please "bear" with me!

The potential role of fatty acids in attention-deficit/hyperactivity disorder

A. J. Richardsonb, a, f1 and B. K. Purib
a University Laboratory of Physiology, Oxford, UK
b MRI Unit, MRC Clinical Sciences Centre, Imperial College School of Medicine, London, UK
Received 22 May 2000; accepted 14 June 2000. ; Available online 12 March 2002.


Abstract

As currently defined, attention-deficit/hyperactivity disorder (ADHD) encompasses a broad constellation of behavioural and learning problems and its definition and diagnosis remain controversial. The aetiology of ADHD is acknowledged to be both complex and multifactorial. The proposal considered here is that at least some features of ADHD may reflect an underlying abnormality of fatty acid metabolism. Clinical and biochemical evidence is discussed which suggests that a functional deficiency of certain long-chain polyunsaturated fatty acids could contribute to many of the features associated with this condition. The implications in terms of fatty acid treatment proposals are also discussed; such a form of treatment is relatively safe compared to existing pharmacological interventions, although further studies are still needed in order to evaluate its potential efficacy in the management of ADHD symptoms.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WPH-45BCP10-F&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1fefb5bd26129f56f8ea8930bdcf3a2f

Another paper:

The potential role of fatty acids in developmental dyspraxia – can dietary supplementation help?
Alexandra J. Richardson, D.Phil (Oxon), PCGE
Senior Research Fellow, University Lab. of Physiology
and Mansfield College, Oxford.
This article appeared in the Dyspraxia Foundation Professional Journal, 2002.
Correspondence address:
University Lab. of Physiology
Parks Road
Oxford
OX1 3PT
Email: alex.richardson@physiol.ox.ac.uk
Acknowledgements:
The author’s work in this area is supported by the Dyslexia Research Trust, Food And Behaviour Research and Mansfield College, Oxford.
Further information on research in this area can be found at www.fabresearch.org

Before ruling this paper out for not dealing directly with ADD and ADHD... please read #1 of the Summary.

Summary
1. Dyspraxia or developmental coordination disorder (DCD) shows substantial overlap with other developmental and psychiatric conditions both within individuals and within families – notably dyslexia, ADHD and autistic spectrum disorders, but also mood disorders and schizophrenia spectrum disorders. This indicates some common predisposing factors at the biological level. The proposal considered here is that these could involve aspects of fatty acid metabolism.
2. Certain HUFA of the omega-3 and omega-6 series are essential for normal brain development...

http://eprints.ouls.ox.ac.uk/archive/00000869/01/AJ_Richardson_2002_-_Fatty_acids_in_developmental_dyspraxia.pdf

I know, it says "could".

I admit I am basing my optimism about using nutrition to abate psychological conditions on my personal experience and on how my son's behaviour changed, for the better, in a very short time after nutrient supplements were introduced to his diet. My hope is that this sort of change of diet can help someone else clear up the "misfiring" taking place in their neurons.

Here's a study on the Health Benefits of DOCOSAHEXAENOIC ACID (DHA)

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WP9-45FCR6X-1C&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=0823a87a6929227d57870ac22df719e9

Here's the methodology taken from a review of a study at Purdue Univ. on ADD and ADHD and the role of essential fatty acid deficiencies using 90 children

METHODOLOGY

Ninety children with symptoms of essential fatty acid deficiencies have been recruited for this study. Children were chosen on the basis of parents and teachers completing the Disruptive Behavior Disorders (DAD) Rating Scales (27), a health questionnaire, and a three day diet record. Additionally, a control group of 20 children with no essential fatty acid deficiency and no behavioral problems were recruited. Four months was chosen as a sufficient time period of supplementations to see improvement in fatty acid status based on previous studies in both animals and humans. (17, 18)

A supplement containing the specific essential fatty acid derivatives that are depleted in the 90 children is being used in a double-blind intervention study with a 3-group parallel (noncrossover) design. The supplement being used in the study is Efalex Focus, a patented dietary supplement which combines tuna oil, evening primrose oil, vitamin E and thyme oil and produced by Efamol Ltd.

The 90 subjects have been randomly assigned to three groups:

Group A: To receive a high does of the supplement

Group B: To receive a low dose of the supplement

Group C: To receive placebo capsules

http://www.neuroimmunedr.com/Articles/ADHD___ADD/Purdue_Study/purdue_study.html

And here is the controlled study itself...

http://www.efph.purdue.edu/files/File/eb2007posters/oral-fish-oil.pdf

 

[Moonbear]

I don't have time (or more accurately, don't feel up to spending the time) right now to look further at your last set of references.

I will just point out that I did comment previously in the thread that things like malnutrition can impair attention and learning. Thus, it is entirely possible that some people will have their ADD-like symptoms disappear if they supplement their diet with missing nutrients. I would argue, however, that those people did not actually have ADD, but were misdiagnosed with ADD when what they really had wrong was a nutrient deficiency.

I also don't see anything inherently wrong with the possibility that some medications may work better with supplementation of some nutrients, especially if they for some reason are depleting a particular nutrient (consider how some high blood pressure medications lower potassium and people taking those medications do best with a potassium supplement). It's just not clear to me that appropriate studies have been done to demonstrate it (those small studies just aren't adequate...it really doesn't mean the hypothesis is right or wrong at this stage, simply that those studies aren't able to test it and will likely do more to muddy the picture with a lot of conflicting results before someone does a large enough study to have the power to really determine if there is really any benefit).

 

[OmCheeto]

I don't have time...

You have ADD.
Sorry.
Call me in the morning.

Dr. Om.

 

[Moonbear]

You have ADD.
Sorry.
Call me in the morning.

Dr. Om.

No, I just have sleep-deprivation.

 

[baywax]

I don't have time (or more accurately, don't feel up to spending the time) right now to look further at your last set of references.

I will just point out that I did comment previously in the thread that things like malnutrition can impair attention and learning. Thus, it is entirely possible that some people will have their ADD-like symptoms disappear if they supplement their diet with missing nutrients. I would argue, however, that those people did not actually have ADD, but were misdiagnosed with ADD when what they really had wrong was a nutrient deficiency.

I also don't see anything inherently wrong with the possibility that some medications may work better with supplementation of some nutrients, especially if they for some reason are depleting a particular nutrient (consider how some high blood pressure medications lower potassium and people taking those medications do best with a potassium supplement). It's just not clear to me that appropriate studies have been done to demonstrate it (those small studies just aren't adequate...it really doesn't mean the hypothesis is right or wrong at this stage, simply that those studies aren't able to test it and will likely do more to muddy the picture with a lot of conflicting results before someone does a large enough study to have the power to really determine if there is really any benefit).

Thank you Moonbear!

Theoretically, in my opinion, the difference between quelling the symptoms of a neurological disorder with pharmaceutical medication rather than with nutritional supplement would be that in the long term, nutrition will offer the repair of the neurological disorder where medication will not.

So, although it may be more tedious for the average American parent to, everyday, put together a concoction of bananas, yogurt and all that...for their affected child, instead of simply popping a pill into their kid's mouth... in the long run, theoretically, specific, targeted nutrition will serve the child better for the rest of their life. This is my hope anyway. And its not hard to imagine, as you said, how what appear to be well fed children running around (all chubby and so on) are actually starving when it comes to certain essential fatty acids etc...

 

[Moonbear]

So, although it may be more tedious for the average American parent to, everyday, put together a concoction of bananas, yogurt and all that...for their affected child, instead of simply popping a pill into their kid's mouth

What? You expect parents to ensure their kids get proper nutrition?! Seriously, I would suggest that be among the very first considerations if a kid is having difficulty with attention or school performance...but it doesn't mean that's what's going on for every kid with that problem.

This is my hope anyway. And its not hard to imagine, as you said, how what appear to be well fed children running around (all chubby and so on) are actually starving when it comes to certain essential fatty acids etc...

Indeed, it is possible to be overweight, even morbidly obese, yet malnourished. It sounds bizarre, but often people who are very overweight get that way because of bad dietary choices, and that can include a diet that provides plenty of calories, but is still deficient in important nutrients.

 

[baywax]

Indeed, it is possible to be overweight, even morbidly obese, yet malnourished. It sounds bizarre, but often people who are very overweight get that way because of bad dietary choices, and that can include a diet that provides plenty of calories, but is still deficient in important nutrients.

I guess I shouldn't get into how much I like beer right now. :|

 

[mgb_phys]

Beer is full of important nutrients (at least proper beer )

 

[baywax]

Beer is full of important nutrients (at least proper beer )

That's a definite. The beers in Germany are noted for their nutrient content. The "Maltz" beer is 1% booze and 99% malt. The vitamin B content is staggering. New mothers drink it to aid in nursing and to make real Germans out of their babies!

 

[Defennder]

My son and I were interviewed by a psychologist, and we took a computer based test that has some kind of a repetitive test. At this stage of my life, I'm borderline, i.e. I've managed to compensate for the most part. My son on the other hand is ADD (borderline ADHD). He takes Concerta, and that makes all the difference. Without Concerta, he has a hard time functioning 'normally'.

How does Concerta differ from Ritalin?

 

[Astronuc]

How does Concerta differ from Ritalin?

CONCERTA and Ritalin are just brand names, and both use methylphenidate
as the active ingredient. Conderta (methylphenidate HCl) differentiates itself from other methylphenidate pills by a special time-release technology. AFAIK, Ritalin is quick release and small doses can be used for relatively quick response until Concerta kicks in, which takes about 1 hr.

 

[Troponin]

Don't know if this has been touched, but if the current understanding of psychoactive disorders such as Depression and ADHD and the role neurotransmitters plays in their action holds true, they are far from "bull."

Dopamine can be called the Prolactin inhibiting hormone. People with Parkinson's (P's action is through Dopamine) take drugs such as Dostinex and Bromocriptine (which are anit-prolactin in nature). If a deficiency in Dopamine can cause a "disease" such as Parkinson's, with very definite somatic changes, an alteration in Nor-epinephrine, Dopamine, and/or Serotonin levels can/should be classified as a disease as well.

Telling someone with ADHD (caused by neurotransmitter deficiencies) to "stop letting your mind wander" is similar to telling someone with Parkinson's to "stop shaking and sit still!"

 

[baywax]

Fish in Mother's Diet Benefits Child, Study Finds

This study seems to support the importance of diet as related to social behavior, personal behavior and cognitive development.

By Sally Squires
Washington Post Staff Writer
Friday, February 16, 2007; Page A03

A large study has found that children of women who ate little fish during pregnancy had lower IQs and more behavioral and social problems than youngsters whose mothers ate plenty of seafood, a finding that challenges the U.S. government's standard advice to limit seafood while pregnant...

"Higher maternal fish consumption results in children showing better neurological function than children whose mothers ate low amounts of or no fish during pregnancy," Gary Myers, a professor of neurology and pediatrics at the University of Rochester Medical Center, said in an editorial accompanying the study. "These results highlight the importance of including fish in the maternal diet during pregnancy and lend support to the popular opinion that fish is brain food...

The findings are also expected to help determine whether the benefits of eating seafood for some segments of the population outweigh the risks of ingesting methyl mercury and other contaminants, including polychlorinated biphenyls (PCBs). "I think that the U.S. warnings are not meant to discourage fish consumption," said Eric Rimm, a professor of epidemiology and nutrition at the Harvard School of Public Health. He urged increased consumption of seafood during pregnancy, but excluded fish that have particularly high mercury levels: shark, swordfish, king mackerel and tilefish."

"In 1991, the Bristol researchers had begun the Avon Longitudinal Study of Parents and Children, one of the longest and most comprehensive studies ever to assess how environmental factors, including diet, affect the development, health and well-being of children. It included more than 14,000 women and about 13,000 of their children who survived to 12 months of age."

I guess I'll have to stop using tile fish and mackerel in the smoothies... (joke)

http://www.washingtonpost.com/wp-dyn/content/article/2007/02/15/AR2007021501515.html