But then, I also think it is logical that our immune systems are responsible for heart disease and high cholesterol, not that our livers (in a desperate effort to do us in) mastermind the release of cholesterol into the bloodstream to clog our arteries like an old sock dropped into the disposal. The reason I find the immune system to be a logical culprit is that the whole purpose of the immune system is to KILL THINGS and wreak havoc. Sometimes your armed forces turns tables on you - friendly fire, as it were.  Did you know there are at least 48 different studies showing a correlation between low cholesterol and greater mortality in the elderly?  Can you see why I at least question the idea of super low cholesterol as a laudable goal in light of the fact that our brains need lots of cholesterol and fat?)

ADHD in children. Controversial, of course, as stimulants are a primary treatment. The controversy looms large in part because behavior is primarily felt to be a parental/discipline problem. And there has always been the idea that "sugar" makes kids "hyper" - so we have this cultural meme of lazy parents and spoiled kids chowing down on skittles and garbage, driving the teachers nuts - the teachers, being lazy themselves, want the kids medicated into oblivion so that no one will have to do any work (especially, presumably, the psychiatrist, who happily prescribes addictive drugs in a 4 minute visit to keep the families coming back and to collect a large paycheck.) Do we really live in a world where everyone entrusted to keep our kids safe and happy is hopelessly lazy and corrupt? Because if the cultural meme is true, we are in deep trouble.

Let's get to reality, where families really suffer, and parents have tried everything, and teachers want kids to do better, and doctors try to spend some time in multifaceted ways to help.  "ADHD" is a recipe list of symptoms - hyperactivity and inattentiveness being primary. Part of the issue is the silly recipe list - ADHD symptoms are a function of problems with the frontal lobe of the brain, and while several neurotransmitters are involved, an inefficiency of dopamine transmission may be the key player. And, indeed, there are some families with lots of ADHD who have known genetic issues with their dopamine receptors. There. Simple. It's dopamine. A kid has the symptoms, hand them dopamine in a ritalin tablet, and call it a day.

Not so fast. Problem is, a lot of different issues can cause problems with the frontal lobe and other associated ADHD areas, not just genetic issues. Depression, for one, seems to torch our ability to stay focused. So will anxiety. Lack of sleep (I'll be more specific about sleep and ADHD symptoms and defiant behavior in another post). Other kinds of inflammation. Issues with a thinning frontal cortex in development. The vulnerability to the different insults will be genetic, and families in general face similar environments, so a family with lousy sleep or lousy eating habits might all turn up with ADHD symptoms, just like the family with the primary dopamine problem. Stimulants will generally help perk up the frontal lobe and behavioral changes will help too, regardless of the cause - but one never wants to ignore an ongoing environmental insult that is damaging the brain while you correct the symptoms with a band-aid.

The stakes are high. Kids with ADHD are much more likely to grow up and get divorced, lose jobs, be in car accidents, and commit felonies. We don't want to dismiss the biology of the problem as non-existent and focus entirely on behavioral treatments, but we also don't want to throw ritalin at every kid who spazzes out in school. It's a complex issue, a complex and multifaceted disorder, and for a while now I have suspected dietary causes to be the problem for some kids. I've even written articles about it a couple times - mostly reviewing the work of a British group who did a well-designed study of 300 some-odd kids in 2007 called the Southampton Study.

In short, the researchers gave kids in the community (so just a random sample of kids, not particularly any diagnosed with ADHD, though some of them may have been diagnosed with it), in blinded crossover fashion, placebo drinks or two types of food additive drinks, with washout periods in between drink trials. Kids on the additive-laden drink were significantly more hyper in the reviews of parents, teachers, and independent observers. The additives were food colorings and preservatives that would be easy to find in a lot of brightly colored "food" marketed for children.  It is the kind of study that should really make your ears perk up - sure, it ought to be repeated, but the results were pretty definitive. In fact, after this study came out, there were calls for voluntary bans on the use of artificial colorings in Europe.  (When I talk about conventional medicine's lack of support for the idea that diet could possibly be related to mental illness, the title of an article in Harvard's Mental Health Letter in June 2009, two years after the Southampton Study, was "Diet and Attention Deficit Hyperactivity Disorder - Can some food additives or nutrients affect symptoms? The jury is still out.").

Well, the British researchers continued to dig deeper into the results of the Southampton Study, and in 2010 they published another study in The American Journal Of Psychiatry (these guys do great work, and get their stuff published in all the premier journals). I wrote specifically about it here - ADHD, Food Additives, and Histamine. Again, in short, the researchers checked out the genetics of the same kids from the Southampton Study, and found that kids who were made more hyper by the food additives were significantly more likely to have certain problems with genes regulating their histamine system. Anyone who has ever taken a benadryl for swollen eyes and a runny nose on a pollen-laden spring day will know what histamine is, more or less. Our bodies release it in response to some sort of allergenic stimulus. I made the point in my blog that the Southampton study seems to show us that, indeed, in some children (not all!), ADHD symptoms are a food allergy.