Did you watch the ABC’s three-part series “Kids on Speed“? It detailed a 9-week intervention for four families with children who are suspected of having ADHD. When the ABC does Reality TV, their point of difference from commercial stations is that they tend to be well-researched, grounded in science, using field experts, and delivering content that can actually help the viewer to make positive changes in their lives (eg Redesign my Brain; Making Couples Happy).
“Kids on Speed” received criticism in some online communities for not including diet as part of their considerations and intervention. Here’s why I think diet wasn’t addressed in the show: It’s too darn complicated. You give kids some medication, you can pretty quickly track what happens; you give parents some behavioural interventions, again it’s pretty easy to monitor and track changes. But diet? Oh My Word – diet is COMPLICATED. Different people react to different foods in different ways, at different doses, at different times, and it takes a heck of a long time to figure it all out.
Here’s the other reason it’s not addressed: the science is inconclusive on diet.
I hate that second reason. I hate it because the anecdotal evidence is large (eg see fedup.com.au for 92 pages of anecdotal accounts of ADHD symptoms being improved by diet). Adding to that anecdotal evidence is my own experience with my children. I think my kids are pretty awesome. I’m proud of how they’re growing up, and I know we do a lot of behavioural stuff with them to make that happen. It is also true that part of our management plan is diet – and there is no way I would be without it. My children CAN NOT have colours, preservatives or other additives – one reacts behaviourally, the other with gut issues. The difference stands out like day against night. As a parent, if food is messing with my kids’ capacity to engage in this world, I want to know about it – rather than disciplining them for things that are (as yet) outside of their capacity to control.
So why is the science “inconclusive”? To get “conclusive” evidence, we need some large-scale, scientifically rigorous randomised control trials. In the field of diet, this is incredibly difficult and costly to achieve. Food intolerances (distinct from allergies) are determined through an elimination diet followed by systematic food challenges. This requires MASSIVE buy-in from participants, who have to commit to weeks of a completely different diet, a new set of recipes, no access to takeaway or processed foods for at least the short-term, with no room for mistakes; followed by (ideally) double-blind placebo-controlled food challenges. A study of this magnitude is expensive to implement, with high risks of non-adherence and participant drop-out – and who would fund such a thing? Certainly not big pharma. Who’s going to be lobbying against it? Most of the processed-food industry. It’s simply not easy science to do.
There have been some studies, for example:
- A double-blind placebo-controlled challenge study of 39 children found that artificial food colours had an adverse effect on children’s behaviour (Pollock & Warner, 1990)
- A double-blind placebo-controlled repeated-measures study with 34 test children (identified as “hyperactive”) and 20 control children found that the artificial colour tartrazine was associated with irritability, restlessness and sleep disturbances for 70% of test participants (Rowe & Rowe, 1994)
- A review of studies into the relationship between diet and behaviour concluded that diet definitely affects some children, including those with ADHD, but that due to the broad range of possible food items, it is a very complex issue to dissect (Breakey, 2008)
I’m sure there’s more… somewhere… but that’s not much, is it? It’s SOMETHING – a definite start. But if you compare it to the wealth of research into the use of ADHD medication and behavioural interventions, it’s hard to argue that an evidenced-based television show should also include an examination of diet.
Nonetheless, I really wish it did.
I am a behaviourist, through and through – and I have also seen across many families dietary modifications alone be responsible for changes in:
- Levels of eye contact
- Capacity to persist at tasks without frustration
- Frequency, duration and intensity of tantrums
- Aggressive and violent behaviour
(and that’s not an exhaustive list).
As a Clinical Psychologist, diet is not my field of expertise at all – and yet as someone who assists parents in the implementation of behavioural interventions it seems remiss of me to not at least mention that the role of food should be considered too. In the same way, I might mention to a consumer of alcohol that our interventions would be more effective if they were sober.
This is the advice I find myself giving often:
- In addition to evidenced-based behavioural interventions why not grab yourself a copy of Sue Dengate’s Fed Up DVD (or book, for those more book-ish)
- Have a watch – and one of two things will happen – either you’ll think “Oh that is totally my little Jack – we really need to give this a try;” or “Yeah, I don’t think that’s relevant to us” – either way, I’ll know you’ve seen some thorough information on the topic, and you can go on from there.
As always, I’m interested in your own experience. Please leave a comment below.
Breakey, J. (1997) The role of diet and behaviour in childhood. Journal of Paediatrics and Child Health, 33, 3, 190-194
Pollock, I. & Warner, J. O. (1990) Effect of artificial food colours on childhood behaviour. Arch Dis Child, 65, 74-77
Rowe, K. S., & Rowe, K.J. (1994). Synthetic food coloring and behavior: A dose response effect in a double-blind, placebo-controlled, repeated-measures study. The Journal of Pediatrics, 125, 5, 691-698