UNRAVELING ATTENTION DEFICIT DISORDER
By Ward Dean, M.D.

I'd like to say that I believe the current epidemic of ADD is actually a created phenomenon. Certainly, there are children who suffer from what was formerly termed " minimal brain dysfunction." But many children who are undeservedly tagged with this diagnosis are merely normally active children. Children are naturally energetic and curious. However, in this daycare oriented society, the "good child" is often considered to be the one who sits quietly and says or does nothing. The child who is often referred for evaluation (inappropriately, I believe) for hyperactivity is the normal, active child who climbs the bookcases, pulls toys off the shelves, and runs around playing with his fiiends. Usually, these children tend to be highly intelligent, and, I believe, they are bored by their environment (classroom or daycare) which fails to challenge them intellectually or physically.

A major contributing factor to the ADD epidemic is the little known fact that public (government) schools all have federally supported programs for the "learning disabled." The more children who re diagnosed with ADD, the more federal money the schools receive, giving public schools a tremendous incentive to maintain as high a number of children with ADD as possible. Link this to the psychologists and physicians to whom these children are referred for evaluation and treatment and who also have a definite financial incentive for making a high percentage of positive diagnoses and we can understand why so many children are (mis) diagnosed with ADD.

THE BREAKFAST CONNECTION

I believe that an unrecognized cause of ADD is often hypoglycemia (low blood sugar). The cause of this condition is, paradoxically, the ingestion of too much carbohydrate (sugar). Browse through the cereal aisle of any grocery store, and read the labels of the breakfast cereals. After a "main ingredient," which may be rice, wheat, corn or oats, you'll discover a list of ingredients which probably includes sugar, fructose, corn syrup, dextrose, brown sugar, maltodextrin, and/or honey ,a veritable feast of refined carbohydrates. Children are normally very efficient in metabolizing carbohydrates. This carbohydrate load causes a rapid rise in blood sugar from the blood into the cells, resulting in a dramatic fall in blood sugar (hypoglycemia). This "crash" usually occurs one to two hours after breakfast, right in the middle of morning class!

Hypoglycemia can cause a number of changes physical, mental and emotional. These changes may manifest as aimless hyperactivity (or underactivity), loss of attention, inability to concentrate and emotional instability (surliness, screaming, crying and meanness), turning a normal child into a totally different person, almost a "Jekyll and Hyde" transformation, like someone who might be considered to have "ADD" and who "should" be treated with Ritalin.

I can't tell you the number of ADD diagnosed children of my patients who have become 11normal" after they were given a high protein, high fat, low carbohydrate breakfast instead of the usual fare of cereal, white toast & jelly, doughnuts, etc. I recommend such children be given poached eggs, bacon or ham for breakfast. This results in a sustained, slow release of sugar throughout the morning, usually lasting until lunch. For lunch, instead of spaghetti, macaroni and cheese or other high carbohydrate meals, give a tuna or peanut butter sandwich (read the label, use peanut butter without sugar) or other high protein, low carbohydrate food. Upon returning home from school, immediately provide another high protein, high fat, low carbohydrate snack. This often eliminates the crying, fighting or other tantrum like behavior after school. Finally, eliminate the "fruit roll ups" or other high sugar snacks and especially stimulating or addictive caffeine containing cola soft drinks. It should be noted that most grains (rice, wheat, oats, etc.) have an extremely high "glycemic index," very close to that of sugar.

When a child is clearly acting hypoglycernic parents must be aware of these acute, emotional turnarounds in a normal, happy, outgoing, ffiendly child give him/her a glass of orange juice or other fruit juice to cause a rapid rise in blood sugar, followed by a high protein, high fat snack to sustain the normalized blood sugar and prevent another "crash." I have often found it necessary to feed many "hyperactive" children (especially my own!) every two hours in order to maintain a state of normal behavior, with extremely gratifying results.

Another not infrequent cause of behavior inconsistent with ADD is food allergies. I have found the most common allergens to be milk, corn or wheat. Allergy induced behavior problems are often accompanied by a history of frequent colds and ear infections and "tubes in the ears."

A SAFER SOLUTION

Finally, for those children who really do have "minimal brain dysfunction" and even for those who don't I recommend use of the time honored and extremely well tested nutritional supplement, DMAE (dimethylanfinoethanol). DMAE has been used for years to improve behavioral disorders in children, and may have positive effects on intelligence and grades as well.

In a groundbreaking study, Dr. Leon Oettinger, Jr., found that DMAE had numerous advantages over the amphetamines (like Ritalin) in that there were no effects on heart rate or blood pressure and no induced "jitteriness." Instead of causing anorexia (loss of appetite) like the amphetamines, he found that DMAE actually improved appetite in many patients and caused no interference with sleep. In fact, he found that DMAE actually reduced sleep requirements. Oettinger concluded that DMAE "was a most useful tool in the handling of the child with behavioral problems. "

Dr. Stanley Geller reported in a double blind study of 75 children that DMAE in doses of 50 mg. twice daily resulted in improved functioning capacity, puzzle solving ability and organization of activity. In another double blind study of 50 children who had been diagnosed as suffering from "hyperkinetic syndrome," DMAE was administered in doses up to 500 mg/day (300 mg. in the morning, another 200 mg. at lunch). The author concluded that DMAE, "when administered at doses of 300 500 mg. per day for 12 weeks to moderately disturbed hyperkinetic children (6 to 12 years of age)... produces greater overall improvement in comparison to patients similarly treated with a placebo. "

RITALIN RISKS

I am neither a great fan of Ritalin nor a believer in the widespread over diagnosing of ADD. I believe learning and behavioral disabilities in children have a number of causes and that the vast majority are due to hypoglycemia and/or food allergies. I do not believe that Ritalin, although effective, is a panacea. Furthermore, I believe that Ritalin has more drawbacks than benefits: (1) dependence or addiction; (2) anorexia, leading to growth and developmental problems, and (3) sleep disturbances, further exacerbating learning problems. An additional consequence of Ritalin use is the recent determination by the Armed Services that a history of Ritalin use is a disqualifying condition for entry into the Army, Air Force or Navy.

Prior to using Ritalin, I would attempt to determine if there is a metabolic cause of the learning/behavioral problems. I would dramatically alter the diet, cutting out simple carbohydrates and increasing quality proteins and fats (eggs, fresh fish, chicken and meat, butter, coconut oil, olive oil, etc.). I would also prescribe the liberal use of vegetables, limited fruit, and rotational avoidance of milk, corn and wheat (to rule out food allergies). I would institute the use of DMAE, in doses beginning at 100 mg., in the morning, advancing the dosage as tolerated to 5 00 mg. per day in divided doses.

Ward Dean, M.D., is a specialist in anti aging and fife extension medicine. After an extensive military career as a flight surgeon and a member of the elite Delta Force, Dr. Dean opened a private practice in Pensacola, FL. He is the founder and medical director of the Center for Biogerontology in Pensacola and a well known author.

(Reprint, Healthy & Natural Journal, June/July'99, Vol 6, Issue 4)