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Attention Deficit Hyperactivity Disorder

Diet and Behavior Modification

10/25/1998

Question:

My son is having a terrible time with Ritalin. He has started taking an antidepressant and its now time to stop the Ritalin completely. How can I get information on diet and behavior modification. He is 10 years old and is extremaly insecure, and impulsive. He repeats destructive behaviors over and over and when I ask him "didnt we just talk about this?" he responds like he has no clue .

Answer:

You sound frustrated...like many parents of children with ADD. I hope your son does well on the antidepressant alone, but if he does not, keep in mind there are other medications in the "stimulant" class and they may react much differently in your son than the Ritalin did. There is little good scientific information on diet and ADD/ADHD. The studies have all pointed towards no positive or negative role for refined carbohydrates (e.g., sugar) although enough parents feel differently I tend to think the jury is still out. My personal opinion is that the current "nutrition pyramid" is an excellent diet for behavioral concerns. It gives a lot of energy yet does not over emphasize meats or sugars or oils. I think that part of the problem we have had identifying diet correlations is that each of us is so unique that one person may react to refined sugar like another does to a specific red dye, and another to a nitrate. It's difficult, but the answer may often be found in trying a "pure" pyramid diet, then, if you notice improvement, add in things--one every few weeks. Even that has little scientific basis, but I have had several families do well with this approach, if they have the time and patience. Unfortunately, diet alone seldom seems to help with ADD. Destructive behavior can have many origins. Some can be "easily" modified with medication. Others need intensive behavioral modification. Still others need extensive psychotherapy. I hope you are seeing a specialist. Good luck with it all and I hope that you get the help you and your son need.

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Response by:

Susan Louisa Montauk, MD
Formerly Professor of Family Medicine
University of Cincinnati