Posts Tagged ‘ADHD’

Can Fish Oil Make Children Smarter?

Written by Dr. Steve Chaney on . Posted in Food and Health, Issues, Supplements and Health

When Do Omega-3 Supplements Make Sense?

Author: Dr. Stephen Chaney

Confused ChildWe know that the omega-3 fatty acids found in fish oil are critically important for brain development. But will they really help our kids learn better? Some studies suggest that they do, while other studies have come up empty. Why is this? More importantly, what does it mean for your children? Will fish oil supplements help or not?

I’ve selected today’s study (Portillo-Reyes et al, Research in Developmental Disabilities, 35: 861-870, 2014) because it sheds some light on those important questions.

Can Fish Oil Make Children Smarter?

This study looked at the effect of supplementation for 3 months with 360 mg of EPA + DHA on cognitive function of malnourished Mexican children, ages 8-12 years old. The children came from poor neighborhoods where foods rich in omega-3 fatty acids were seldom available. Low intake of omega-3 fatty acids was confirmed by a food frequency survey.

Cognition was assessed based on a battery of 16 standardized cognition tests at the beginning of the study and again 3 months later.

The results were fairly clear cut. The children receiving the fish oil supplements showed significant gains in mental processing speed, visual-motor coordination, perceptual integration, attention span and executive function compared to children receiving a placebo. In case you were wondering, the first three most strongly affect a child’s ability to learn and last two affect their tendency to display ADHD symptoms.

What Is the Significance of This Study?

There are a lot of things not to like about the study:

  • It was a small study (59 children total)
  • Blood levels of omega-3 fatty acids were not determined.
  • It was a short term study (12 months would have been better).
  • Measuring the ability to learn is difficult. Experts in the field differ about which cognitive tests are best. I’m not taking a position on the adequacy of the tests they were using because that is not my area of expertise.
  • Because it was done in a poor region of Mexico, one could argue that its applicability to children in this country is uncertain.

 

So why even mention this study? That’s because it illustrates an important principle – one that is often ignored in the design and interpretation of clinical studies.

Simply put, the principle is that not everyone will benefit equally from supplementation. It is the malnourished and the sick who will benefit most. When you focus your clinical studies on those groups you are most likely to observe a benefit of supplementation. When you focus your study on well nourished, healthy individuals it will be much more difficult to observe any benefit. And if you perform a meta-analysis of all studies, without evaluating the studies on the basis of need – nutrition status and health status – benefits will also be much more difficult to demonstrate.

This study is just one example of that principle. In an earlier “Health Tips From the Professor” (Can DHA Help Johnny Read?) I reported on a study looking at the effect of DHA supplementation on reading ability of English schoolchildren. In that study, it was the children who were most deficient in DHA and started with the lowest reading skills who benefitted most from DHA supplementation.

What does all of this mean to you?

  • If you are a parent, you may be asking if a study done with Mexican children eating poor diets has any relevance for your kids. In today’s world of pop tarts and pizza it just might. Most children don’t order sardines on their pizza. As a consequence, many American children don’t get enough omega-3 fatty acids in their diet.
  • Should your children be getting more omega-3s in their diet? A recent study concluded that most American children only get 20-40 mg/day of DHA from their diet. So if your child’s food preferences don’t include salmon, sardines and the like – and if your child is experiencing learning issues or problems with ADHD, you might consider adding fish oil supplements to their diet. There’s no need to megadose. The international standard is around 200 mg/day of DHA for children 7 or older.
  • If you are one of those people who is confused by conflicting headlines about the benefits of supplementation, you may want to look at the studies behind those headlines and ask if supplementation would have been likely to provide any benefit in the subjects studied.

The Bottom Line:

1)     A recent study reported that supplementation with fish oil significantly improved learning skills in children consuming a diet that was deficient in omega-3 fatty acids.

2)     If your children are not consuming foods rich in omega-3 fatty acids such as coldwater fish, you might wish to make sure that they are getting adequate levels of omega-3 fatty acids in their diet. Most experts recommend around 200 mg/day for children over 7.

3)     This study also illustrates the principle that supplementation is most likely to be of demonstrable benefit to those who have the worst diets and the greatest need. That doesn’t mean that supplementation won’t benefit everyone, but it does mean that it may be difficult to prove the value of supplementation in healthy people consuming a good diet.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

Do Artificial Colors Cause Hyperactivity?

Written by Dr. Steve Chaney on . Posted in Food and Health, Muscle Therapy and Health

Color Them Hyperactive

Author: Dr. Stephen Chaney

artificial food colorsEach year between 3 and 10% of school aged children are diagnosed with attention deficit/hyperactivity disorder (ADHD), also known as hyperactivity.

Most of these children are currently being treated with drugs. And these drugs have side effects – ranging from relatively minor (loss of appetite, weight loss, insomnia and mood swings) to major (suicidal thoughts, psychotic behavior and drug abuse).

So it is only natural for parents to ask whether there is a more natural approach that they could follow and, more specifically, whether diet could make a difference.

The Feingold Diet And Hyperactivity

To answer that question let’s start by looking at just one aspects of children’s diets – the increasing prevalence of artificial food colors and preservatives in the diet. The average child today is consuming over 10 pounds of food additives every year!

The idea that food additives – specifically artificial colors and preservatives – might be responsible for hyperactivity was first raised by Dr. Ben Feingold over 30 years ago. He devised the Feingold Diet – a diet that was free of artificial food colors, preservatives
and other artificial food additives.

Some small scale clinical studies suggested that the diet might be successful and millions of parents used the diet for their hyperactive children with great success.

But the medical authorities pooh-poohed the Feingold Diet. They pointed out that when parents are putting their child on a special diet they are also giving that child more attention – and it might be the parent’s increased attention that decreased the child’s hyperactive behavior.

They also pointed out when you eliminate food additives from the diet you are decreasing the “junk” food and increasing fresh fruits and vegetables – in short the child’s diet is much healthier.

So eventually the Feingold Diet lost popularity – but the idea that artificial food colors & preservatives might trigger hyperactivity has refused to go away.

Do Artificial Colors Cause Hyperactivity?

Angry boy portraitIn fact, a couple of recent studies have substantially strengthened the link between artificial ingredients and hyperactivity.

The first study was a meta-analysis of 15 previous studies looking at the effect of artificial food colors and preservatives on hyperactivity (Journal of Developmental & Behavioral Pediatrics, 25: 423-434, 2004).

This meta-analysis concluded that artificial food colors & preservatives caused an increase in hyperactivity in 28% of the children tested.

Almost all of the children in those previous studies were selected for the study because they had been diagnosed as hyperactive (ADHD). However, a more recent study looked at 297 children from Southampton England who had not been diagnosed as hyperactive (Lancet, 370: 1560-1567, 2007).

After an 8 week elimination phase in which artificial food colors and preservatives were removed from their diets, they were given a one week challenge consisting of fruit juice containing one of two different mixtures of four artificial food colors and the preservative sodium benzoate or a placebo.

The amount of artificial food colors and sodium benzoate in the fruit juice drinks was designed to match the average amount found in the English diet (which isn’t all that different from the American diet).

Once again, the results were clear. The amount of artificial food colors and preservatives found in the typical child’s diet is enough to trigger hyperactivity in many children.

The Bottom Line

So what does that mean to you if you have a hyperactive child? Could the simple act of eliminating artificial colors, flavors & preservatives from your child’s diet eliminate hyperactivity and give you back that calm, sweet child that you love?

  • The available data suggest that removing artificial food additives from your child’s diet can make a difference in their behavior, but I tend to side with experts who suggest that a holistic approach is best.
  • Eliminating food additives from your child’s diet is important, but also make sure the diet is a healthy one, that your child is getting all of the nutrients that they need and that they are getting all of the attention and support that they need.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Are Toxic Chemicals Lowering Our IQ?

Written by Dr. Steve Chaney on . Posted in Environment and Health, Issues

Is Chemical Brain Drain A Pandemic?

 Author: Dr. Stephen Chaney

In a past issue of “Health Tips From the Professor” I examined the evidence suggesting that toxic chemicals in the home could cause childhood asthma. That is alarming because asthma can predispose individuals to other diseases and affects quality of life.

Confused ChildBut, what if that were only the tip of the iceberg? For example, a recent headline stated: “More Toxic Chemicals [In Our Environment] Are Damaging Children’s Brains”. If that headline is true, it’s downright scary.

The authors of this study suggested that toxic chemicals which are abundant in our environment can cause decreases in IQ and aggressive or hyperactive behavior in children – and that those changes may be permanent.

The Study Behind The Headlines

The paper that generated the headlines (Grandjean & Landrigan, The Lancet Neurology, 13: 330-338, 2014) was a review of the literature, not an actual clinical study.

Based on published clinical studies, the authors identified 12 chemicals commonly found in the environment as developmental neurotoxins (toxins that interfere with normal brain development) based. [If you would like to find out what those “Dirty Dozen” chemicals are and where they are found, click here.]

This finding compares with 6 developmental neurotoxins that they were able to identify in a similar study in 2006.

The authors were not claiming that the number or amount of toxic chemicals changed between 2006 and 2014. They were saying that science has advanced to the point where we can classify six more chemicals that have been in our environment for years as developmental neurotoxins.

Even more worrisome, the authors postulate that many more environmental neurotoxins remain undiscovered.

Are Toxic Chemicals Lowering Our IQ?

To answer that question, you need to look at some of the studies they cited in their review. For example:

  • Elevated blood lead levels in children are associated with as much as a 7 point decrease in IQ (Lamphear et al, Environmental Health Perspectives, 113: 894-899, 2005).
  • Elevated fluoride levels in drinking water are also associated with as much as a 7 point decrease in IQ (Choi et al, Environmental Health Perspectives, 120: 1362-1368, 2012).

The effects of many of the toxic chemicals on IQ were difficult to quantify, but the authors estimated that exposure of US children to just 3 of the chemicals (lead, methymercury and organophosphate pesticides) was sufficient to lower their average IQ by 1.6 points.

What Are The Potential Consequences?

The authors spoke of the environmental neurotoxins they identified as representing a “silent pandemic of a chemical brain drain” that could cost the US economy billions of dollars.

One of the blog posts I read on this topic summarized the consequences in a very graphic manner. It said:

If one child’s IQ is reduced by 5 points, it doesn’t appear to make a big difference.  For example, that child might be:

  • A little slower to learn
  • A little shorter of attention
  • A little less successful at tests and at work

That might result in $90,000 in lost lifetime earnings

However, if the average IQ of every child in the US were decreased by 5 points, the effect becomes significant:

  • Only half as many members of the next generation would be “intellectually gifted”.
  • Twice as many of the next generation would be “intellectually impaired”
  • Lost productivity could be in the billions

Of course, statements like that are a bit over the top. Drs. Grandjean and Landrigan did not claim that the net effect of the chemicals they identified was a 5 point drop in IQ. Nor did they claim that all US children were affected equally.

Still, it’s enough to make you think.

Are Toxic Chemicals Causing Behavior Problems?

Angry boy portraitThe authors cited numerous studies linking the chemical neurotoxins they identified to aggression and hyperactivity. But perhaps the most compelling reason to suspect that environmental chemicals may be affecting brain development is the spiraling incidence of developmental disorders such as autism and ADHD. For example:

  • Autism has increased by 78% since 2007 and now affects 1 of 88 eight year old children.
  • ADHD has increased by 43% since 2003 and now affects 11% of children age 4-17.

Some of this increase could be due to better diagnosis of these conditions, but nobody believes that all of it is due to improved diagnosis. The authors claim that much of this increase is likely due to environmental exposure to the kinds of developmental neurotoxins they identified.

Is The Science Solid?

This is a difficult area of research. You can’t do the gold standard double-blind, placebo-controlled clinical trial. Nobody in their right mind would give one group of children toxic chemicals and the other group a placebo.

The studies cited in this paper were mostly population studies. Basically this means that they compared children with exposure to certain toxic chemicals to a control group that was as similar as possible to the first group except that their exposure to the toxic chemicals was less.

The limitation of this kind of study is obvious. We are usually comparing children from different locations or of different backgrounds. We almost never know if we have controlled for all possible variables so that the groups are truly identical.

As a consequence it becomes important to ask how many studies come to the same conclusion. For some of the toxic chemicals, such as lead, methymercury and organophosphate pesticides, the weight of evidence is very strong. For some of the newer additions to their list of developmental neurotoxins, it is pretty clear that the chemicals have neurotoxic properties, but the significance of those effects on the developing human brain are hard to quantify at this point.

The Bottom Line:

1)     A recent review claims that there is a good scientific basis for classifying at least 12 environmental chemicals as developmental neurotoxins that are likely to reduce IQ and contribute to behavioral problems in US children. [If you would like to find out what those “Dirty Dozen” chemicals are and where they are found, click here.]

2)     The science behind the claims in this review is solid, but not iron-clad.

3)     However, there are times when we need to simply ask ourselves: “What if it were true?” The consequences of lowered IQ and developmental behavioral problems are so significant that it may not make sense to wait until we have unassailable scientific evidence before we act.

4)     We all need to be guardians of our personal environment. But, it is not easy. The “Dirty Dozen” chemicals identified in this study come from many sources:

  • Some are industrial pollutants. For those, we need lobby for better environmental regulation.
  • Some are persistent groundwater contaminants. For those we need to drink purified water whenever possible.
  • Some are insecticides and herbicides used in agriculture. For those we need to buy organic, locally grown produce when feasible.
  • Some are found in common household products and furnishings. For those we need to become educated label readers and use non-toxic products in our home whenever possible.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

The Dirty Dozen

Written by Dr. Steve Chaney on . Posted in Environment and Health, Issues

Environmental Toxins That Affect Brain Development

 Author: Dr. Stephen Chaney

 In a recent review, Drs. Grandjean and Landrigan (The Lancet Neurology, 13: 330-338, 2014) identified 12 toxic chemicals which are abundant in our environment and are developmental neurotoxins.

These are all chemicals that damage brain development. They can cause decreases in IQ and aggressive or hyperactive behavior in children – and that those changes may be permanent.

Let’s look at these developmental neurotoxins and where they are found.

The Dirty Dozen

In their review Grandjean & Landrigan identified 6 developmental neurotoxins that were known in 2006, and 6 more chemicals that have been confirmed to be developmental neurotoxins between 2006 and 2023.

Developmental Neurotoxins Known in 2006 and their sources:

  • Lead
    • Main Sources: paint, gasoline, solder and consumer products such as toys & jewelry
    • Current status: Lead has been banned in paint since 1978 and from gasoline since 1996. Millions of houses still contain lead paint. Other current sources are inexpensive toys and costume jewelry imported from China and other countries without tight regulations.
    • The EPA estimates that 1 million children in the US are affected by elevated lead levels.
  • Methylmercury
    • Main Sources: discharges into air & water from coal-burning power plants, mining, pulp & paper industries.
  • Polychorinated biphenyls (PCBs)
    • Main Sources: transformers and many commercial products
    • Current status: Banned in 1979, but continues to be a common environmental contaminant because this group of chemicals is very long-lived.
  • Arsenic:
    • Main Sources: extraction of metals from rock (smelting), algaecides, herbicides, pesticides and pressure-treated wood.
    • Current status: Pressure treated wood banned in 2003 for residential use. Still found in some playgrounds and older buildings.
  • Toluene:
    • Main Sources: gasoline. It is also a solvent for paints, paint thinners, spot removers, adhesives, antifreeze, & some consumer products like fingernail polish removers.
    • Current status: Common in consumer products. Read labels and make sure windows are open if you use.

Developmental Neurotoxins Identified Since 2006 and their sources:

  • Manganese
    • Main Sources: municipal wastewater discharge, emissions generated during alloy, steel & iron production, emissions from burning of fuel additives
  • Flouride
    • Main Sources: naturally elevated in groundwater in certain regions, added to municipal water supply, most bottled beverages and toothpaste.
    • The American Academy of Pediatrics has warned that children drinking fluoridated water, fluoridated beverages, using fluoridated toothpaste and receiving fluoride treatments for their teeth may be receiving excess fluoride.
  • Chlorpyrifos
    • Main Sources: insecticide
    • Current status: Banned for use in homes in 2001. Still one of the most widely used insecticides in agriculture.
  • DDT
    • Main Sources: insecticide
    • Current status: Banned for use in this country in 1972. DDT and its breakdown products still found in our water supply. DDT still in use in agriculture and insect control in some countries.
  • Trichloroethylene (TCE)
    • Main Sources: widely used in dry cleaning fabrics, the textile industry and metal degreasing
    • Current status: Found in groundwater due to discharge from factories and dry cleaners.
  • Polybrominated diphenyl ethers (PBDEs)
    • Main Sources: flame retardants – used in building materials, electronics, mattresses & household furniture, plastics, polyurethane foams & textiles.
    • Current status: Readily leached into the environment. Found in dust, water, food & human breast milk

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

Omega-3 Fatty Acids And Brain Health

Written by Dr. Steve Chaney on . Posted in Food and Health, Issues

Is it How Much You Eat, or How Much You Keep?

Author: Dr. Stephen Chaney

 

Brain HealthWhy do some studies conclude that omega-3 fatty acids are essential for a strong mind, a strong heart and will wipe out inflammation – while other studies suggest that they are ineffective? The simple answer is that nobody really knows.

However, in the process of reviewing two recent studies on omega-3 fatty acids and brain health I made an interesting observation that offers a possible explanation for the discrepancies between studies. And if my hypothesis is correct, it suggests that the design of many of the previous studies with omega-3 fatty acids is faulty.

Omega-3 Fatty Acids And Brain Health

The first study (J.K. Virtanen et al, J Am Heart Assoc, 2013, 2:e000305 doi: 10.1161/JAHA.113.000305) looked at the effect of omega-3 fatty acids on brain function in older adults (>65 years old). It concluded that high omega-3 levels were associated with better white matter grade and a 40% reduction in subclinical infarcts (Sorry for the technical jargon – but both of those are good things in terms of brain function for those of us who are getting a bit older).

The second study (C. M. Milte et al, J of Attention Disorders, 2013, doi: 10.1177/1087054713510562) looked at the effect of omega-3 fatty acids on children (ages 6-13) with ADHD. It concluded that high omega-3 levels were associated with improved spelling and attention and reduced oppositional behavior, hyperactivity, cognitive problems and inattention.

What Is The Common Thread In These Studies?

Why, you might ask, am I comparing a study in the elderly, where the concern is retention of cognitive skills, with a study on ADHD in children?

That’s because there is a very important common thread in those two studies. It wasn’t the amount of omega-3 fatty acids in their diet that counted. It was the levels of omega-3 fatty acids in their blood that made the difference.

The first study included a detailed dietary history to estimate the habitual intake of omega-3 fatty acids in the participants.

  • There was no correlation between estimated dietary intake of omega-3 fatty acids and any measure of brain function in those older adults.
  • However, there was a strong correlation between blood levels of omega-3s and brain health in that population group.

The second study was actually a placebo controlled intervention study in which the children were given 1 gm/day of either omega-3 fatty acids or omega-6 fatty acids.

  • Once again, there was no correlation between dietary intake of omega-3 or omega-6 fatty acids and any outcome related to ADHD.
  • However, there was a strong correlation between blood levels of omega-3 fatty acids or omega-3/omega-6 ratio and improvement in multiple measures of ADHD.

How Could The Effect of Dietary Intake And Blood Levels Of Omega-3s Be So Different?

Fish OilBoth studies were relatively small and suffered from some technical limitations, but the most likely explanations are:

  • Inaccurate recall of the participants as to what they eat on a habitual basis. (study 1)
  • Individual differences in the ability of participants to convert short chain omega-3 fatty acids (found in foods such as canola oil, flaxseed oil and walnuts) to the beneficial long chain fatty acids (found in cold water fish). (study 1)
  • Poor compliance in taking the supplements. (study 2)

Why Are These Studies Important?

The most important insight to come out of both of these studies is that it is essential to actually measure blood levels of omega-3 fatty acids and not just rely on dietary intake or supplementation for a valid clinical trial.

That’s a concern because blood measurements of omega-3 fatty acids are expensive and have not been a part of many of the clinical studies that have been performed to date. Even the largest, best designed clinical study is worthless if the dietary recalls aren’t accurate or people don’t take their capsules.

We need to go back and reevaluate many of the clinical studies that have been published.

We need to ask:

  • Are their conclusions valid?
  • Did some studies fail to show that omega-3s were effective simply because they only measured dietary intake and not how much of the omega-3s actually accumulated in the blood?

The Bottom Line

  • High blood levels of omega-3s in the blood correlated with improved brain health in the elderly and reduced ADHD symptoms in children
  • These studies were small, but they are consistent with a number of other studies that have come to similar conclusions.
  • Blood levels of omega-3s are better predictors than dietary intake for evaluating the health benefits of omega-3 fatty acids.
  • Many previous studies that failed to find an effect of omega-3 fatty acids on brain health, heart health or inflammation did not actually measure blood levels of the omega-3 fatty acids. These studies should be reevaluated.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Omega-3 Fatty Acid Deficiency And ADHD: Do The Effects Worsen From Generation to Generation

Written by Steve Chaney on . Posted in Food and Health, Issues

The Seventh Generation Revisited

Author: Dr. Stephen Chaney

Angry boy portraitDo the effects of omega-3 fatty acid deficiency on ADHD get worse from one generation to the next?

When I was a young man I read an article called “The Seventh Generation” in Organic Gardening magazine. That article was based on the old Indian admonition to consider the effects of everything we do on the seventh generation of our descendents.

The article was written before the environmental movement had co-opted the seventh generation concept. It was also written at a time when the food industry and the public had really started buying into the “better living through chemistry” concept. Processed foods, fast foods and artificial ingredients had just started to replace real foods in the American diet.

The author envisioned a world in which, if we continued to eat nutrient depleted foods, each generation would be sicker than the previous generation until by the seventh generation our descendents would live miserable, sickly, shortened lives – and nobody would know why.

That article made a powerful impression on me. I always like to keep my mind open to new ideas, especially ideas that challenge my preconceived thinking.

So I asked myself “Could it be true? Could eating nutrient depleted foods actually make each generation sicker than the previous generation?”

The author did not have the foresight to predict the obesity epidemic, so he did not envision a world in which we might live sicker, shorter lives in as little as one or two generations.

In addition the author was not a scientist, and his whole premise seemed scientifically implausible at the time. In those days we thought of DNA as the sole determinant of our genetic potential and as something that could not be influenced by our environment. Now we know the DNA and the proteins that coat the DNA can be influenced by the foods we eat and other environmental factors – and that those changes can be passed down from generation to generation. This has lead to a whole new scientific discipline called epigenetics.

Could it be true?

All of that leads me to this week’s article (Bondi et al, Biological Psychiatry, doi:10.1016/j.biosych.2013.06.007). Let me start by pointing out that this is an animal study. It was done with rats. I usually base my health tips on human clinical trials, but it is simply not possible to do multi-generation studies in humans.

The authors hypothesized that omega-3 fatty acid deficiency could be associated with psychiatric disorders such as ADHD, autism, schizophrenia and depression. They based this hypothesis on the known role of omega-3 fatty acids in both brain development and maintenance of normal brain function. They also pointed to numerous clinical studies showing that omega-3 fatty acids could either prevent or reduce the severity of these diseases in humans.

They focused on adolescent rats as well as adult rats because these diseases frequently emerge, and are sometimes more severe, during the adolescent years in humans. Finally, they included second generation rats in the study because the change in our food supply that created an excess of omega-6 fatty acids and a deficiency of omega-3 fatty acids started in the 1960s and 1970s. They reasoned that if the effect of omega-3 deficiency is multigenerational it would be more severe in today’s human adolescents. As I said before, you can’t do multigenerational studies in humans, but you can do them in rats.

They separated litters of rat pups from omega-3 sufficient parents into two groups. One group was fed a diet sufficient in omega-3 fatty acids, and the second group was fed an identical diet except that it was deficient in omega-3 fatty acids. When the omega-3 sufficient group reached adulthood, they were mated and their offspring were continued on the same omega-3 sufficient diet. Similarly, when the omega-3 deficient group reached adulthood, they were mated and their offspring were raised on the same omega-3 deficient diet.

They put each group of rats through a series of behavioral tests when they were adolescents and again when they were adults. It is beyond my expertise to analyze the validity of rat behavioral assays, but the authors claim that the tests they employed were good measures of behavioral traits in human that would be classified as hyperactivity, anxiety, attention deficit disorder and reduced behavioral flexibility. [If you have adolescents in your household, some of those behaviors may sound awfully familiar].

The results were thought provoking. They found little evidence that omega-3 fatty acid deficiency triggered these behaviors in the first generation rats. However, they found strong evidence that omega-3 fatty acid deficiency triggered each of those behaviors in the second generation rats – and the effect was much stronger in the adolescent rats than in the adult rats.

The Bottom Line

At the present time, it isn’t possible to predict the significance of this study for you. This is a single study. And, it is an animal study. It could mean nothing, or it could mean everything.

We do know that the incidence of ADHD in US children has increased by 38% from 2003 to 2012 – and nobody really knows why. We also know that some studies have shown that the American diet is often deficient in omega-3 fatty acids. These same studies have suggested that providing adequate amounts of omega-3 fatty acids in the diet may prevent or reduce the symptoms of ADHD.

I’m a hard-nosed scientist. So I’m not going to be one of those bloggers who writes sensational headlines claiming that omega-3 fatty acid deficiency, or some other nutritional factor, is the cause of our skyrocketing rates of ADHD.

But, it is enough to make you wonder “What if? Could it be true?”

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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