Children and adults with ADD and associated disorders including depression, emotional lability, asthma, recurrent ear infections and learning difficulties have been found to be allergic to common foods such as wheat, rye, barley, oats, milk, eggs, yeast, peanuts, chocolate, oranges, tomatoes, shellfish, food additives, artificial colourings and preservatives, caffeine and wine.

Food not only provides energy and the structural building blocks for growth and repair of cells it is also a source of information. Food allergies and other adverse reactions to food can manifest in a multitude of different ways.
Here is a partial list of some of the most common symptoms associated with them.

There has been much confusion about describing the difference between food allergies and food sensitivities.

FOOD ALLERGY - adverse reactions to foods which are primarily caused by the immune system.

A Type I hypersensitivity is an immune system reaction which is responsible for an immediate allergic reaction such as rhinitis (hay fever) and anaphylaxis.

Mast cells which line all entrances to the body and found in all locations in the body, primarily defend the body against parasitic infection.

In a Type I hypersensitivity, antigens break through the skin or mucous membranes of the respiratory or digestive tracts and are greeted by mast cells which set off a violent explosion. When a person has an immediate Type I hypersensitivity, their mast cells are covered with lots of allergy promoting antibodies (large protein molecules produced by the immune system) known as IgE.

Each antibody is specifically designed to attach to one particular antigen. (There are 5 classes of antibodies each with a different role in the immune system IgA, IgD, IgE. Ig G, IgM). This means that mast cells of allergic individuals are covered with vast amounts of IgE designed to attack only those antigens to which they are allergic.

These allergy generating antibodies are known as allergens. If large numbers of allergens attach to IgE molecules on mast cells, they set off a chain reaction releasing alarm molecules such as histamines and leukotrines which cause immediate inflammation, redness, swelling, mucous, hives, nasal congestion, coughing sneezing, red and itching eyes.

Mast cells in the digestive tract react differently to food allergens. Huge amounts of allergens may cross the mucous membrane of the gut and travel throughout the body activating mast cells in other locations distant from the digestive tract. Therefore food allergies are accompanied by hives, fatigue, malaise, headaches, stomach pains, irritability, hyperactivity, and "mental fog" and antihistamines have no place in the treatment of food allergies because a wide variety of inflammatory molecules are released in the gut.

Recent research indicates that mast cells within the GALT (gut associated lymphoid tissue) may release their contents under circumstances not associated with Type I hypersensitivity. For example, mast cells in the gut may release their contents when directly stimulated by nerve endings, or when communicated to by neuropeptides (released from nerves or absorbed from the diet if digestion is inefficient or the gut is leaky) or a variety of inflammatory mediators released from other immune cells.

This is in direct contrast to what immunologists and allergy specialist have been taught – i.e. that food allergy only exists when specific IgE molecules on the surface of mast cells are stimulated by specific allergens.

Recent estimates that Type 1 hypersensitivity based on food allergens occurs between 3-5 % in children (as high as 8 %) and between 1-2 % in adults does not account for the much higher incidence of adverse reactions to food in the general population. Furthermore, when ADHD children are placed on a high-quality, low allergy potential diet, 75% or more showed marked improvement in overall health, behaviour and cognitive performance. This cannot be explained by Type I hypersensitivity alone (Lyon 2000).

Although very important in defending the body against foreign invaders, this type of hypersensitivity is unlikely to play a major role in food allergies as it does not involve specific IgE antibodies. Instead the body manufactures IgA, IgG and IgM antibodies to defend itself against invasion.

This occurs to some extent in leaky gut (increased permeability of gut membrane) where whole cells e.g. bacteria, yeasts, undigested food cross the mucous membrane of the gut and have to be destroyed through Type II hypersensitivity reactions. The end result of Type II hypersensitivity is the release of inflammatory mediators from the immune cells.

This may yet prove to be the most important class of immune reactions for those experiencing adverse food reactions, particularly children and adults with hard-to-pinpoint, delayed food allergies.

Type III hypersensitivity occurs when antibodies and antigens combine together in the blood stream to form large complexes called immune complexes. These stimulate immune cells to release inflammatory molecules which can lead to an extraordinary variety of symptoms. Very common in snake bite victims who have been given an antidote made with horse serum (serum sickness).

Type III hypersensitivity is amplified when gut permeability is increased. These reactions are delayed (4-6 hours) and if a person keeps eating a food which provokes a Type III hypersensitivity, they may never associate specific foods with specific adverse reactions and may simply experience poor health with no apparent cause. Type III hypersensitivity is also thought to be associated with food addictions.

People with food allergies often crave the very foods they are allergic to. When placed on an elimination diet they may feel like "death warmed over" for the first 3-10 days and experience "allergen withdrawal syndrome". This occurs because of a transient serum sickness-like event that occurs when allergenic foods are suddenly withdrawn form the diet. When a person regularly eats foods to which they are allergic, immune complexes formed are small and numerous. High numbers of small immune complexes create vague and hard to define symptoms. Once the food is withdrawn, smaller numbers of very large immune complexes are formed and have to wait for a few days before being cleared by the immune system.

Large complexes provoke more severe symptoms. Headaches, muscle and joint pains, stomach aches, mood swings, malaise, cognitive, emotional and behavioural changes commonly occur during this withdrawal phase. If the allergic food is eaten during this phase, theses individuals experience a short-term "high" most likely caused by the release of stress hormones, increased sympathetic nervous system activity or the release of "opioid" peptides from nerve endings or immune cells in the gut. This would explain why these individuals are very reluctant to eliminate favourite foods from their diets. Opioids have been implicated, in animal studies, in delaying neuron and glial development (Zagon, McLaughlin, 1990) dendrite development (Hauser, McLaughlin, Zagon, 1989), and brain development (Zagon, McLaughlin, 1984). Food addictions seem to be most common with dairy or wheat allergy.

In Type IV hypersensitivity, specialised immune cells (natural killer cells) become highly sensitised to specific antigens and attack those antigens without the need for the production of antibodies.

This type of hypersensitivity is a very slow reacting process which has been implicated in celiac disease (gluten intolerance) and is also thought to be a contributing factor in Crohn’s disease (inflammatory bowel disease).

FOOD INTOLERANCE - adverse reactions to foods which are not primarily caused by the immune system.

Celiac disease (also called celiac spruce) is caused by an intolerance to gluten, a component of wheat, rye, barley and oats.

Gluten contains a protein called alpha-gliadin and in persons with this disease this protein causes a reaction in the mucous lining of the intestine. The villi lining the small intestine suffer damage and destruction, which impairs the body’s ability to absorb vital nutrients.

Malabsorption becomes a serious problem, and the loss of vitamins, minerals, and calories results in malnutrition despite an adequate diet. Diarrhea compounds the problem. Since digestion is impaired, food allergies may also appear. There appears to be a very strong familial pattern of food intolerance, which may also include patterns of digestive enzyme deficiencies disease (Dohan 1972; Horvath, Horn, Bodanszky, Toth, Varadi, 1983; Leung, Robson, 1996 ).

Lactose intolerance also often accompanies celiac disease. Kaczmarski, Kurzatkowska (1988) have reported a very high familial incidence of cow’s milk intolerance in the families (34%) of children with cow’s milk intolerance and a 13.3% family incidence of gluten intolerance in the families of children with celiac disease Similar familial patterns have also been observed regarding ADHD patients (Biederman, Faraone, Keenan, 1992; Sandberg, 1996; Hechtman, 1996). Investigations of children of short stature has revealed that 5% to 20% of these children have celiac disease (Arucchio, et al, 1988).

Celiac disease is often misdiagnosed as irritable bowel syndrome or spastic colon as many physicians are not aware of the various symptoms associated with gluten intolerance. Many people therefore go a long time before being diagnosed correctly, and often they identify themselves because of what they have read or heard about the disease.

The latest estimates for the prevalence of this condition in the US is 1:150 and the only thing that is rare about it is diagnosis. Europe is ahead of the US, and Italy (1 in 7 children) requires testing of every 7 year old child. A study done in Italy found the prevalance in Northern Italy to be twice that of Southern Italy.

Susceptibility to celiac disease is a genetically transmitted trait which has been associated with genetically coded immune system factors identified as human leukocyte antigens (HLA) (Auricchio, Greco, Troncone, 1988). There is a significant association with HLA B8, which has also been demonstrated in 10% to 30% of European populations (Ammerman, Cavalli-Svorsa, 1984). Other HLA factors have been demonstrated to have an even stronger association with celiac disease, but the HLA B8 is found in more than 80% of celiac patients (Cooke & Holmes, 1984).

Depression has also been asserted to be the most prevalent symptom of celiac disease (Cooke & Holmes 1984) and reported as very common by others ( Addolorato, Stefanini, Capristo, Caputo, Gasbarrini, 1996; Holmes 1996; Pellegrino, D’Altilia, Germano, 1995; Hallert, Astrom, Walan, 1983) which is thought to be a function of central monoamine metabolism dysfunction (Hallert, Martensson, Allgen, 1982) or due to reduced serotonin binding sites on the platelets of celiac patients (Chiaravalloti, Marazziti, Batistini, Favilli, Ughi, Ceccarelli, Cassano, 1997).

Celiac disease affects both adults and children, and can appear at any age. It can be triggered by emotional stress, physical trauma, a viral infection, pregnancy or surgery. It often appears in babies when they are first introduced to cereal foods at around three or four months of age.

A baby with celiac disease may gain weight more slowly than normal or may lose weight. The infant may have a poor appetite, flatulence, and offensive smelling bowel movements. Infants and children may exhibit stunted growth, vomiting, an intense burning sensation in the skin and a red itchy skin rash called dermatitis herpetiformis. Children are likely to have an anemic, undernourished appearance. Ulcers may develop in the mouth. Celiac spruce may trail off in adolescence only to reappear, in some instances, in adults in their thirties or forties. The first signs are often weight loss, diarrhea and nutritional deficiencies such as anemia.

Other symptoms include nausea, abdominal swelling, large and frequently pale and/or light-yellow coloured stools that float, depression, irritability, muscle cramps and wasting, and joint and/or bone pain.

There is a great deal of evidence suggesting that gluten may also contribute to the rapidly increasing incidence of malignancy. Gluten has been implicated in the pathogenesis of schizophrenia, bi-polar disorder, obsessive-compulsive disorder, and autism (Dohan et al., 1969; Singh & Kay, 1976; Reichelt, et al, 1990a).

Gluten produces exorphins which are opioid-acting peptides derived from external sources, instead of being synthesized within the body. These exogenous opioids have been shown to bind to the same cellular receptors that endogenous opioids bind to, thus impacting on the immune system, nerve function, myelination processes, vascular walls, neuromuscular function, and a variety of CNS functions. As may be expected, such opioids can have an anaesthetizing, analgesic, and addictive effect.

Zioudrou et al. (1979) identified some opioid peptides in the digests of wheat prolamines and dairy proteins which have opioid activity, and Fukudome and Yoshikawa (1992) have since characterized 15 separate amino acid sequences of gluten-exorphin A-5 in a single molecule of wheat. It bears noting that four other opioid-acting amino acid sequences have also been identified in wheat protein and may also occur in multiple regions of the proteins in this very common food ( Fukudome & Yoshikawa, 1992). It is also likely that passage of at least some of these exorphins into the blood, as is witnessed by anti-gliadin antibodies, is occurring in at least 15% of the random population (Arnason, et al., 1992).

There is also a significant population of patients with autism, schizophrenia, and bi-polar disorder, many of whom do not mount a discernable antibody response to these proteins, but whose symptoms improve on a diet which excludes them (Reichelt, 1996).

One sequence of amino acids which has been identified in abundant quantity in both wheat and cow’s milk is similar to melanocyte-stimulating-hormone-release-inhibiting factor (MIF) which has been shown to enhance CNS dopaminergic activity in animals (Mycroft et al,1982). A condition of increased central dopaminergic activity has long been associated with ADHD and a variety of other psychiatric conditions (Gill, Daly, Heron, Hawi, Fitzgerald, 1997; Raskin, Shaywitz, Shaywitz, Anderson, Cohen, 1984).

The earliest report that opioid peptides could be derived from food proteins is probably that of Zioudrou et al.(1979). This group named exorphins and established their functional similarity to morphine. They reported that Naloxone, a morphine antagonist, blocked 70% of gluten-derived exorphin activity, while blocking 100% of milk-derived exorphin activity. Animal studies conducted by the same group show that these exorphins will bind to opiate receptors in the brain.

Gluten-derived opioids are thought to have a much greater potency than those derived from milk, and the former are claimed to have a potency that is a small fraction of that of morphine (Huebner, Lieberman, Rubino, Wall, 1984), so the signs of behavioural impact would likely be much more subtle than is seen in morphine addiction

There was evidence almost thirty years ago, from double blind trials that some schizophrenics benefited from exclusion of gluten and dairy from their diets (Dohan, et al, 1969; Singh & Kay, 1976. The patients in question were released earlier than previous patients who had consumed a regular diet These positive results were replicated by all the researchers who worked within the clear and simple parameters outlined by Dohan. It was a decade after publication of the first clinical trial of this diet with schizophrenics, that Zioudrou et al. (1979) published their discovery of morphine-like peptides in the digests of wheat and dairy products, thus providing subsequent support for the application of the exorphin hypothesis to schizophrenia.

Opioids, in general, have been implicated in sleep onset (Wilson, Dorosz , 1984) and hypothalmic-pituitary-adrenal axis function (Hoggan, 1997b). Reduced attention may be the result of the CNS attachment of opioid-acting exorphins. Paul et al. (1985) have indicated that exorphins can stay in the circulation of celiac children for as long as a year after consumption of gluten. Since there are five known types of opioids which have been isolated from proteins in wheat, and eight which have been isolated from milk proteins the number of possible variations in presentations should amount to the square of the sum of these two numbers.

If left untreated celiac disease can be quite serious, even life threatening. Bone disease, central and peripheral nervous system impairment, internal hemorrhaging, pancreatic disorders, infertility, miscarriages and gynecological disorders are just some of the long term maladies that can complicate celiac disease. It also increases the risk of developing intestinal lymphoma and other intestinal malignancies.

Certain autoimmune disorders can also be associated with celiac disease, including dermatitis herpetiformis, kidney disease (nephrosis), sarcoidosis (the foramtion of lesions in the lungs, bones, skin, and other places) insulin dependent diabetes mellitus, systemic lupus erythematosus, thyroid disease, and rarely chronic active hepatitis, sclerodoma, myasthenia gravis, Addison’s disease, rheumatoid arthritis and Sjogern’s syndrome.

Celiac disease is increasingly being linked to epilepsy, autism, schizophrenia, depression and chronic fatigue syndrome (Lancet). Endorphin-like substances may be created in celaic disease and together with increased gut permeability allows absorption of these substances into the brain. Delays in neuron, glia, dendrite, and brain development have also been associated with opioid peptides (Hauser, et al., 1989; Zagon, et al., 1991; Zagon, et al., 1984).

"Dietary compliance is an intense learning experience. Errors are the rule, not the exception, as one learns the pitfalls of such a diet in the context of a culture inundated with gluten" (Hoggan 1998). "One of the most important skills that children and adults with ADHD must learn is how to properly feed their own brains for life" (Lyon, p121).

This article is an extract from the THE CLINICAL PSYCHOPHYSIOLOGY FORUM.

Food is one of our most basic needs. However, in our modern society fresh food is a thing of the past. The so called fresh fruits and vegetables we buy today have little nutritional value because they are grown in nutrient-deficient soil, picked before they ripen naturally, gassed, irradiated, artificially ripened and stored for days before we eat it. Therefore, our diets lack the essential building blocks of functional foods vital to our health and well being.

Without functional foods the body cannot continue the miracle of healing itself as these foods provide the raw materials needed to assist in this healing process thus giving the body fuel to perform at optimum levels. Without sufficient functional foods the following four problems exist for most people:

Functional foods or Neutraceuticals are "foods that are thought to prevent disease" (Harvard Health Letter April '95). The building blocks of functional foods are called phytochemicals (plant chemicals) These phytochemicals (carbohydrates) are naturally occurring bioactive substances that prevent diseases by interacting with the body's innate healing process to maintain vibrant health and energy.

Of the 200 simple sugars (glyconutrients) occurring in plants, only eight are known to be essential for cell-to-cell communication. These are only found in food that is ripened on the vine/tree and remain active for 48 hours after being picked. However, only two of these, glucose & galactose are found in modern diets. The body can convert these two into the six missing sugars, but this enzymatic process is long (up to 20 steps), unreliable and error-prone. Thus we need to supplement our diets with these missing sugars.

All cell surface receptors, binding and signalling components are glycoproteins (proteins and sugar). They essentially act as the language between cells in our body. The glycoprotcins are like the letters and words of a language. If the correct sugar (carbohydrate) is not placed in the proper location, or is missing, the glycoprotein is not formed correctly and will not be able to carry out its function in the cell membrane. Only effective cell membrane communication can make the proper cells for our organs.

The functional components of glyconutrients appear to boost the production or activity of enzymes that act as:

1. Blocking agents: deloxifying carcinogens or keeping them from reaching or penetrating cells;
2. Suppressing agents: restraining malignant changes in cells that have been exposed to carcinogens.

There are four basic reasons why people get sick. These are:

(1) decreased function of the immune system

(2) increased oxidative stress

(3) diminished/ faulty neurotransmitter function

(4) poor/faulty cellular repair/regeneration

Therefore anyone with the following diseases will benefit from glyconutritional supplementation:

The discovery of the importance of glycoproteins was awarded the "Biochemical Discovery of'. the Year" in 1996 by the American Naturopathic Medical Association. The ANMA further t released the statement "The most Significant Discovery of the Century". "Almost without exception where ever two or more living cells interact in a specific way, cell surface carbohydrates will be involved " (Bio/'I'echnology, John Hodgson 1990). Major studies have recently indicated exciting revelations regarding the significance of glycoproteins in our development', out- growth, and in the formation of disease.

Scientists are suggesting that glyconuirients may provide the missing link in the body's amazing capacity to heal itself and sustain health. Thus anyone who eats, drinks or breathes in today's world is likely to benefit from these supplements.

In addition to glyconutrient support, research suggests that supplementation with essential fatty acids (EFA's) are also beneficial in ameliorating the symptoms of dyslexia, dyspraxia and ADHD.

Brain neurons are fluid filled structures completely covered with a thin membrane composed mostly of various types of fat. Nerve endings in the executive regions of the brain are important in ADHD. The whole cycle of dopamine release, attachment to receptors, reuptake into the neuron and breakdown of dopamine all occurs at an extraordinarily rapid rate. The speed of this process depends largely upon the fats that compose these specialised nerve endings. Approximately 80% of these dopamine producing nerve endings are made up of the thinnest, lowest viscosity fat within the human body, known as docosahexaenoic acid (DHA). DHA is an extremely fragile omega-3 fatty acid which gives the nerve endings extremely fluid properties enabling very rapid release of dopamine.

If there is an insufficient supply of DHA during foetal development, infancy or childhood, the body will substitute thicker fats (omega-9 instead of omega-3) to build these important brain cells. Thicker fats at these nerve endings means that nerve endings are less fluid and dopamine release may be more sluggish. MRI scans consistently show executive centres in ADHD brains to be more underdeveloped and shrunken and this may be in part due to DHA deprivation.

Furthermore, since DHA is a super-polyunsaturated fat and therefore fragile, it is more susceptible to oxidation it must be continually supplied to the brain throughout life in order to maintain adequate brain function. Oxidative stress in the brain occurs as the result of the following:

Prolonged periods of excessive stress can actually cause molecular damage to the brain and accelerate the aging process ( Campbell 99; Seeman 97)

In addition to brain function, DHA is critically important in the development and function of the eye. Raid processing of light information to the brain depends upon the fluidity of the membranes of the retina. A deficiency in DHA especially during foetal development or childhood could lead to visual problems.

DHA is a rare nutrient found only in certain fish and aquatic plants. The richest sources of DHA is tuna oil. DHA is also found in sardines and salmon. The body can produce DHA from a more readily available omega-3 fatty acid alpha linolenic acid (ALA) found in vegetables oils (canola, soy, flax seed). However, there may not be enough ALA in the diet without supplementation. Furthermore, the conversion of ALA to DHA requires the enzyme delta-six desaturase and nutritional elements. Without adequate amounts of Vitamin, A, E, B and zinc, magnesium the action of this enzyme is impaired. Conversion is also impaired by stress hormones, alcohol, nicotine, drugs, heavy metals, chronic infections, trans-fatty acids and pesticides and also depends upon a person’s genetic make up.

Omega-6 fatty acids are also necessary for brain function and effective functioning of the immune system. Arachidonic acid (AA) is readily available in animal fats and in the developed world excessive AA is often the case and is associated with allergies, inflammation or muscle spasms. Gamma linolenic acid (GLA) is another omega-6 fatty acid which is important in brain and immune system function. Unfortunately, GLA is not common in the western diet and is usually manufactured in the body through enzymatic conversion of linoleic acid (LA) readily available from vegetable oils. The richest source is evening primrose oil, borage oil or black current seed oil. Whilst recent studies have shown adequate amounts of LA in levels in children with ADHD, the same research shows inadequate GLA levels in these children.

New research suggests that there is a series of related conditions (dyslexia, attention deficit [hyperactivity] disorder and dyspraxia) which can overlap, so an affected child is likely to display a combination of problems which are extremely distressing both for the child and his or her parents. Such problems often lead to disruptive behaviour and school failure.

Striking results from a major ongoing research program on Dyslexia, Dyspraxia and Attention Deficit Hyperactivity Disorder (ADHD) show that lipid supplementation can make a child less clumsy and more able to catch a ball within 12 weeks. These findings are supported by observations from leading UK medical research centres indicating unusual brain lipid biochemistry in people with Dyslexia.

Efamol Ltd are sponsoring a major series of research programmes into these three linked disorders and important advances have emerged in findings presented to date. These include-.-

This worldwide research indicates that supplementation with a combination of tuna oil, high in docosahexaenoic acid and thyme oil, offers hope to dyslexic, dyspraxic and ADHD.

Research has shown:-

A major study conducted at Purdue University compared 52 hyperactive boys with 42 normal ones and found that many of the hyperactive children are EFA deficient based on clinical signs such as thirst, dry skin & hair, more asthma and infections. They also took blood samples from the boys to test evidence for EFA deficiency. These showed that the problem is not dietary deficiency but that the hyperactive children can't convert the dietary EFAs to the long chain EFAs required by the body for brain and eye function.

In addition to glyconutrients and essential fatty acids, the brain needs adequate amounts of numerous other nutrients.

B group vitamins are essential for many metabolic processes and require daily supplementation because they are not stored in the body. A lack of Vitamin B1 ((thiamine) manifests in disorders of the neuromuscular, intestinal and cardiovascular systems. Deficiency symptoms include depression, irritability, memory loss, mental confusion, weight loss etc. Vitamin B1 is easily destroyed during cooking, with alcohol consumption and is depleted in celiac disease.

Vitamin B2 (riboflavin) facilitates the metabolism of carbohydrates, fats and proteins and is critical for the conversion of carbohydrates to ATP in the production of energy. Deficiencies affect primarily the skin, eyes and mucous membranes of the intestinal tract. Eczema, red, itchy eyes, light sensitivity and depression are some of the symptoms of a B2 defeciency.

Vitamin B3 (Niacin) is important because it functions as a component of two important coenzymes: nicotineamide adenine dinucleotide (NAD) and nicotineamide adenine dinucleotide phosphate (NADP). It is useful in reducing elevated cholesterol levels, enhancing response to insulin and important in the Krebs cycle. The parts of the body most affected by niacin defeciency are the skin (dermatitis), intestinal tract and nervous system.

Vitamin B5 (pantothenic acid) is necessary for the production of some hormones and neurotransmitters and is involved in the metabolism of carbohydreates, fars and proteins. Deficiencies manifest as problems related to the skin, liver, thymus and nerves.

Vitamin B6 (pyridoxine) is required for the proper functioning of more than 60 enzymes. It is involved in the metabolism of amino acids, haemoglobin, serotonin, various hormones and the prostaglandins. Deficiencesmanifest as depression, sleep disturbances, nerve inflammation, PMS, lethargy, decreased alertness, anemia, elevated homocysteine levels, nausea, vomiting, seborrheic dermatitis.

Vitamin B12 (cyanocobalamin) is an essential growth factor and plays a vital role in the metabolism of all cells especially those of the intestinal tract, bone marrow, and nervous tissue. Deficiencies manifest primarily as anemia and neurological changes. Symptoms include fatigue, depression, confusion and memory (particularly in the elderly), poor blood clotting, dermatitis, easy bruising, loss of appetite, nausea and vomiting.

Iron Trace minerals also have a significant role to play in ADHD. Iron deficiency which leads to anemia reduces the quantity of red blood cells within the blood stream depriving the oxygen-hungry brain of its fuel. Iron is also incorporated into enzymes such as cytochromes which help detoxify drugs and poisons. Dopamine producing neurons in the brain’s executive centre require the highest concentration of iron. Thus a deficiency in iron robs the brain of energy to perform adequately and cognitive impairments and behavioural problems can result.

Magnesium. Magnesium has a multitude of different uses in the and is an essential cofactor of the enzyme delta 6 desaturase which converts vegetable derived omega 3 fatty acids to the brain critical omega 3 fatty acid DHA (docosahexaenoic acid) which is essential for the rapid release of dopamine. Thus if magnesium levels are low, DHA deficiency is very likely to exist. Magnesium is also a calming mineral that relaxes nerves and muscles. Emotional and physical stress, chemical abuse (caffeine, cortisone, alcohol, nicotine, Ritalin, dextroamphetamine,), recurrent infection, food or environmental allergies and gastrointestinal parasites can all result in magnesium depletion and can increase hyperactivity.

Zinc is another mineral that may be of prime importance in ADHD. Zinc is responsible for the activation of numerous enzyme systems in the body. Low-grade zinc deficiency results in a weakened immune system (recurrent infections) and diminished digestive system function (intestinal parasites, bacteria and yeast in the gut). Kids who are zinc deficient are often fussy eaters who love junk food, have poor appetites and a poor sense of taste. Zinc is also a cofactor for the enzyme delta 6 desaturase mentioned above. Additionally, inadequate zinc levels affect the production of a complex protein called metallothionein which acts likes a "metal clean up service" for toxic metals such as lead, cadium, mercury, aluminium and arsenic. Since the ADHD brain is very susceptible to these toxins adequate levels of zinc may be of critical importance.

Calcium, chromium and selenium are other important minerals. For those who are allergic to dairy products eating adequate amounts of vegetables from the cabbage family, nuts, seeds, sardines, tofu and legumes is essential. Calcium is the key component in bones and teeth but is also necessary for blood clotting, nerve conduction, muscle contraction, and enzyme activity. Calcium also helps the body detoxify from lead poisoning and calcium citrate and micro-crystalline hydroxyapatite are usually free of heavy metals contamination. Supplementation if the diet is inadequate needs to occur.

Chromium is thought to play a vital role in the immune system and is known to be important in the regulation of blood sugar levels. Hypoglycemia (weakness, shakiness, irritability, moodiness, cognitive problems, sweating, rapid heart rate, hyperactivity or lethargy) result when there is an excessive drop in the blood sugar level. Avoiding sugary foods, beginning the day with breakfast and frequent balanced meals during the day as well as supplementation if necessary are ways to overcome hypeglycemia and keep the blood sugar levels stable and the brain on an even keel.

Selenium is important for the production of antioxidant enzymes the most important of which is glutathione peroxidase. Inadequate levels of this enzyme leaves the body highly susceptible to oxadative damage and the brain vulnerable to toxic stress. Furthermore, selenium plays a major role in thyroid function. The enzyme 5’deiodinase depends on selenium for its activity. It is responsible for converting the hormone T4 to the active hormone T3 which is difficult to measure and thus subtle thyroid problems often go undetected. It has been suggested that inadequate T3 activity may result in profound diminishing of brain function. Those who are selenium deficient are also at greater risk to the accumulation of toxic mercury (amalgam filings, fresh water fish) because the activity of the enzymes glutathione peroxidase and 5’deiodinase are decreased.

Other trace elements may also play a role in ADHD. The most important way to ensure an adequate intake of nutritional traces minerals is to eat a whole foods diet with adequate whole grains (be careful of gluten), proteins, fruits and vegetables. Care should be taken to ensure that multivitamin supplements supply adequate quantities of the desired trace minerals and vitamins in a highly absorbable form and they should be free from common allergens (wheat), artificial colours, flavours and sweetners.

Probiotics which are known to be beneficial and are never responsible for disease (friendly flora).

Consists mainly of Lactobacilli (predominantly in the small intestine) and Bifidobacteria (predominant in the large intestine or colon) used in fermented foods like cheese, yogurt, sauerkraut.

Streptococus ,Enterococus, Bacillus and E.coli are also probiotic.

Those that have no known benefits and which cause or contribute to disease processes only under certain circumstances. Consist mainly of bacteria and yeast eg. Streptococus pneumoniea and Candida albicans. In small numbers they may help to maintain the immune system in a vigilant state but in large numbers they cause disease. Candida can cross the blood brain barrier and has been found in many children with learning difficulties and ADD/ADHD.

Those that have no known benefits and which are known to readily cause or contribute to disease processes (pathogenic or parasitic). These include bacteria, protozoans, viruses and worms such as Salmonella or enterotoxigenic E coli (food poisoning), Cholera or rotavirus (cause dysentery or diarrhea), Heliobacter pylori (ulcers), enterotoxigenicE.coli, Gardia lamblia (associated with growth retardation in children) Klebsiella (in the colon increases the risk of anky-losing spondylitis - apainful arthritic condition of the spine).

The relative balance of these various organisms have a tremendous influence on a person’s health. GALT simply cannot function without the assistance and adequate populations of friendly flora. They not only suppress immunity to decrease allergic states, they also diminish gut inflammation and food allergies whilst improving immune responsiveness toward infection.

Recent research (Lyon 2000) reported that in a sample of 63 children with ADHD 46% of children had no Lactobacillus or Bifidobacteria species. Additionally, over 80% of these children had significant quantities of Group 3 bacteria. In the same study, 32% of the stool samples were found to have Candida albicans or other related fungi. In 41% of cases, protozoal parasites were found on microbial analysis. (Previous research suggested that 5-10% of the normal population would be found).

Shaw (1996) reported high levels of tartaric acid in the urine of many children who have autism. Tartaric acid is a fermentation by-product of an overgrowth of Candida. Tartaric acid is a potent inhibitor of certain microbial enzymes used in energy production, particularly in the mitochondria. This is also found in the urine of those with chronic fatigue syndromme.

It is interesting to note that McGregor (1996 a &b) discovered a substance in the urine of individuals with chronic fatigue syndrome (CFS). The substance (CFSUM1) is a marker which has been detected in approximately 85% of cases and is similar in molecular structure to the common pesticide N-methyl proline – known to cause overgrowth of certain undesirable gut bacteria, and although no research has been done to date to look for this gut derived toxin in those with ADHD, the finding further establishes the reality of a gut brain connection.

Unfriendly microorganisms come in many guises and are responsible for a range of diseases and disorders including bowel problems, constipation, diarrhea, colitis, irritable bowel syndrome, urinary tract infections, migraines, rheumatic and arthritic conditions, some skin conditions including acne, eczema and psoriasis. Healthy colonies of flora in the gastrointestinal tract (GIT) constitute the first line of defense against illness and disease. For those taking antibiotics it is vital to supplement the GIT with L.acidophilus, B. bifidum and L. bulgaricus since antibiotics do not discriminate between friendly and unfriendly microorganisms. Probiotics should ideally be taken at least two hours after a dose of antibiotics. Once antibiotic treatment is over, the probiotic regimen should be doubled for the next ten to fourteen days to ensure the gut reestablishes its friendly flora.

Dehydration also causes significant impairment of the immune system, constipation and increases the risk of respiratory infections. Detoxification also requires optimal function of the liver, kidneys and bowel , all of which require good hydration. The usual recommendation of six to eight glasses of water may be insufficient for children who are active, have food allergies or fatty acid deficiencies. Sending a child to school with a litre bottle of filtered water is one way for parents to control the quality of water and allows some degree of monitoring the child's intake of water.

Alexander, P (1997): It could be allergy and it can be cured. Ethicare Pty. Ltd.

Lyon, M (2000): Healing the Hyperactive Brain. Focussed Publications

Osiecki, H (1998): The Physician’s Handbook of Clinical Nutrition. Bioconcepts Publishing

Pelton, R & LaValle, J.B (2000): The Nutritional Cost of Prescription Drugs. Morton Publishing Company

Rapp, D (1981): Diet and Hyperactivity. Paediatrics. 67 (6), 937-938

Trenev, N (1998): Probiotics: Nature’s internal healers; Your body’s first line of defense against most common diseases. Avery Publishing Group

This article is well worth reading as it explores the pharmacological properties of cereals and milk and the possible link between diet and mental illness. Exorphins – opioid activity in wheat, rye, barley and oats and casomorphin (in bovine [cow’s] and human milk) have been shown to be absorbed from the intestine and can produce effects such as analgesia and reduction in anxiety usually associated with poppy-derived opioids (heroin and morphine). The questions raised in this article "Are cereals and milk chemically rewarding and are humans somehow addicted to these foods?" are thought provoking and the arguments presented are certainly food for thought.