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Kosthold uten tilsetningsstoffer bør vurderes brukt som standarbehandling ved hyperaktivitet foreslår en ekspert i British Medical Journal

Selv om det nå foreligger god dokumentasjon på sammenhengen mellom tilsetnngsstoffer og hyperaktivitet hos barn anses det fortsatt som alternativbehandling i steden for standarbehandling å fjerne disse stoffene fra kosten i behandling av ADHD.

Av de tre hovedbehandlingsmetodene for barn med ADHD, medisinering, adferdsterapi og kostholdsmodifikasjoner er det bare medisinering og kostholdmodifikasjoner som er støttet av data fra flere studier. Alikevel blir adferdsterapi, hvis effekt ikke har støtte i vitenskapelig studier, fortsatt sett på som nødvendig i behandlingsstrategier.

Eliminering av tilsetingsstoffer er en relativt harmløs intervensjon, og bør vurderes innført som standarbehandling konkluderer Professor Andrew Kemp

Editorials: Food additives and hyperactivity BMJ 2008
professor of paediatric allergy and clinical immunology, Andrew Kemp


Mer om tilsetningsstoffer og hyperaktivitet (eksterne linker) :

* http://www.sciencedaily.com/releases/2008/05/080522210010.htm

* Hyperaktiv av fargestoffer (NRK): http://www.nrk.no/nyheter/utenriks/1.3398473

* Tilsetningsstoffer og hyperaktivitet (Mattilsynet): http://matportalen.no/artikler/2007/9/tilsetningsstoffer_og_hyperaktivitet

Disse kan gi hyperaktivitet:
E 102 Tatrazin: Gult fargestoff
E 104 Kinolingult: Grønngult fargestoff
E 110 Paraoransje: Gult fargestoff
E 122 Azorubin: Rødt fargestoff
E 124 Nykockin: Rødt fargestoff
E 129 Allurarød AC: Rødt fargestoff
E 211 Natriumbenzoat: Konserveringsmiddel

 



Barn oppfører seg hyperaktivt etter å ha fått i seg fargestoffer

 

Vi gleder oss over at forskning om dette også har nådd det norske mattilsynet. Mange i vår forening

reagerer ekstra tydelig på fargestoff i mat og spiser helst "ren", hjemmelaget mat. Vi håper at kunnskapen brer seg også til produsenter slik at vi får en enklere hverdag. Les mer her...

En i vår forening har skrevet et brev til aviser om dette. Her står mer forklart om Feingolddietten. Les brevet her.

 


Effekt av diett for barn med AD/HD-problematikk

av Liv Nina Hustoft
Masteroppgave 2007 Master i spesialpedagogikk

23 barn med AD/HD-problemer og avvikende urinpeptidmønstre og nivå deltok i en gluten- og melkefri studie, "AD/HD - diett som supplerende hjelpemiddel i spesialpedagogikk” ledet av Nødland og Fosse.


Elleve barn deltok videre i prosjektet over 5 år.

Liv Nina Hustoft har skrevet en master i spesialpedagogikk for Universitetet i Stavanger om resultater for gruppen barn som fortsatte diettforsøket ut over den opprinnelige studieperioden.


Det femte året var det enighet mellom foreldre og lærere om at 54,54% av utvalget ikke lenger viste betydelige atferdsvansker.

Konklusjon: Kasein og glutenfri diett har effekt på barn med AD/HD-problematikk og er verd å prøve som en behandlingsmetode dersom barnet får påvist ved urinprøve avvikende urinpeptidmønstre og forhøyde urinpeptidnivå.

Hele oppgaven er tilgjengelig her...

 



Masteroppgave fra Heidi Osa Michalsen om Kosthold og atferd som forskningsfelt.

 

Kosthold og atferd
En review av forskning foretatt om sammenhengen mellom kosthold og atferd.

Denne reviewen vil kunne være av stor interesse for alle som er opptatt av den drøftede problemstillingen, men også for alle som er i kontakt med barn i en eller annen setting. Oppgaven tar for seg 9 studier på kosthold og adferd og drøfter interessante aspekter knyttet til denne typen studier.
 Ny randomisert studie viser 50% eller mer reduksjon av ADHD-symptomatikk ved diett.

 


 

Ny randomisert åpen "few food diet" viser god effekt på ADHD-symptomatikk.

Diettstudien ble utført på 15 barn, med 12 barn i kontrollgruppen. Diettgruppen viste etter 9 uker 50% eller mer reduksjon i ADHD symptomatikk. Dietten viste seg også å ha svært god effekt på Oppositional defiant disorder (ODD).

Few food dietten besto av ris, kalkun, lam, grønnsaker, frukt, margarin, vegetabilske oljer, te, pærejuice og vann.

Mekanismene mellom kosthold og ADHD symptomatikk er ukjente, og mer forskning på dette området er nødvendig. Samtidig konkluderer studien med, på bakgrunn av denne og tidligere diettstudier, at foreldre som ønsker å forsøke diettbehandling av sitt barn bør få støtte til å forsøke, forutsatt at de får råd fra ernæringsfysiologer før gjennomføringen.
 
Hele studien: http://www.adhdenvoeding.nl/uploads/File/ADHD_and_Food,_ECAP_2008,_Pelsser_et_al.pdf
Abstraktet: http://www.ncbi.nlm.nih.gov/pubmed/18431534
 

 



Eur Child Adolesc Psychiatry. 2008 Apr 21.
A randomised controlled trial into the effects of food on ADHD.

 

Pelsser LM, Frankena K, Toorman J, Savelkoul HF, Pereira RR, Buitelaar JK.
ADHD Research Centre, Liviuslaan 49, 5624 JE, Eindhoven, The Netherlands, Denne e-postadressen er beskyttet mot programmer som samler e-postadresser. Du må aktivere javaskript for å kunne se den. .

The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder (ADHD). Dietary studies have already shown evidence of efficacy in selected subgroups. Twenty-seven children (mean age 6.2) who all met the DSM-IV criteria for ADHD, were assigned randomly to either an intervention group (15/27) or a waiting-list control group (12/27). Primary endpoint was the clinical response, i.e. a decrease in the symptom scores by 50% or more, at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale. The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [parent ratings 11/15 (73%) versus 0/12 (0%); teacher ratings, 7/10 (70%) versus 0/7 (0%)]. The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 (cohen's d) and a scale reduction of 69.4%. Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group (cohens's d 1.1, scale reduction 45.3%). A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children's behaviour.

PMID: 18431534 [PubMed - as supplied by publisher]

Hele studien: http://www.adhdenvoeding.nl/uploads/File/ADHD_and_Food,_ECAP_2008,_Pelsser_et_al.pdf  

 


 

Ned Tijdschr Geneeskd. 2002 Dec 28;146(52):2543-7.Links

Erratum in:
Ned Tijdschr Geneeskd. 2003 Dec 27;147(52):2612.
Comment in:
Ned Tijdschr Geneeskd. 2003 Mar 29;147(13):630-1; author reply 631.
Ned Tijdschr Geneeskd. 2003 Mar 29;147(13):630; author reply 631.
[Favourable effect of a standard elimination diet on the behavior of young children with attention deficit hyperactivity disorder (ADHD): a pilot study][Article in Dutch]

Pelsser LM, Buitelaar JK.
Onderzoekscentrum voor Hyperactiviteit en ADHD,

Vlokhovenseweg 11, 5625 WT Eindhoven. Denne e-postadressen er beskyttet mot programmer som samler e-postadresser. Du må aktivere javaskript for å kunne se den.

OBJECTIVE: To determine whether a standard elimination diet can decrease the ADHD-symptoms in a heterogeneous group of young children with ADHD. DESIGN: Open, descriptive. METHOD: 40 children, 36 boys and 4 girls, aged 3-7 (average 4.8 years), who met the DSM-IV-criteria for ADHD, followed their usual diet for two weeks and thereafter for two weeks an elimination diet, based on the few foods diet (rice, turkey, pear and lettuce). The behaviour of the child was evaluated at study entry, after the baseline period and at the end of the diet. Parents completed the 10-item Conners list, the ADHD Rating Scale and a physical complaints list. The teachers completed the 10-item Conners list and the ADHD Rating Scale twice, at the beginning and at the end of the diet. RESULTS: According to the parent-ratings, 25 children (62%) showed an improvement in behaviour of at least 50% on both the Conners list and the ADHD Rating Scale at the end of the elimination diet. Nine children (23%) withdrew from the study because the parents were unable to stick to the diet or because the child fell ill. Among the 15 children with both parent and teacher ratings, 10 responded both at home and in school. CONCLUSION: In young children with ADHD an elimination diet can lead to a statistically significant decrease in symptoms.

PMID: 12532668 [PubMed - indexed for MEDLINE]

 


 
J Atten Disord. 2006 Nov;10(2):200-4
A preliminary investigation of ADHD symptoms in persons with celiac disease.
Niederhofer H, Pittschieler K.
Regional Hospital of Bolzano, Bolzano, Italy. Denne e-postadressen er beskyttet mot programmer som samler e-postadresser. Du må aktivere javaskript for å kunne se den.

 

OBJECTIVE: Several studies report a possible association of celiac disease (CD) with psychiatric and psychological disturbances, such as ADHD. METHOD: The authors assess 132 participants from 3 to 57 years of age (M = 19.3 years) affected by CD for the possibility of an associated ADHD-like symptomatology, using the Conner Scale Hypescheme, a behavioral scale similar to the Conners Rating Scales, before their gluten-free diet was started and 6 months later. RESULTS: The overall score improves significantly as well as most of the ADHD-like symptomatology specific features (Bonferroni-corrected, paired-sample t tests). CONCLUSION: The data indicate that ADHD-like symptomatology is markedly overrepresented among untreated CD patients and that a gluten-free diet may improve symptoms significantly within a short period of time. The results of this study also suggest that CD should be included in the list of diseases associated with ADHD-like symptomatology.

PMID: 17085630 [PubMed - indexed for MEDLINE]

 



Ned Tijdschr Geneeskd. 2002 Dec 28;146(52):2543-7.Links
Erratum in:
Ned Tijdschr Geneeskd. 2003 Dec 27;147(52):2612.
Comment in:
Ned Tijdschr Geneeskd. 2003 Mar 29;147(13):630-1; author reply 631.
Ned Tijdschr Geneeskd. 2003 Mar 29;147(13):630; author reply 631.

 

[Favourable effect of a standard elimination diet on the behavior of young children with attention deficit hyperactivity disorder (ADHD): a pilot study][Article in Dutch]

Pelsser LM, Buitelaar JK.
Onderzoekscentrum voor Hyperactiviteit en ADHD, Vlokhovenseweg 11, 5625 WT Eindhoven. Denne e-postadressen er beskyttet mot programmer som samler e-postadresser. Du må aktivere javaskript for å kunne se den.

OBJECTIVE: To determine whether a standard elimination diet can decrease the ADHD-symptoms in a heterogeneous group of young children with ADHD. DESIGN: Open, descriptive. METHOD: 40 children, 36 boys and 4 girls, aged 3-7 (average 4.8 years), who met the DSM-IV-criteria for ADHD, followed their usual diet for two weeks and thereafter for two weeks an elimination diet, based on the few foods diet (rice, turkey, pear and lettuce). The behaviour of the child was evaluated at study entry, after the baseline period and at the end of the diet. Parents completed the 10-item Conners list, the ADHD Rating Scale and a physical complaints list. The teachers completed the 10-item Conners list and the ADHD Rating Scale twice, at the beginning and at the end of the diet. RESULTS: According to the parent-ratings, 25 children (62%) showed an improvement in behaviour of at least 50% on both the Conners list and the ADHD Rating Scale at the end of the elimination diet. Nine children (23%) withdrew from the study because the parents were unable to stick to the diet or because the child fell ill. Among the 15 children with both parent and teacher ratings, 10 responded both at home and in school. CONCLUSION: In young children with ADHD an elimination diet can lead to a statistically significant decrease in symptoms.

PMID: 12532668 [PubMed - indexed for MEDLINE]

 


 

BMC Psychiatry. 2005 Mar 17;5:14.
Gluten-free diet may alleviate depressive and behavioural symptoms in adolescents with coeliac disease: a prospective follow-up case-series study.
Pynnonen PA, Isometsa ET, Verkasalo MA, Kahkonen SA, Sipila I, Savilahti E, Aalberg VA.
Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland. Denne e-postadressen er beskyttet mot programmer som samler e-postadresser. Du må aktivere javaskript for å kunne se den.

BACKGROUND: Coeliac disease in adolescents has been associated with an increased prevalence of depressive and disruptive behavioural disorders, particularly in the phase before diet treatment. We studied the possible effects of a gluten-free diet on psychiatric symptoms, on hormonal status (prolactin, thyroidal function) and on large neutral amino acid serum concentrations in adolescents with coeliac disease commencing a gluten-free diet. METHODS: Nine adolescents with celiac disease, aged 12 to 16 years, were assessed using the semi-structured K-SADS-Present and Lifetime Diagnostic interview and several symptom scales. Seven of them were followed at 1 to 2, 3, and 6 months on a gluten-free diet. RESULTS: Adolescent coeliac disease patients with depression had significantly lower pre-diet tryptophan/ competing amino-acid (CAA) ratios and free tryptophan concentrations, and significantly higher biopsy morning prolactin levels compared to those without depression. A significant decrease in psychiatric symptoms was found at 3 months on a gluten-free diet compared to patients' baseline condition, coinciding with significantly decreased coeliac disease activity and prolactin levels and with a significant increase in serum concentrations of CAAs. CONCLUSION: Although our results of the amino acid analysis and prolactin levels in adolescents are only preliminary, they give support to previous findings on patients with coeliac disease, suggesting that serotonergic dysfunction due to impaired availability of tryptophan may play a role in vulnerability to depressive and behavioural disorders also among adolescents with untreated coeliac disease.

PMID: 15774013 [PubMed - indexed for MEDLINE]

 


 

World J Biol Psychiatry. 2001 Jul;2(3):144-8.
A serotonin uptake-stimulating tetra-peptide found in urines from ADHD children.
Liu Y, Reichelt KL.
Department of Pediatric Research, Rikshospitalet, Oslo, Norway.

A tetra-peptide has been isolated from the urines of children with Attention Deficit Hyperactivity Disorder (ADHD) that we could not find in control urines. The tetra-peptide (G-S-E-N) stimulates the uptake of serotonin into platelets. The peptide may explain why serotonin is increased in platelets of ADHD children.
PMID: 12587197 [PubMed - indexed for MEDLINE]

1994 May;72(5):462-8.
Foods and additives are common causes of the attention deficit hyperactive disorder in children.
Boris M, Mandel FS.
North Shore Hospital-Cornell Medical Center, Manhasset, New York.

The attention deficit hyperactive disorder (ADHD) is a neurophysiologic problem that is detrimental to children and their parents. Despite previous studies on the role of foods, preservatives and artificial colorings in ADHD this issue remains controversial. This investigation evaluated 26 children who meet the criteria for ADHD. Treatment with a multiple item elimination diet showed 19 children (73%) responded favorably, P < .001. On open challenge, all 19 children reacted to many foods, dyes, and/or preservatives. A double-blind placebo controlled food challenge (DBPCFC) was completed in 16 children. There was a significant improvement on placebo days compared with challenge days (P = .003). Atopic children with ADHD had a significantly higher response rate than the nonatopic group. This study demonstrates a beneficial effect of eliminating reactive foods and artificial colors in children with ADHD. Dietary factors may play a significant role in the etiology of the majority of children with ADHD.
PMID: 8179235 [PubMed - indexed for MEDLINE]


 

Lancet. 1992 May 9;339(8802):1150-3.Links
Comment in:
Lancet. 1993 Jan 9;341(8837):114-5.
Controlled trial of hyposensitisation in children with food-induced hyperkinetic syndrome.

Egger J, Stolla A, McEwen LM.
Universitatskinderklinik, Munchen, Germany.

Food intolerance seems to be an important cause of the hyperkinetic syndrome, but restricted diets are expensive, socially disruptive, and often nutritionally inadequate. Enzyme-potentiated desensitisation (EPD) may overcome some of these difficulties. EPD was tested in a double-blind placebo-controlled trial among 40 children with food-induced hyperkinetic behaviour disorder. A total of 185 children with established hyperkinetic syndrome underwent oligoantigenic dietary treatment for four weeks. 116 whose behaviour responded had provoking foods identified by sequential reintroduction. Foods that reproducibly provoked overactivity were avoided. 40 patients who were then invited to take part in the hyposensitisation trial were randomly assigned to treated and control groups. Treated patients received three doses of EPD (beta-glucuronidase and small quantities of food antigens) intradermally at two-monthly intervals. Controls received buffer only. Thereafter, patients were allowed to eat known provoking foods. Of 20 patients who received active treatment, 16 became tolerant towards provoking foods compared with 4 of 20 who received placebo (p less than 0.001). Our results show that EPD permits children with food-induced hyperkinetic syndrome to eat foods that had previously been identified as responsible for their symptoms. These results also support the notion that food allergy is a possible mechanism of the hyperkinetic syndrome.
PMID: 1349376 [PubMed - indexed for MEDLINE]



3.Egger J, Stolla A and McEwen LM (1992) The Lancet 339: 1150-1153.

0.    Egger J, Stolla A, McEwen LM.
Universitatskinderklinik, Munchen, Germany.
Food intolerance seems to be an important cause of the hyperkinetic syndrome, but restricted diets are expensive, socially disruptive, and often nutritionally inadequate. Enzyme-potentiated desensitisation (EPD) may overcome some of these difficulties. EPD was tested in a double-blind placebo-controlled trial among 40 children with food-induced hyperkinetic behaviour disorder. A total of 185 children with established hyperkinetic syndrome underwent oligoantigenic dietary treatment for four weeks. 116 whose behaviour responded had provoking foods identified by sequential reintroduction. Foods that reproducibly provoked overactivity were avoided. 40 patients who were then invited to take part in the hyposensitisation trial were randomly assigned to treated and control groups. Treated patients received three doses of EPD (beta-glucuronidase and small quantities of food antigens) intradermally at two-monthly intervals. Controls received buffer only. Thereafter, patients were allowed to eat known provoking foods. Of 20 patients who received active treatment, 16 became tolerant towards provoking foods compared with 4 of 20 who received placebo (p less than 0.001). Our results show that EPD permits children with food-induced hyperkinetic syndrome to eat foods that had previously been identified as responsible for their symptoms. These results also support the notion that food allergy is a possible mechanism of the hyperkinetic syndrome.
PMID: 1349376 [PubMed - indexed for MEDLINE]

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