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Healthnotes Newswire (July 31, 2008)—Premature babies are at risk for complications in their mental development, but new evidence shows that their brains may get a boost from fatty acids: A study in Pediatrics reports that breast milk supplemented with omega-3 DHA (docosahexaenoic acid) and omega-6 AA (arachidonic acid) may improve brain development in premature infants.DHA and AA are two types of fatty acids essential for many bodily functions including brain, eye, and nervous system development. The optimal amounts of these fatty acids for premature infants has not been determined, but researchers suggest that increasing the amounts in early infancy may reduce the risk of developmental problems later in life.

Learning disabilities and school-related problems are more common among premature infants than full-term infants. Prior studies, however, have shown that premature infants who are breast-fed have higher IQs than babies receiving formula milk. This finding was attributed to higher concentrations of DHA found in human milk compared with formula milk. The authors of the new study considered the possibility that increasing the DHA content of human milk and adding AA could further improve preemies’ brain development.

Study results encouraging

In the study, 141 premature infants weighing less than 1,500 grams (about 3 pounds) were randomly assigned to receive human breast milk supplemented with either 32 mg of DHA and 31 mg of AA per 100 ml of milk, or breast milk supplemented with soy oil and medium-chain triglyceride oil. Infants received more than 100 ml of human milk per kilogram of body weight per day beginning on the first or second day of birth and continuing until discharge from the hospital (an average of nine weeks).

At six months of age, infants who received the human milk supplemented with DHA and AA were better at problem-solving and were better able to discriminate between familiar and unfamiliar objects compared with infants in the control group.

“There is growing evidence that DHA and AA have specific functions related to memory and problem-solving,” said Christine Henriksen, PhD, lead author of the study from the Department of Nutrition at the University of Oslo, Norway. Dr. Henriksen and her colleagues point out that these functions are critical for being able to focus, be attentive, learn, and process information. Further research is needed to understand the long-term impact of supplementing with fatty acids on school performance and attention capacity later in life.

Ensure you eat your EFAs

Babies are dependent on breast milk and/or fortified formula milk for DHA and AA, but there are other important sources of essential fatty acids (EFAs) to consider as the child grows older. In addition, recent research has shown that it is important for pregnant women to eat plenty of fatty acids in order to help optimize their baby’s brain function. You can find them in these sources:

• Fatty fish such as salmon, halibut, and tuna are good sources of DHA, which is also found in smaller amounts in eggs. Pregnant women should balance the need for fatty acids from fish with reducing exposure to mercury by limiting the amount of fish they eat and avoiding fish high in mercury content.

• AA is found in meat, chicken, and eggs.

• Some people may benefit from supplements that contain fatty acids. Check with your doctor about the appropriateness of using supplements to further enrich your diet.

(Pediatrics 2008;121:1137–45)

Healthnotes Newswire (July 10, 2008)—For children with hyperactivity, eliminating food additives should be part of a standard treatment program, according to Andrew Kemp, MD, author of an editorial in the British Medical Journal and professor of pediatric allergies and immunology in Sydney, Australia. Despite the lack of agreement on the effect of dietary modifications on hyperactivity in children, increasing evidence suggests that eliminating food preservatives and artificial colorings from a child’s diet may help.

The roots of hyperactive behavior

When a child is hyperactive, parents and health professionals often look at a variety of factors that may be contributing to the child’s behavior, such as stress in the home or school environment, divorce, death of a loved one, and certain medical or psychiatric conditions. But something as simple as a child’s diet may also play a role. In fact, increasing scientific evidence suggests that food additives may increase hyperactivity in some children.

A study published in the Lancet found that artificial colors and/or sodium benzoate preservative in the diet led to increased hyperactivity in three-, eight-, and nine-year-old children who did not have attention deficit–hyperactivity disorder (ADHD). The study noted that food additives may increase hyperactivity in some children but not in others.

Various experts have weighed in about the impact of such additives on childhood hyperactivity. Dr. Kemp notes that a panel from the European Food Safety Authority acknowledged, after reviewing 22 studies and two meta-analyses from 1975 to 1994, that research provides evidence that food additives and colorings may affect activity and attention in children. However, a recent review of treatment for ADHD by the American Academy of Pediatrics Subcommittee did not review dietary modification as a treatment but supported stimulant medications.

Treatment options: drugs, behavioral therapy, diet—and ditching food additives

Currently, specific treatments for hyperactivity may include drugs, behavioral therapy, and dietary changes. Eliminating food additives is often regarded as an “alternative” rather than standard treatment for ADHD even though research has supported both drug therapy and dietary modifications, according to Dr. Kemp.

In advocating for diet modification as standard treatment, Kemp says, “In view of the relatively harmless intervention of eliminating colorings and preservatives, and the large numbers of children taking drugs for hyperactivity… an appropriately supervised and evaluated trial of eliminating colorings and preservatives should be part of standard treatment for individual children.”

Tips for parents

Parents with a hyperactive child may discuss these types of questions with their healthcare provider:

• Is increased stress causing the behavior? A divorce, loss, a move to another neighborhood, increased school workload, competitive activities, and many other factors can contribute to a change in your child’s behavior.

• Is your child getting enough exercise? A child may be labeled as “hyperactive” when in fact he or she is merely in need of more physical activity.

• Does your child have a supportive and nurturing environment at school that encourages individual learning styles? Again, a child may be labeled “hyperactive” if he or she does not conform to typical classroom standards.

• Any child with a significant change in behavior or persistent disruptive behavior should be evaluated by a physician to determine whether or not there is a medical cause. Evaluation by a physician or psychologist who is specifically trained in the area of hyperactivity may be helpful.

• Ask a physician or nutritionist who is aware of the effects of dietary factors on hyperactivity for suggestions in treating the behavior. Consider the role that food additives may be playing, and look for more fresh, unprocessed foods to enjoy with your family.

(BMJ 2008;336:1144; Lancet 2007;370:1560–67)

Healthnotes Newswire (June 19, 2008)—Until recently, attention deficit–hyperactivity disorder (ADHD) was considered mainly a childhood disorder. Today it is recognized as a common condition in many adults throughout the world, and now there is evidence that the condition may interfere with work performance).

The World Health Organization dustributed a World Mental Health Survey Initiative in ten countries to collect data from more than 11,000 people, ages 18 to 44. Approximately 3.5% of workers had adult ADHD, and men were more likely than women to suffer from the disorder. When compared with their colleagues, people with ADHD were less productive. This lost time was due to poor work quality, reduced quantity, or a complete inability to carry out their tasks. The survey revealed that most adults are not treated for their ADHD.

Symptoms of adult ADHD may include difficulty with concentrating or focusing on a task, being easily distracted, difficulty with following instructions, problems with organizing and prioritizing, and restlessness. The disorder may affect a person’s work performance because he or she is not able to complete a task on time or at all due to lack of focus or procrastination, or because the person is often very busy but not accomplishing a lot. People with ADHD often have other mental or substance abuse disorders that may affect their work performance as well.

“ADHD is a relatively common condition among working people in the countries studied and is associated with high work impairment in these countries,” according to the study authors. “This impairment, in conjunction with the low treatment rate and the availability of cost-effective therapies, suggests that ADHD would be a good candidate for targeted workplace screening and treatment programs.”

Finding focus

Treatments for the condition include self-regulating techniques such as learning about the disorder, instituting time and project management techniques, and creating structure that can be followed. Some people seek professional help for therapy to help them regulate their behaviors, and medications are available to help ease symptoms.

Natural treatments that have been found to benefit children with ADHD include consuming less refined sugar and food additives, identifying and avoiding allergenic foods, and supplementing with B vitamins, magnesium, and essential fatty acids. These treatments have not been studied in adults with ADHD.

(Occup Environ Med 2008; doi:10.1136/oem.2007.038448)