According to the food and agriculture organization, about 1 billion people in the world were living in hunger or insecurity in the year 2010 (1). Additionally, 5 to 15 % of people in industrial countries experience food insecurity which makes it all the more a public health concern in Europe (2).

But, what exactly is food insecurity about?

Food insecurity means that the access to sufficient food, meeting the dietary and cultural needs and the individual food preferences for a healthy and active life is not possible. It is not only a lack of food, what`s more, is the feeling that the preferred food supply is not available or may be threatened in the future, which has, in turn, an effect on the eating behavior. That means even if food is sufficient, people may be food insecure, but not necessarily undernourished. Two risk groups are students, who do not have the money for buying their preferred food, and refugees, who can´t buy their traditional food in their new home towns. Food insecurity can result in a reduction on micro-and macronutrition intake. Macronutrients are large food components that the body needs to maintain its metabolism; it includes lipids (fats), sugars (carbohydrates) and proteins. Micronutritions, like vitamins, minerals (such as calcium or magnesium), trace elements (such as iron and zinc), are essential because, without them, numerous normal functions such as growth or energy production could not take place.

Effects on mental health

Food insecurity is also found more often in families with low social economic status (4). Researchers have found that food insecurity caused an increase of depression and anxiety symptoms (3). Furthermore the uncertainty of having food in the future produced stress and created desperation and hopelessness in the families. They perceived the situation as shameful and resigned or used drugs and alcohol to compensate. In addition to this ,children from food insecure families were also more likely to develop symptoms of depression/ anxiety, aggression and hyperactivity/inattention (2). However, when you control for many demographical and psychological variables such as immigrant status, family structure and income and paternal depression, only increased impulsive behavior and inattention seem to be specifically linked to food insecurity Another factor is maternal mental health. It has been shown that food insecurity is especially bad for children’s development if the mother has additional mental health problems like depression, domestic violence and psychosis.

Further insights can be derived from Canadian students (5). Here are financial constraints a primary contributing factor. It represents a barrier because often students can´t afford to buy qualitative and expensive food. Another important factor is insufficient time because the effort to buy, prepare and cook healthy meals takes time and requires planning. It may also be the limited access to culturally appropriate food. This could be a barrier especially for people from other countries, who don´t have the opportunity to buy their traditional food and spices in local supermarkets. In urban areas, more exotic and international food supply is possible, due to the higher demand. The consequences for students were feelings of shame, frustration and loneliness. Some have felt socially isolated, and in general the food insecurity was associated with high psychological stress. Nonetheless the students in the reports believed that the situation is temporary and that after university life gets better in terms of food quantity and quality. For now they accepted the current situation.

So overall, food insecurity may occur in different social classes, with different reasons and effects of varying intensity. It`s interesting to see that it can occur in developing countries and rich countries, and that it can have an influence on whole families and children of food insecure families and students. More studies about people with cultural issues (e.g. refugees) are needed.

So, if you have the chance:

Buy the food you prefer and take time for preparing your meal,                      to live your life as healthy as you want it to be!

REFERENCES

(1) Cole, S. M.; Gelson, T. (2011). The effect of food insecurity on mental health: Panel evidence from rural Zambia. Social Science & Medicine. 73 (7)1071-1079.

(2) Melchior M.; Chastang J.- F.; Falissard B.; Galera, C.; Tremblay, R.E.; Cote, S.M., Boivin, M. (2012). Food insecurity and children’s mental health: a prospective birth cohort study. PLoS One 7 (12).

(3) Weaver, L. J.; Hadley. C. (2009) Moving Beyond Hunger and Nutrition: A Systematic Review of the Evidence Linking Food Insecurity and Mental Health in Developing Countries, Ecology of Food and Nutrition, 48(4), 263-284.

(4) Melchior, M.; Caspi, A.; Howard, L.M.; Ambler, A.P.; Bolton, H.; Mountain, N; Moffitt, T.E. (2009) Mental health context of food insecurity: a representative cohort of families with young children. Pediatrics, 124 (4).

(5) Hattangadi, N.; Vogel, E.; Carroll, L. J.; Cote, T. (2019). “Everybody I Know Is Always Hungry…But Nobody Asks Why”: University Students, Food Insecurity and Mental Health. Sustainability. 11 (6).

Please share and like us:
error

For my research, I measured impulsive behaviour in 3-year-old children. Briefly, impulsivity is the opposite of inhibitory control. There are several forms of inhibitory control, and although there is no official categorisation of different forms of inhibitory control in young children, Anderson & Reidy (2012) defined five categories. The categories are:

  • Delay of gratification: the ability to resist direct temptation in order to receive a bigger reward after the delay.
  • Impulse control: the ability to inhibit an instinctive response.
  • Verbal inhibition: the ability to inhibit verbal responses.
  • Motoric inhibition: the ability to learn response sets that conflict with an established behaviour.
  • Go/No go: the ability to perform certain behaviour after being shown a certain stimuli but to inhibit that behaviour after being shown a different stimuli.

The Marshmallow test is a famous example of an inhibitory control task (more specifically: delay of gratification). For this task, a marshmallow is placed in front of the child. The child is told that if s/he refrains from eating the marshmallow while the examiner is gone, s/he will receive two marshmallows when the examiner returns. Another example of an inhibitory control task (more specifically: Go/No go) is the Bear/Dragon task. For this test, the child has to obey the commands (e.g. ‘hands on your head’) of the bear hand puppet, but must inhibit obeying the commands of the dragon hand puppet.

When comparing the Marshmallow task with the Bear/Dragon task, similarities and differences can be found. They are similar in the way that both tests require the child to inhibit their impulses. However, the Marshmallow task requires minimal working memory demand, while the Bear/Dragon task requires complex greater working memory demand (Petersen, Hoyniak, McQuillan, Bates, & Staples, 2016). The Bear/Dragon task is thus a complex inhibitory control task, because children are instructed to not only inhibit a prepotent response, but also to respond in a certain way to a salient, conflicting response option.

In my research, I used both behavioural tasks and parental report (both mothers and fathers) to assess inhibitory control. However, results from the behavioural tests and the parental questionnaires correlate poorly with each other; a finding which is also often reported in other studies. While behavioural tests show objective observations of the child’s behaviour, these observations are mostly only carried out at one specific time point (e.g. during a home visit). As such, the child’s performance might be prone to noise, such as that the child slept poorly the past night. Reports of behaviour, on the other hand, reflect the behaviour of the child during daily life. However, these reports can be prone to social desirable answering and parental perceptions of their child’s behaviour. By measuring inhibitory control with both behavioural tasks and parental reports, we obtain the most robust view of the child’s behaviour.

Overall, measuring inhibitory control behaviour in 3-year-olds can be challenging, but also a lot of fun! (Stay tuned for a blog on interesting anecdotes during my data collection.)

REFERENCES:

Anderson, P. J., & Reidy, N. (2012). Assessing Executive Function in Preschoolers. Neuropsychology Review, 22(4), 345–360. https://doi.org/10.1007/s11065-012-9220-3

Petersen, I. T., Hoyniak, C. P., McQuillan, M. E., Bates, J. E., & Staples, A. D. (2016). Measuring the development of inhibitory control: The challenge of heterotypic continuity. Developmental Review: DR, 40, 25–71. https://doi.org/10.1016/j.dr.2016.02.001

Please share and like us:
error

Why do we eat what we eat? What makes us choose an apple over chocolate cake, or the other way around? How do we decide whether or not to have that tempting dessert, despite feeling satiated after a hearty meal? I previously wrote about how our daily food choices are, at least in part, influenced by our genetic make-up, but there are many other factors determining what, when, where and why we eat. Today I will discuss the importance of personality traits.

Personality is a set of relatively stable traits, that together determine who we are. While some characteristics of us change day by day, or even hour by hour, others are more stable. For instance, although we all feel worried from time to time, you may – generally speaking – be easily worried or nervous. The famous Big Five model of personality proposes that all people can be described in terms of five traits: neuroticism, agreeableness, openness to experience, conscientiousness and extraversion. These five traits in turn host a number of more specific characteristics, such as impulsivity, self-consciousness, anger, excitement seeking and thoughtfulness.1

What does this have to do with eating habits? Well, as it turns out, specific personality traits are associated with different food choices. Most studies look at healthy versus unhealthy food choices. A healthy diet has consistently been associated with the Big Five trait “conscientiousness”, which includes characteristics such as self-discipline, diligence, thoughtfulness and goal-orientedness. An unhealthy diet, on the other hand, has been associated with neuroticism, stress-sensitivity and impulsivity.2 Impulsivity and neuroticism have also been linked to emotional eating, binge-eating, external eating and (not surprisingly) stress-eating and impulsive eating (e.g. 3).

So, among the numerous factors influencing what, when, where and why we eat, how important are personality traits? Imagine a test in which we ask participants to choose between an apple and chocolate cake. Indeed, knowing how impulsive, neurotic and conscientious these participants are helps us better predict what they’ll choose; however, the accuracy of our prediction would improve only very slightly compared to a prediction without knowing the participants’ personality. In my own study (which is ongoing and therefore yet unpublished), I found that those with an extremely high score on an impulsivity questionnaire (i.e. higher than 97% of all other participants), on average, consumed 2192 kcal per day, compared to an average of 2030 kcal/day for those with an extremely low impulsivity score (i.e. those scoring lower than 97% of all other participants). For self-discipline, a trait belonging to the conscientiousness domain, the effect was even smaller: extremely self-disciplined people on average consumed only 112 kcal per day less compared to people with an extreme lack of self-discipline. To give you an indication, 112 kcal equals about one medium-sized cookie, or one glass of orange juice. In other words, being a conscientious person doesn’t mean one will always choose the healthy option over the unhealthy one; nor will impulsive or neurotic people always choose chocolate over apples.

Mind you, the above reported findings are associations. Although it is compelling to think that impulsivity causes us to make unhealthy food choices, it may in fact be the other way around! Perhaps an unhealthy lifestyle makes us more impulsive. We do know, for instance, that certain mental health conditions can be improved by healthier diets, suggesting that what we eat can change the way we feel and behave (rather than the other way around). This question of “direction of causality” is an important and very challenging issue that we, researchers, urgently need to tackle.

Finally, a few words on attention-deficit hyperactivity disorder (ADHD); after all, impulsivity is one of its key symptoms. Does this mean that people with ADHD make less healthy food choices? Indeed, this seems to be the case. Studies have shown that – on average – people with ADHD have less healthy eating habits4, and are more prone to overweight and obesity5,6, compared to people without ADHD. However, other factors associated with ADHD may contribute to poorer eating habits as well. For instance, lower socio-economic status makes healthier foods less accessible to people with ADHD, as healthier foods are generally more expensive; also, lower levels of education may result in people with ADHD knowing less about healthy and unhealthy lifestyles.

REFERENCES

  1. Costa, P.T., McCrae, R.R. (1992). Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) manual. Odessa, FL: Psychological Assessment Resources
  2. Stevenson (2017). Psychological correlates of habitual diet in healthy adults. Psychological Bulletin, 143(1), 53-90
  3. Keller, C. & Siegrist, M. (2015). Does personality influence eating styles and food choices? Direct and indirect effects. Appetite, 84, 128-38
  4. Ríos-Hernández, A., Alda, J.A., Farran-Codina, A., Ferreira-García, E., Izquierdo-Pulido, M. (2017). The Mediterranean Diet and ADHD in Children and Adolescents. Pediatrics, 139(2)
  5. Bowling, A.B., Tiemeier, H.W., Jaddoe, V.W.V., Barker, E.D., Jansen, P.W. (2018). ADHD symptoms and body composition changes in childhood: a longitudinal study evaluating directionality of associations. Pediatric Obesity, 13(9):567-575
  6. Chen, Q., Hartman, C.A., Kuja-Halkola, R., Faraone, S.V., Almqvist, C., Larsson, H. (2018). Attention-deficit/hyperactivity disorder and clinically diagnosed obesity in adolescence and young adulthood: a register-based study in Sweden. Psychological Medicine, 1-9 (e-pub)
Please share and like us:
error

In our Eat2BeNice project, we want to know how lifestyle-factors, and nutrition contribute to impulsive, compulsive, and externalizing behaviours. The best way to investigate this is to follow lifestyle and health changes in individuals for a longer period of time. This is called a prospective cohort study, as it allows us to investigate whether lifestyle and nutrition events at one point in time are associated with health effects at a later point.

Luckily we can make use of the LifeGene project for this. LifeGene is a unique project that aims to advance the knowledge about how genes, environments, and lifestyle-factors affect our health. Starting from September 2009, individuals aged 18 to 45 years, were randomly sampled from the Swedish general population. Participants were invited to include their families (partner and children). All study participants will be prompted annually to respond to an update web-based questionnaire on changes in household composition, symptoms, injuries and pregnancy.

The LifeGene project (1) consists of two parts: First, a comprehensive web-based questionnaire to collect information about the physical, mental and social well-being of the study participants. Nine themes are provided for adults: Lifestyle (including detailed dietary intake and nutrition information), Self-care, Woman’s health, Living habits, Healthy history, Asthma and allergy, Injuries, Mental health and Sociodemographic. The partners and children receive questions about two to four of these themes. For children below the age of 15 the parents are requested to answer the questions for them.

The second part is a health test: at the test centres, the study participants are examined for weight, height, waist, hip and chest circumference, heart rate and blood pressure, along with hearing. Blood and urine samples are also taken at the test centres for analysis and bio-banking.

Up until 2019, LifeGene contains information from a total of 52,107 participants. Blood, serum and urine from more than 29,500 participants are stored in Karolinska Institute (KI) biobank. From these we can analyze genetic data and biomarkers for diabetes, heart disease, kidney disease and other somatic diseases. Based on LifeGene, we aim to identify nutritional and lifestyle components that have the most harmful or protective effects on impulsive, compulsive, and externalizing behaviors across the lifespan, and further examine whether nutritional factors are important mediators to link impulsivity, compulsivity and metabolic diseases(e.g. obesity, diabetes). We will update you on our results in the near future.

For more information, please go to the LifeGene homepage www.lifegene.se. LifeGene is an open-access resource for many national and international researchers and a platform for a myriad of biomedical research projects. Several research projects are underway at LifeGene https://lifegene.se/for-scientists/ongoing-research/.

This was co-authored by Henrik Larsson, professor in the School of Medical Science, Örebro University and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

AUTHORS:
Lin Li, MSc, PhD student in the School of Medical Science, Örebro University, Sweden.

Henrik Larsson, PhD, professor in the School of Medical Science, Örebro University and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

REFERENCES:

  1. Almqvist C, Adami HO, Franks PW, Groop L, Ingelsson E, Kere J, et al. LifeGene–a large prospective population-based study of global relevance. Eur J Epidemiol. 2011;26(1):67-77.
Please share and like us:
error

Yoga practice has become very popular in the last two centuries. In most western countries, yoga studios are booming. For example, Dutch practitioners are said to spent 325 million euros per year on yoga classes, clothes and events.

In scientific research, yoga and its beneficial effects on physical and mental health, have also become a serious topic of interest. In a previous post, Hannah Kurts had already outlined the positive effects of yoga for several psychiatric disorders (https://newbrainnutrition.com/how-to-help-mental-health-with-yoga/)

Recently, the effects of yoga on cognitive performance and behavioral problems in 5-year old children have been examined. A group of Tunisian researchers offered 5-year old children in kindergarten a 12-week yoga program, regular physical education, or no kind of physical activities.

They found that this kind of kindergarten-based yoga practice, had significant positive effects on visual attention, visuo-motor precision and symptoms of hyperactivity and impulsivity, in comparison to regular physical activities or no physical activities [1].

One might wonder: Quiet and peaceful yoga exercises with a bunch of energetic 5-year olds? How would that even work?

The yoga they offered in this project was a 30-minute routine, instead of a more regular 90-min session: 5 minutes of warming up, doing jogging, jumping, stretching. Next, 15 minutes of the well-known yoga postures, standing, sitting, flexing. Next, 5 minutes of breathing techniques and lastly, 5 minutes of yogic games, to train memory, awareness and creativity. And they practiced only twice a week.

It seems very promising that such a curtailed version of yoga practice can have positive effects on attention, executive functions, and behavioral control, which are all skills that are vital to good academic performance [2][3].

In some European and North-American countries, the idea of school-based yoga practice isn’t so revolutionary anymore. France, Italy, Brazil, and Canada have recognized yoga practice in its school curriculum. Italy seems to be the school-yoga champion: Classroom-based yoga is performed in all Italian schools since 2000 [4].

REFERENCES
[1] Jarraya S, Wagner M, Jarraya M and Engel FA (2019) 12 Weeks of Kindergarten-Based Yoga Practice Increases Visual Attention, Visual-Motor Precision and Decreases Behavior of Inattention and Hyperactivity in 5-Year-Old Children. Front. Psychol. 10:796. doi: 10.3389/fpsyg.2019.00796

[2] Chaya, M. S., Nagendra, H., Selvam, S., Kurpad, A., and Srinivasan, K. (2012). Effect of yoga on cognitive abilities in schoolchildren from a socioeconomically disadvantaged background: a randomized controlled study. J. Altern. Complement. Med. 18, 1161–1167. doi: 10.1089/acm. 2011.0579

[3] Verma, A., Uddhav, S., Ghanshyam Thakur, S., Devarao, D., Ranjit, K., and Bhogal, S. (2014). The effect of yoga practices on cognitive development in rural residential school children in India. Natl. J. Lab. Med. 3, 15–19.

[4] Flak, M. (2003). Recherche Sur Le Yoga Dans L’éducation. 3ème Millénaire: Spiritualité – Connaissance De Soi – Non-Dualité – Méditation, 125. Available at: http://www.rye-yoga.fr/ (accessed July 15, 2018).

Please share and like us:
error

Recent research (1,2) on children and adolescents has reported that elevated levels of ADHD symptoms are positively associated with unhealthy dietary habits, including a higher consumption of refined sugars, processed food, soft drink, instant noodles, and a lower intake of vegetables and fruits. However, the link between low-quality diets and risk of ADHD in adults is still not well established, which would be further explored in the ongoing Eat2beNICE research project.

What is the underlying mechanism for an association between ADHD and unhealthy dietary habits? There is still no clear answer. Nemours’ potential biological pathways, by which dietary intake could have an impact on mental health, has been proposed in the literature (2). For example, iron and zinc are cofactors for dopamine and norepinephrine production (essential factors in the etiology of ADHD), so unbalanced diet with lower levels of iron and zinc may further contribute to the development of ADHD. However, we cannot overlook the possibility of a bi-directional relationship between diet quality and ADHD, especially when the interest in the concept of “food addiction” has received increased attention.

Food addiction refers to being addicted to certain foods (e.g. highly processed foods, highly palatable foods, sweet and junk foods) in a similar way as drug addicts are addicted to drugs. Animal models (3) have suggested that highly processed foods may possess addictive properties. Rats given high-sugar or high-fat foods display symptoms of binge eating, such as consuming increased quantities of food in short time periods, and seeking out highly processed foods despite negative consequences (e.g. electric foot shocks). One human study (4) found that individuals with high levels of ADHD-like traits (e.g. high levels of impulsively, disorganised, attention problems) were more likely to suffer from problematic eating behaviour with overconsumption of specific highly palatable foods in an addiction-like manner. Therefore, food addiction may, just as substance abuse, be over-represented among individuals with ADHD.

Thus, it seems there could be a vicious cycle between unhealthy dietary habits and ADHD: ADHD may lead to a worse choice of diet, lowering the health quality, which could eventually exacerbate ADHD symptoms. We will further test the bidirectional diet-ADHD associations in the ongoing Eat2beNice project.

This was co-authored by Henrik Larsson, professor in the School of Medical Science, Örebro University and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

AUTHORS:
Lin Li, MSc, PhD student in the School of Medical Science, Örebro University, Sweden.
Henrik Larsson, PhD, professor in the School of Medical Science, Örebro University and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.

REFERENCES:
1. Kim KM, Lim MH, Kwon HJ, Yoo SJ, Kim EJ, Kim JW, et al. Associations between attention-deficit/hyperactivity disorder symptoms and dietary habits in elementary school children. Appetite. 2018;127:274-9.

2. Rios-Hernandez A, Alda JA, Farran-Codina A, Ferreira-Garcia E, Izquierdo-Pulido M. The Mediterranean Diet and ADHD in Children and Adolescents. Pediatrics. 2017;139(2).

3. Gearhardt AN, White MA, Potenza MN. Binge Eating Disorder and Food Addiction. Curr Drug Abuse Rev. 2011;4(3):201-7.

4. Ptacek R, Stefano GB, Weissenberger S, Akotia D, Raboch J, Papezova H, et al. Attention deficit hyperactivity disorder and disordered eating behaviors: links, risks, and challenges faced. Neuropsychiatr Dis Treat. 2016;12:571-9.

Please share and like us:
error

A little while ago, this blog featured an entry by Annick Bosch on the TRACE study, an amazing intervention study using the Elimination Diet to treat ADHD in kids (https://newbrainnutrition.com/adhd-and-elimination-diet/). Very shortly summarized, the Elimination Diet entails that participants can only eat a very restricted set of foodstuffs for several weeks, which can greatly reduce the number of ADHD symptoms in some kids. Subsequently, new foodstuffs are added back into the diet one by one, all the time checking that ADHD symptoms do not return. This ensures that every child for which the Elimination Diet proves successful ends up with a unique diet which suppresses their ADHD symptoms.

Now this is a fascinating study, since it indicates a direct influence of diet on ADHD behavior. What we know from the neurobiology of ADHD, is that it is caused by a myriad of relatively small changes in the structure, connectivity and functioning of several brain networks 1. For the most common treatments of ADHD, like medication with methylphenidate 2, we can quite accurately see the changes these interventions have on brain functioning. However, for the Elimination Diet, this has not been studied before at all. This is why we are now starting with the TRACE-MRI study, where kids that participate in a diet intervention in the TRACE program, are also asked to join for two sessions in an MRI scanner. Once before the start of the diet, and once again after 5 weeks, when the strictest phase of the Elimination Diet concludes. In the MRI scanner, we will look at the structure of the brain, at the connectivity of the brain, and at the functioning of the brain using two short psychological tasks. We made a short vlog detailing the experience of some of our first volunteers for this MRI session.

 

 

With the addition of this MRI session, we hope to be able to see the changes in brain structure and function over the first 5 weeks of the diet intervention. This will help us establish a solid biological foundation of how diet can influence the brain in general, and ADHD symptoms specifically. It can also show us if the effect of the Elimination Diet is found in the same brain networks and systems which respond to medication treatment. And lastly, we can see if there is a difference in the brains for those participants for whom the diet has a strong effect versus those where the diet does little or nothing to improve their ADHD symptoms. This can then help us identify for which people a dietary intervention would be a good alternative to standard treatment.

We will update you on the TRACE-MRI study and on the developments in this field right here on this blog!

 

REFERENCES
Faraone, S. V et al. Attention-deficit/hyperactivity disorder ­­­. Nat. Rev. Dis. Prim. 1, (2015).

Konrad, K., Neufang, S., Fink, G. R. & Herpertz-Dahlmann, B. Long-term effects of methylphenidate on neural networks associated with executive attention in children with ADHD: results from a longitudinal functional MRI study. J. Am. Acad. Child Adolesc. Psychiatry 46, 1633–41 (2007).

Please share and like us:
error

When Alice’s mother first contacted our team to get more information on the dietary intervention at New Brain Nutrition, she mentioned that her daughter seems to be on edge all the time. On a typical day, Alice would be triggered easily over seemingly small things and stay upset for a long time. She told us that these emotional problems caused not only very strained and cheerless moments on the weekends and evenings, they also interfered notably with Alice’s social life. In between her angry or sad moments, Alice seems to be a perfectly happy and energetic 11-year old. Alice’s attention problems didn’t obstruct a healthy didactic development since she started ADHD-medication. However, the emotional problems were still present and seemed to cause severe impairment in social interactions, within the family and with peers. Therefore, her mother asked: Could we please try a dietary intervention to see if Alice’s nutrition may play a role in these problems?

Faraone[1] distinguishes two features in these kind of emotional problems: Emotional Impulsivity and Deficient Emotional Self-Regulation. Some children may experience explosive anger but also recover quickly from it. These children experience high Emotional Impulsivity but low Deficient Emotional Self-Regulation. Alice however, based on her mother’s narrative, seems to experience both high Emotional Impulsivity and high Deficient Emotional Self-Regulation.

The second week into the Elimination Diet treatment, the researcher checks in with the family: She’s still edgy and irritable for most of the time, her mother says, but she seems to break out of it a whole lot sooner. The other day her brother Daniel came home, telling Alice he ate lots of non-elimination diet snacks at his friend’s house. Understandably, Alice became upset but it didn’t last as long as her parents expected. In other words: The Emotional Impulsivity hadn’t decreased yet, but the Deficient Emotional Self-Regulation had.

By the end of the first 5 weeks of the dietary intervention, Alice’s parents reported a convincing decrease in emotion regulation problems. The teacher also reported that the attention problems had stabilized, as much as they did with the ADHD-medication that Alice had before. The family decided to continue the Elimination Diet and start with the re-introduction phase. Every two weeks a new product was re-introduced to see if this may elicit symptoms. This was probably the most interesting period for the family, as emotion regulation problems and attention problems arose and subsided over different phases.

After one year, Alice and her family had figured out a set of foods that, when eliminated from her diet, helped diminishing both the attention problems and emotional problems. Alice is less responsive to emotional triggers and more balanced during social interactions. Alice’s personalized diet or personalized nutrition is based on her experiences and symptoms during the dietary intervention. Her mother is very glad that they discovered this lifestyle intervention as an alternative to their previous treatment with ADHD-medication.

Writers note: This is the story of one individual participating in the New Brain Nutrition study. Evaluating the role of nutrition in treatment of mental health with scientific evidence is part of our future.

More information can be found in [1] Faraone S.V., Rostain A.L., Blader J., Busch B., Childress A.C., Connor D.F., & Newcorn J.H. (2018). Practitioner Review: Emotional dysregulation in attention‐deficit/hyperactivity disorder – implications for clinical recognition and intervention. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.12899

Please share and like us:
error

In studies about treatment for children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), it is important to use valid and reliable instruments to measure effects. A valid instrument can measure a difference in symptoms before and some time after the treatment has started. Usually questionnaires for parents and teachers are used.

In the TRACE project, currently running in the Netherlands, we are looking at the effectiveness of a dietary intervention versus care as usual, for children diagnosed with ADHD in the age group of 5-12 year old. In addition to the standard questionnaires, there is an observation instrument called the Disruptive Behavior Diagnostic Observation Schedule (DB-DOS). This instrument was added in the TRACE project as an objective measurement for changes in behavior.

DB-DOS, ADHDThe DB-DOS was originally developed to measure disruptive behavior disorders (DBD) in preschoolers1. This way, treatment effects are not only measured in an indirect way, through information of caregivers, but also in a direct observation in the clinical setting. However, the age range of the children in the TRACE project is different from the preschoolers the DB-DOS was originally intented for. That’s why the TRACE project added several tasks to the original DB-DOS, to make sure it elicits disruptive behaviours, as well as hyperactivity and impulsivity, and to make it suitable for older children. During the current trial we try to find out if the DB-DOS is also a valid measurement for older children, aged 5-12 years.

The DB-DOS uses three different interactional contexts: parent-child context, examiner-child context and parent-examiner-child context. Children will be asked to complete different tasks. Some are rather boring, or frustrating, to see if this may elicit attention problems, hyperactivity, impulsive behaviour or disruptive behaviors. The DB-DOS contains, for example, some tasks which can evoke anger or sadness and some tasks where children get the chance to cheat. The reaction of the child is observed from behind a one-way screen. The observation lasts about 60 minutes and afterwards the observed behavior is scored by the examiner through a coding system. With more evidence-based instruments, mental health problems can be targeted more efficiently and reliably.

Our final goal is earlier interventions which prevent mental health problems in these children getting more severe and spreading through other domains such as school, work, or social contacts.

We will keep you posted about the results of the DB-DOS in the TRACE project!

REFERENCE
1 Bunte, T. L., Laschen, S., Schoemaker, K., Hessen, D. J., Van der Heijden, P. G. M., & Matthys, W. (2013). Clinical Usefulness of Observational Assessment in the Diagnosis of DBD and ADHD in Preschoolers. Journal of Clinical Child & Adolescent Psychology, 42(6), p.p. 749-761.
http://dx.doi.org/10.1080/15374416.2013.773516

 

Please share and like us:
error


Welcome to New Brain Nutrition. You can enjoy FREE Online Courses when you Log In or Join here.

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 728018

New Brain Nutrition is a project and brand of Eat2BeNice, a consortium of 18 European University Hospitals throughout the continent.

Partners:
You may log in here to our Intranet website with your authorized user name and password.