Lifestyle Factors That Can Affect ADHD

An increasing number of children are kicking, screaming, hitting, and otherwise acting out. Some are so violent that they can't be in the same room with other children. The reason: attention deficit hyperactivity disorder (ADHD), a condition that affects up to 5 percent of children. While some people think that sugar, TV, and video games are to blame, experts claim there's no evidence to support such theories.

"We seem to keep revisiting these urban legends when the research has overwhelmingly been either inconclusive or contradictory," says Floyd Sallee, M.D., Ph.D., professor of psychiatry at the University of Cincinnati. But there are other environmental factors that do have an effect:

Nicotine Several studies have shown that children of mothers who smoked during pregnancy display more signs of attention deficit and are more likely to exhibit learning problems in school. "The risks aren't only posed by mothers smoking but also, more alarmingly, by exposure to secondhand smoke during pregnancy on into the first year of life," says Sallee. Why? Nicotine exposure in the womb and during early ages is toxic to developing brain tissue and may have sustained effects on behavior.

Alcohol While fetal alcohol syndrome is not directly related to ADHD, its symptoms — inattention and cognitive impairment — are similar to those of ADHD. Drinking during pregnancy can certainly increase the risk that the child will develop ADHD or ADHD-like symptoms. In adults who have ADHD, drinking can exacerbate symptoms, especially as regards impulsivity.

Heavy Metals "There's a known relationship between lead toxicity and detrimental effects on the functioning of a child's central nervous system that look like ADHD," says Sallee. "We've cleaned up the lead in gasoline, but there's a lot of lead in the environment — for example, in paint." And it's not just lead. Heavy metals such as cadmium and mercury (which is harbored in large predatory fish like swordfish and mackerel) have similar effects. Pregnant and nursing women as well as children should avoid these fish.

Food More than 30 years ago, Benjamin Feingold, M.D., suggested that food additives — colorings, flavorings, and related substances — have a pharmacological effect and may influence hyperactivity in children. After reviewing a series of studies, however, the National Institutes of Health concluded that food additives affect only a small number of children with behavioral problems. That said, a balanced, healthy diet does improve focus by stabilizing blood sugar levels, a key to managing ADHD symptoms.

Secondary Conditions ADHD does not occur in a vacuum. In fact, many researchers believe it is a syndrome or cluster of behaviors rather than a single disorder. In a study of 152 parents with ADHD, 87 percent had at least one psychological disorder, such as depression, multiple anxiety disorder, or substance abuse. "When the brain is abnormal on one circuit, there's a propensity for further abnormality — sort of a chain reaction of negative events," says Sallee. "If you're depressed, you don't pay attention and you have difficulties with performance" — symptoms that are similar to those of ADHD. It's the same thing with insomnia. After all, sleep deprivation makes the best of us cranky, inattentive, and irritable. Even in a person without ADHD, insomnia and depression can result in behaviors that are not all that different from those of a child with ADHD — irritability, inability to focus, inattention, and so on.