An Apple A Day

The rate of Attention Deficit Hyperactivity Disorder (ADHD) is rapidly rising and estimated to be 12% nationwide by US Census Bureau data. According to community estimates, ADHD rates are as high as 20% in some areas. Nationwide the percentage of children receiving prescription medication for ADHD is approaching 5% (and well over that in some areas). As the number of children diagnosed with ADHD soars in the US, parents, educators, health care providers and scientists are asking, “why”?

The list of answers and possible explanations is quite long. With no blood test to diagnose ADHD, and many reasons why overworked teachers, stressed parents and hurried doctors would want easy fixes, stamping a child with the ADHD label and starting that child on medication is an appealingly quick shovel-it-under-the-carpet response. Anyone with the most superficial experience of the challenges posed by these children will be sympathetic.

One reasons for over-diagnosis is uncertainty about what really is normal. Kids who are creative and unusually smart, need challenges or they will often create them for those around them. Kids who learn well but need a lot of physical activity also draw negative attention. Sadly, a child who sits quietly underachieving is often neglected. We live in a culture where driving a two ton metal projectile hurtling down the road, inches away from dozens or even hundreds of other vehicles, is boring. So we crank it up by talking on the phone, messing with CDs, running videos in the car and TEXTING! Driving has become our most popular extreme sport. Our culture is ADHD. We create children in our own image.

Cultural elements have a huge impact. So does diet. As I’ve discussed before, many in the medical community have decades-long experience of the ADHD-reducing effects of a diet limited in additives, preservatives and sugar. Even the British government is on board with this idea, after they funded a study expecting to discredit the theory. Prenatal care is vital, as is getting enough of the right nutrients, physical activity, positive parenting and teaching. Besides avoiding food additives, more and more research is linking unwanted “environmental additives” (ie, toxins) to ADHD.

The latest is a newly released Harvard study of nearly 250 pregnant women. Researchers tested their urine for BPA, finding it in over 97% of the women, and compared those BPA levels to mothers’ reports of ADHD behaviors in their children at age 3. With each 10 fold rise in BPA levels, there was a significant rise in mothers’ reports of their daughters’ emotional instability, anxiety and depression. Although ADHD is much more common in boys, there was no correlation between BPA levels and the behaviors of boys in this sample.

For decades now, we have known that the poisons we dump into our world poison our brains, causing ADHD and other problems. In the early 1970’s Harvard researcher Herbert Needleman discovered a very close correlation between blood lead levels and IQ. Since then the list of bad actors grows year by year. Organophosphates, developed for chemical warfare and present now in herbicides, pesticides and other chemicals, cause severe neurologic damage, as originally intended. Studies by UC Berkeley on the young children of agricultural workers in California’s Central Valley, by Harvard on preteen and early teens and by Columbia have all found links between even barely detectable levels of organophosphates and ADHD. In 2008, 20-30% of US samples of foods such as celery, strawberries and blueberries found contamination with one or more organophosphates. Korean studies have discovered strong links between phthalates and ADHD in school-aged children. Government research shows that nearly every American man, woman and child now has detectable levels of phthalates in our bodies.

What to do? Follow the essential health habits. Drink enough water. Exercise. Eat a healthy diet. Take a moderate amount of vitamin and mineral supplementation. Develop and maintain a positive attitude and social interactions. Avoid the stuff that makes us sick. That covers a broad range. Avoid food additives, including preservatives and flavoring agents. Select foods least likely to expose you to unwanted chemicals (review the list below and favor organic and local). Make your water as clean as possible. Create a stable, calm and pleasant environment. Use music and physical activity to help your child move in the rhythm that suits him or her.

Most contaminated

Fruits - peaches, apples, nectarines, strawberries, cherries, imported grapes, pears

Vegetables - bell peppers, celery, kale, lettuce, carrots

Least contaminated

Fruit - pineapples, mangoes, kiwis, papayas, watermelons

Vegetables - onions, avocados, sweet corn, asparagus, sweet peas, cabbages, eggplants, broccoli, tomatoes, sweet potatoes

Last week we experienced one of the landmark “freak out” moments in the history of discovering how we are poisoning ourselves. Years ago we learned that phthalates, the chemicals that make softer plastics, were hormone mimicking and thus very bad for us. They were in widespread use, including in pacifiers and water bottles. So, people moved to hard plastics, thinking they were safe. Then we recognized that bisphenol A (BPA) used in many products, including those hard plastic drinking bottles and the lining of metal food cans, was also an endocrine disruptor. Oooops! Honestly, those who touted BPA bottles as safe were at best woefully ignorant, because BPA was developed in the 1930′s AS A SYNTHETIC ESTROGEN. It waned in popularity after DES (yes that DES) was found to be stronger and therefore “better”(???). Recent government studies testing American citizens for environmental toxins in our blood found that everyone tested was contaminated with BPA

Last week even the new level of concern proved naively optimistic, with the discovery that we may have been blaming the wrong items for our BPA exposure. Spoiler alert - this discovery does not mean water bottles and those cans and other BPA sources are okay. Unfortunately, we just learned that another source appears to be far worse. Worst of all, that source is very, very difficult to avoid.

Got your interest?

The big nasty source is paper sales receipts. Investigators analyzed receipts from all the usual sources (ATMs, banks, grocery stores, gas stations, etc). Excepting ATMs, they were all heavily contaminated with BPA. While we have been fretting about exposures in the microgram range and lower, some of the receipts tested in this new study contained as much as 41 milligrams of BPA, nearly 3% of the weight of the receipt.

Now for those of you who don’t have much scientific training, 1 milligram (mg) is 1,000 micrograms (mcg). So, a receipt with 41 mg contains 41,000 mcg of BPA.

The sliver of good news is that BPA is probably absorbed less through our skin than by swallowing it. The obvious bad news is what to do about touching all of those receipts?

All I can suggest is to not accept any more of them than you have to, and wash your hands after touching them. The largest US manufacturer of these receipts, accounting for 40% of the market, has announced that because of their own concerns, their paper has been BPA-free for the last couple of years. Hopefully other manufacturers will follow suit and commercial establishments will have some way to choose BPA-free receipts. As the paper is processed into receipts by other paper companies, businesses cannot buy their paper directly from the primary non BPA company and no company is required to declare BPA content. I am hoping that the companies selling BPA-free papers will recognize this as a healthy marketing opportunity.