- Twelve months ago, at school and in his Glasgow home,
seven-year-old Ryan Gallacher was all but uncontrollable. Then, in August
last year, his father Alex changed Ryan's diet. Off the menu went anything
with artificial food additives. Ryan's behaviour improved - dramatically.
-
- Around 20,000 children have been diagnosed as having
what is variously known as "hyperkinetic disorder" or "attention
deficit and hyperactivity disorder" (ADHD). But some commentators
believe that the true number could be 10 times that. To Alex Gallacher,
a down-to-earth Glaswegian who would normally have little time for "alternative"
theories, the part that additives had played in causing Ryan's problem
was blindingly obvious. But many clinicians and scientists who work on
additives remain cautious if not downright dismissive about the alleged
link.
-
- The woeful gap between parental conviction and scientific
rigour makes a difficult problem even harder. It needs to be bridged -
and the best hope of doing so lies in research at the University of Southampton.
Its preliminary findings suggest that, to some degree at least, parents
may have been right all along.
-
- Ryan's problems began when he was just 18 months old.
"He was excluded from his nursery for inappropriate behaviour,"
Alex recalls. "He was very excitable, very jumpy. Not just raucous,
it was completely beyond that."
-
- Nothing had improved by the time Ryan began school. Alex
would be summoned by teachers as often as two or three times a week. "I'd
get a call saying, 'Your son is running through the corridors screaming'.
Or they'd say, 'You've got to come, he's hiding under a desk holding his
head in his hands'."
-
- Educational and family psychologists considered various
explanations, from parental disharmony to sibling rivalry. But nothing
added up. Ryan's older brother was fine. "I could let him play with
the kids in the street," says Alex. "But not Ryan. I had to make
excuses to him why he couldn't go out, because we knew that as soon as
he did, there was going to be trouble."
-
- Alex became increasingly frustrated and angry. He and
his wife Phoebe almost split up. "There was a point at which I couldn't
work properly because my mind was constantly on what was happening to Ryan.
The strain was destroying us."
-
- Salvation came from a Sunday- newspaper article on diet
and behaviour. Out went all foods containing additives - and Ryan's six-year
nightmare drew rapidly to a close.
-
- The best-known treatment for ADHD is a drug called Ritalin,
which first gained notoriety in the States. The number of prescriptions
being issued in Britain - up from 90,000 in 1997 to well over 200,000 in
2002 - reveals its rising popularity here.
-
- A hint of psychiatry's caution in linking the disorder
to diet can be gleaned from the brevity of the relevant section in a Royal
College of Psychiatrists fact sheet. "There is a small body of evidence
about the effect of diet on some children," says the leaflet. "A
few may be sensitive to certain foods. If parents notice that specific
foods worsen hyperactivity, these may be avoided. It is best to discuss
this with the specialist."
-
- That's it. So, who is right: the doctors or the parents?
Enter Professor John Warner of Southampton General Hospital, a physician
with a long-established interest in additives. His team's study of their
effects, published recently in the authoritative journal entitled Archives
of Disease in Childhood, used methods of a kind that are standard in all
careful medical research.
-
- Among the 400 children who took part were some who showed
signs of hyperactivity and some who didn't. Their parents were asked to
keep them on a diet free of all additives and artificial preservatives
for one month. In the second and fourth weeks, each child had to drink
a daily bottle of fruit juice. During one week it was pure; during the
other it was laced with a cocktail of additives. The drinks themselves
were indistinguishable in taste and colour, and parents weren't told which
was which.
-
- The test drink contained four widely used food colourings:
sunset yellow, tartrazine, carmoisine and ponceau 4R, and also the preservative
sodium benzoate. The researchers conducting the study assessed each child
at weekly intervals using tests that are routine in behaviour-disorder
clinics.
-
- Most importantly, parents, too, rated the everyday behaviour
of their children. They looked for signs such as switching from one activity
to another, talking or interrupting a lot, fiddling with objects, and general
restlessness.
-
- The results showed a clear distinction between the parents'
assessments and those of the psychologists. The latter found no significant
difference between the effect of the two drinks; the parents did.
-
- So, what to make of the apparent contradiction? One of
Warner's colleagues, the psychologist Professor James Stevenson, thinks
that he can explain it. "Children were coming along to a clinic, meeting
a bright young tester who was interested in them, and they were on their
best behaviour. It wasn't a context that would elicit inattention, distractability
and the rest. But parents see kids when they're tired, they see them in
the evening, on the bus, in the supermarket queue."
-
- In short, in real life. This wouldn't be the first time
that measurements made within the clinic have failed to detect what is
more apparent outside it.
-
- The Southampton team's conclusions are unequivocal: "The
observed effect of food additives and colourings in this community sample
is substantial." For Stevenson in particular, the findings prompted
a change of heart. "I'd worked in hyperactivity for a number of years,
and originally thought that diet was probably important only in an exceptional,
odd group of children. Having done this work, I've changed my mind."
-
- His guess is that within the general population there's
a range of behaviour that is affected by nurture as well as nature. "Additives
seem to be shifting that distribution of behaviour towards the more hyperactive
end."
-
- Neither Stevenson nor Warner suggests that additives
are the only factor; but their effects are large enough to take seriously.
Not least, adds Stevenson, because most of them are there only for marketing
purposes.
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- Heartened by these findings, Warner is planning a further
study. This, like its predecessor, will be partly financed by the Food
Standards Agency, a body that takes the issue seriously.
-
- Among parents eager to take part in the new study is
Vickie Gilfillan, a single mother whose son Jacques, aged six, showed the
first signs of hyperactivity when he was just eight months old. "He
wouldn't sleep, he screamed all the time, he would throw things, and his
temper tantrums were horrendous. As he got older, it got worse and worse."
-
- She is enthusiastic about the new study. "I heard
of the last one from a report on the TV. I e-mailed them to tell them about
Jacques. I was quite lucky because my mother went through the same problem
with my brother, so we managed to spot it early on. Jacques now has a largely
additive-free diet.
-
- "If Jacques goes to a birthday party, it's a nightmare.
You can't stop children going to parties, but I don't know what he's eating.
And you can't tell other parents what to give the children."
-
- As for young Ryan up in Glasgow, he, too, rebelled at
first over the loss of sweets. But his parents' will prevailed, and the
change in his behaviour has now persisted for a year. "Far from me
being called up to the school," says his father, "he has even
won a 'pupil of the week' award. That in itself is just mind-blowing. When
people see Ryan now, they ask if it's the same boy."
-
- Small wonder that Alex Gallacher talks about the effects
of additives with a crusading zeal.
-
- At the beginning of July, the food giant Birds Eye announced
its intention to remove all additives from its products. An opportunistic
gimmick? Or a sign that the food industry is finally getting the message.
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- COLOURS TO WATCH
-
- * Sunset yellow (E110) is a dye used in, among other
foods, orange jellies and squashes, apricot jam and packet soups. It's
also in Smarties, and at least one variety of Lucozade.
-
- * Tartrazine (E102), one of the more controversial colouring
additives, is another yellow dye used in fizzy drinks, ice cream, sweets
and jams. Also used in Sainsbury's processed peas and Batchelors mushy
peas.
-
- * Carmoisine (E122), a red dye, is used in jellies, sweets,
blancmanges, marzipan and cheesecake mixes. You'll also find it in novelty
cakes, such as the Harry Potter ones, but not, as of next month, Burtons
Jammie Dodgers - it's being replaced with a natural dye.
-
- * Ponceau 4R (E124), also red, is used in tinned fruit,
jellies and salamis. Smarties and Simpsons cakes also contain it.
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- © 2004 Independent Digital (UK) Ltd http://news.independent.co.uk/uk/health_medical/story.jsp?story=552022
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