- ultra-processed food,
- nature deficit disorder,
- the decline of rough-and-tumble play,
- the lack of adequate sunshine,
- the toxic effects of environmental contaminants, and
- inadequate sleep.
It recommends that we not turn a blind eye to these problems by perceiving ADHD solely as a medical disorder existing in an ecological vacuum, but that we engage in a cultural transformation to promote nurturing ecological influences that all kids deserve incuding adequate play, plenty of sunshine, good food, enough sleep, time in nature, and freedom from toxins. Isn’t it better that we give children these gifts instead of just more drugs?
Transcript of Video
Hi, I’m Dr. Thomas Armstrong. This is part 9 of my 12-part video series on The Myth of the ADHD Child. This video is entitled ‘’6 Environmental Factors Contributing to ADHD’’
Let me preface this presentation by saying that I DO believe that ADHD symptoms exist. But I believe after 50 years of studying this issue, that the hypothesis that there is a specific medical disorder called ADHD causing these symptoms is wrong and there are many other points of view that can account for these symptoms. The videos in this series describe some of these perspectives. In this video, I look at six environmental factors that contribute to ADHD.
The first factor I’d like to address is food and the impact of ultra-processed food on ADHD symptoms.
Approximately 73 percent of the U.S. food supply is ultra-processed, according to Northeastern University’s Network Science Institute. These foods include so-called ‘’junk food,’’ like sugary soda pop, salty snacks, and fatty treats like Hostess Twinkies, but also a wide range of other foods that combine one or more food items with flavorings, colorings, preservatives, hidden sugars, and other additives. Countless scientific studies have shown how these foods are linked to poor health outcomes including cancer, heart disease, diabetes, and a shorter lifespan. But now researchers are beginning to understand how these foods contribute to a diagnosis of ADHD.
This 2022 study for example [slide 5] suggests that ADHD kids are more likely to eat ultra-processed meat and snacks compared with a control group of non-ADHD children, and that these eating habits are related to ADHD symptoms.
On the other hand, a Mediterranean diet consisting of whole grains and legumes, vegetables, fruit, nuts, seeds, fish rich in omega oils, extra virgin olive oil, and lean meats, is now regarded as the healthiest of all the diets currently being studied by nutritionists worldwide.
In this study in the journal Pediatrics [slide 7], low adherence to a Mediterranean diet was associated with an ADHD diagnosis. Lower frequency of consuming fruit, vegetables, pasta, and rice and higher frequency of skipping breakfast and eating at fast-food restaurants were associated with an ADHD diagnosis. High consumption of sugar, candy, cola beverages, and noncola soft drinks and low consumption of fatty fish were also associated with a higher prevalence of ADHD diagnosis.
In the 1960’s, there was a special diet called the Feingold diet that research suggested lowered the incidence of hyperactivity in children. It called for the elimination of certain food additives and foods containing salicylates. The diet involved a considerable amount of time and effort from the family to control for these ingredients, and did not ever really catch on as a treatment for hyperactivity.
Now, however, the simple fact of the matter is that we can reduce the symptoms of ADHD (including hyperactivity) by eating well. That’s it. Just eating well. The poor diet characteristic of most Americans is associated with ADHD, and a healthy diet is related to a reduced incidence of ADHD.
The next factor that contributes to ADHD is ‘’nature deficit disorder.’’
In 2005, the non-fiction author and journalist Richard Louv wrote a book with that term in its subtitle [slide 9], causing many readers to realize the extent to which our kids have become increasingly home-bound and estranged from nature and natural green settings.
In his book, Louv recounts talking with a fourth-grade boy who told him ‘’I like to play indoors better ’cause that’s where all the electrical outlets are.” Nature, with its slower and deeper joys turns out to be no match for the fast-paced thrills and chills of video games, TV, social media, and the Internet.
For the past decade or so, researchers have suggested that not spending time in nature, an activity that kids used to engage in all the time, is connected with the rise of ADHD.
Francis Kuo, a professor in the Department of Natural Resources and Environmental Sciences at the University of Illinois, found that when children diagnosed with ADHD are in green spaces, their symptoms go down. And she pointed out that the wilder the environment, for example, a forest as opposed to a city park, the more the symptoms go down. So, it seems that ‘’nature deficit disorder’’ is actually a prime cause of ‘’attention deficit disorder’’
The next factor contributing to ADHD is related to nature deficit disorder. Kids aren’t getting enough sunlight, either because they spend too much of their time indoors, or because they live in areas of the country that do not receive much sunshine.
This map [slide 14] from the Society of Biological Psychiatry tells the tale. At the top you see a map of the United States showing which areas receive the most and the least sunshine. Clearly the nation’s southwest is where you see the most sun.
The map at the bottom shows the incidence of ADHD, and the states with the lowest levels of ADHD are those same states that receive the most sunshine. True, there are exceptions to this rule, such as Minnesota which has less sunlight and a lower incidence of ADHD. But other studies have similarly pointed to the role of natural light, even when provided indoors through full-spectrum bulbs, in promoting health and in reducing ADHD symptoms.
The fourth environmental factor contributing to ADHD is the loss of rough-and-tumble play.
This is a behavior involving primarily boys, but we can also extend our definition of play to include any child-centered play that is imaginative, improvisational, and filled with adventure and no fixed goals or competitive structure.
As we saw earlier, the decrease in rough-and-tumble play probably is due in large part to children withdrawing from spontaneous play that is primarily outdoors in nature, and going inside to play videos, watch TV, check their social networks, and surf the Internet.
The neuroscientist Jaak Panksepp, who is famous for suggesting that rats have a sense of humor (he would tickle them in his studies!), believed that play was an integral part of optimal brain development for kids, especially importantly in the development of the frontal lobes, and that a decrease in play could significantly impact frontal lobe development and give rise to ADHD.
Number five on our list of factors contributing to the rise of ADHD is the toxic influence of environmental contaminants in the atmosphere, in home and office furnishings, and in everyday consumer articles.
The two toxins that have been most conclusively tied to ADHD are lead exposure and second-hand smoke. Lead can be found in contaminated paint, water pipes, dust, soil, and water, especially in and near buildings built before the U.S. banned lead in residential buildings in 1978. It can also be found in ceramics, china, and porcelain (which can leach into food and water), and in some imported toys and canned goods.
According to the American Cancer Society, in 2017 25.8% of persons aged 3 years and older were exposed to second-hand smoke.
Also seen to be moderately to highly associated with ADHD, as noted in this 2022 meta-review [slide 21] are phthalates (a group of chemicals used to make plastics more durable) and bisphenol A (BPA) a chemical found in shatterproof windows, eyewear, water bottles, and epoxy resins that coat some metal food cans, bottle tops, and water supply pipes.
Finally, we can talk about sleep, and the lack of it, as a contributing factor in the incidence of ADHD. Studies suggest that kids diagnosed with ADHD have a shorter sleep duration than typically developing children and adolescents.
A diagnosis of ADHD is associated with a greater likelihood for sleep disturbances including sleep-onset difficulties, night awakening, difficulties with morning awakening, sleep breathing problems, and daytime sleepiness. Parents of kids diagnosed with ADHD report more problematic “evening” behaviors during the time period just preceding bedtime, including arguing with siblings and difficulty transitioning into sleep compared with reports from parents of typically developing children.
This 2018 study [slide 24] suggests that ADHD is highly associated with delayed sleep phase disorder, a circadian rhythm sleep–wake disorder, which is prevalent in 73–78% of children and adults with ADHD. The study proposes a novel view on ADHD, where a part of the ADHD symptoms are the result of chronic sleep disorders, with most evidence for the delayed circadian rhythm as the underlying mechanism. The study’s authors go on to say that this substantial subgroup should receive treatment of the sleep disorder in addition to ADHD symptom treatment.
To sum up, it seems that many of the activities that we associate with a carefree, optimal childhood – play, sunshine, nature, good nutrition, sleep – have disappeared from the cultural landscape in the past few decades and that one of the consequences of this loss is the epidemic rise in the number of children, teens, and adults being diagnosed with ADHD. To simply say that ADHD is a medical disorder to be treated primarily with drugs, takes our eye off the real culprits in our society. To remedy the situation, we need a cultural transformation, not simply more drugs to cover over the fact that we’re not giving our kids the best life that they can live.
For more information about these six environmental factors contributing to ADHD and other themes of this video series, see my book The Myth of the ADHD Child: 101 Ways to Improve Your Child’s Behavior and Attention Span without Drugs, Labels, or Coercion. It’s available through online stores like Amazon, national chains like Barnes and Noble, and independent bookstores worldwide. It’s also available as an audio recording on Audible. See also my book for K-12 educators: ADD/ADHD Alternatives in the Classroom. And make sure to watch my other videos in this series on You Tube. Thanks so much!
This blog post was brought to you by Thomas Armstrong, Ph.D. and www.institute4learning.com.
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