KIDSHEALTH

A DOCTORS GUIDE FOR PARENTS UNCOVER THE hidden causes of illness and behavior PROBLEMS

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KIDSHEALTH
by

CAROLYN DEAN, MD, ND

Copyright 2010 by Carolyn Dean, MD, ND, and Active Interest Media, Inc. All rights reserved. No part of this booklet may be reproduced, stored in an electronic retrieval system, or transcribed in any form or by any means, electronic or mechanical, including photocopying and recording, without the prior written permission of the publisher, except for the inclusion of quotations in a review. Published by: Active Interest Media, Inc. 300 N. Continental Blvd., Suite 650 El Segundo, CA 90245 This booklet is part of the Better Nutrition Healthy Living Guide series. For more information, visit www.betternutrition.com. Better Nutrition magazine is available at fine natural health stores throughout the United States. Design by Aline Design: Bellingham, Wash. The information in this booklet is for educational purposes only and is not recommended as a means of diagnosing or treating an illness. All health matters should be supervised by a qualified healthcare professional. The publisher and the author(s) are not responsible for individuals who choose to self-diagnose and/or self-treat.

KIDSHEALTH
CONTENTS
Introduction ............................................................................ 5 Chapter One: Childhood Diabesity............................ 11 Chapter Two: Attention Deficit and Hyperactivity................................................................... 16 Chapter Three: The Carbohydrate Revolution..... 19 Chapter Four: Childrens Nutrients............................ 26

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Introduction

A Disturbing Trend

ook around you. Children across America are developing chronic illnesses once reserved solely for adults. How is this possible? After all, chronic disease implies years of accumulated damage. Its certainly not something you would expect in a child who has yet to celebrate his 13th birthday. And yet, this trend has reached epidemic proportions. Heres a good example: By the time Emily became a mother, she had a long history of taking antibiotics for acne, sinusitis, and stomach ulcers. This eventually resulted in a serious case of yeast overgrowth. During her pregnancy, Emilys vaginal yeast infection got so bad the doctors thought they might have to do a C-section. Fortunately, she was able to have a vaginal delivery. But her baby, Andy, was didnt come through it unscathed. As he traveled through his mothers birth canal, Andy picked up a yeastrelated ear infection and diaper rash. At just three days old, Andy was misdiagnosed with a bacterial ear infection. But Emily, who was a nurse, suspected it was more than that. Something was wrongvery wrong. By the time they came to see me, Andy had been diagnosed with a failure to thrive. He was far too small for his age. Whats more, he had been given antibiotics for nearly two-and-a-half of his first three months of life! Emily thought his ear discharge smelled yeasty, but the doctors wouldnt listen to her. But, by treating Emily and Andy together, I was finally able to solve the problem. Unfortunately, not all children are so lucky. Many of todays children fail to thrive because of a constant exposure to harmful substances without the benefit of healthy food and exercise. But, apart from what our kids eat and how much exercise they get, weve created a toxic environment with 80,000 chemicals in current use. Not only have few of these chemicals been studied for their long-term health effects, we know next to nothing about the effects of their combined interactions. What we do know is that there is an unprecedented rise in asthma, allergies, and immune reactions in children throughout the United States. In one specific study in the June 2010 issue of Pediatrics, researchers found that children with attention deficit hyperactivity disorder (ADHD) had higher amounts of pesticide metabolites in their urine than those without the condition. Weve seen a trend toward ill health in our children for many years, but no effective measures have been taken to stem the tide. In this booklet, Ill focus on obesity, diabetes, and ADHD. But those are just a few of the
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health problems facing our kids. Our children also suffer from increasing allergies, asthma, autism, bowel disease, autoimmune disease, high cholesterol, hypertensionand the list goes on. The final result translates into shorter lives for todays kids.

Who or What Is to Blame?

The reasons for this epidemic are many, from sociological to cultural tocommercial. Because of todays work schedules and family structures, many  parents have no time to cook real meals for their children, and few families sit down to meals together. For some families, that makes fast food the diet of choice. on cell phones, watching TV, playing video games, and surfing or socializing online. Physical activities have been largely replaced byelectronics. Commercial interests have targeted kids with billions of dollars of advertising messages promoting sugar-coated cereal, liquid candy (sodas), and junk food. research, invariably the food is said to be healthy.

Kids spend much of their time outside of school texting, talking 

A child sees an estimated 10,000 junk food commercials each year. 

Bias in research is rampant. When the food industry funds food  Soy and corn are cheap commodities that are subsidized by the  government. These ingredients now form the basis for many of the foods served in school lunch programs, as well as fastfoodrestaurants.

Information, Please
Its rare to see ads for vegetables or the promotion of home-cooked meals, and health warrants only occasional sound bites. When I was a frequent guest on ABCs hit talk show, The View, the focus was on entertainment instead of educating the public on health matters. The news media isnt any better. We wont get any real answers or leadership about healthy living from news reports or talk shows. Some medical experts think that labeling the number of calories in fast foods and junk food will somehow stem the tide of their consumption. Yet, most people who eat this kind of food dont read labels. Another problem? The nutrients are listed in gramseven though few Americans are familiar with the metric system. Whats more, most people dont understand calories and how they impact the body.
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It would be easier for consumers to understand what they are putting in their bodies if labels displayed the amount of sugar a food contains in teaspoons instead of grams. For example, there are about 40 grams (10 teaspoons) of sugar (or high fructose corn syrup) in a 12-ounce can of soda and 70 grams (17.5 teaspoons) in a 20-ouncer. Ive found that its a pretty dramatic illustration when I stand up in front of a classroom or a television audience and spoon out the actual number of teaspoons of sugar in sodas and milkshakes!

Although the governments focus is on obesity, its important to note that the health crisis affecting our children is not confined to that condition.
Sparks of Hope from Government Agencies
Although desperately trying to implement nationwide programs to fight obesity, the government is entangled in bureaucratic red tape that has slowed its efforts. Government receives considerable pressure from the food industry, the healthcare sector, nonprofits, and the public. Although the governments focus is on obesity, its important to note that the health crisis affecting our children is not confined to that condition. The government has achieved some success in educating the public. The United States Department of Agriculture (USDA) has published a series of Nutrition TipSheets, and one that I especially like is No. 8: Ten Tips to Cut Back on Sweet Treats. Many of the other TipSheets are just as useful and informative, and I highly recommend them. You can go to www. mypyramid. gov and search TipSheets to find the list of one-page nutrition tips that you can print out for your kids or take them to your school for teachers to work with in class. You can also go to www.healthfinder.gov for Nutrition and Fitness tips that can be used in the same way. Of course, the government doesnt go as far as I will go in this booklet, but it is a long-overdue start.
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Long Live the Internet

Another hopeful sign is the empowerment of the public, largely through the Internet. Pharmaceutical companies and allopathic (drug-based) medicine no longer control what information the public can access. We now have the ability to distribute and circulate health information via the Web. Due to advances in digital filmmaking, documentarians are able to get the message out in very graphic ways. The Internet has become their distribution center. For example, the documentaries Food, Inc. and Fresh showed us how the cruel conditions of factory farming affect how animals are raisedand how this impacts the quality and safety of our food. Armed with this information, people can then make conscious choices about what they feed themselves and their families. So, change will comethats guaranteed. Once the barn door has been opened, you cant simply shut it and have people forget what theyve seen inside. But how much damage has already been done, and what steps need to be taken to reverse the damage? Many of us turn to our doctors for answers, yet physicians are woefully uneducated in matters of nutrition. In fact, medical nutrition doesnt even exist as a specialty in medicine. Its lumped into bariatrics (obesity), endocrinology (endocrine glands and hormones), and diabetes. Most doctors wait for a problem to occur and then they try to treat the symptoms. Nutritional information is dispensed by dieticians, most of whom simply want to make sure people get all four food groups in each meal. It matters little whether or not the food is synthetic, overly processed, or laced with contaminants. Yet, this can have a huge impact on our health and the health of our children.

Celebrity Health Advocates

We are fortunate to be living in wired times in which we can obtain information about natural foods via the Internet from world-renowned doctors and clinical nutritionists who go beyond their dietetics training. And there are also celebrities who jump on the bandwagon of health. Some of the best exposure comes from chefs and health advocates like these:
Chef Jamie Oliver. This celebrity chef brought his television show Food Revolution from the United Kingdom to the United States, bringing a film crew to the most obese city in America. His target: the school lunch program, which was filled with frozen and processed junk foods. During the first episode of his reality show, Jamie was shocked to discover that pizza was being served for breakfast. When he confronted the lunch ladies, they told him in no uncertain terms that pizza contains all four food groups and is therefore a well balanced meal. Very detailed nutritional
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guidelines put out by the USDA do indeed show that pizza contains grain (white-flour crust), dairy (cheese), vegetables (tomato sauce and green peppers), and meat (pepperoni). These are the same guidelines that also mandate two servings of bread per meal and designate French fries as a vegetable. Yet, by the end of the season, Jamie had convinced not only the lunch ladies, but also the school district, that fresh, wholesome food was in the best interest of their students.
Morgan Spurlock. As the writer, director, producer, and star of the 2004 movie, SuperSize Me, Spurlock documented his experience of eating nothing but fast food from McDonalds for 30 days. In the process, Spurlock proved that we are the cause of our own health problems. After one month, he gained 25 pounds, had elevated blood pressure, and had increased blood levels of cholesterol, triglycerides, liver enzymes, and uric acid. He also developed mood swings, depression, fatigue, and apathy. Michael Pollan. A journalist, Pollan is the author of In Defense of Food (2008) and Food Rules (2009). In a New York Times editorial, Pollan states theres lots of money to be made selling fast food, and then treating the diseases that fast food causes. One of the leading products of the American food industry has become patients for the American health care industry. Chef Alice Waters. This very important health advocate started the trend of using fresh, locally and sustainably grown food in her California cuisine restaurant, Chez Panisse. She also spearheads the Edible Schoolyard project, in which students ofall ages actually plant, raise, andharvest vegetables and fruits ontheir school grounds. Such knowledge will stay with them for the rest of their lives.

Marketing to Kids
I knew something was terribly askew when I saw the expanding number of fast food chains housed in hospitals. I was even more disturbed to see schools raising money for their athletic teams with the profits from vending machines that were brimming with chips and soft drinks. For monetary gain, these hospitals and schools have turned over the health of their charges to the junk food industry. Surveys by the Centers for Disease Control and Prevention (CDC) show that, in 2006, 62 percent of high schools sold soda and fruit drinks containing high fructose corn syrup (HFCS), and 54 percent sold candy and salty snacks. By 2008, due to public pressure, the numbers had improved. Only 37 percent sold soda and HFCS fruit drinks, and 36 percent sold candy and salty snacks. But the damage has already been done to a generation of kids who grew up on vending machine food.
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Schools and Hospitals Sell Sickness

The very organizations we entrust to support and protect our children are failing miserably. Hospitals and schools that provide homes and endorsement for fast food chains are sending an unhealthy message that is almost impossible to counter. Health insurance companies pay the cost of medical care. One would think they would be interested in keeping people healthy, but that doesnt seem to be the case. In a recent study, Harvard Medical School researchers reported that 11 multimillion-dollar insurance companies that offer life, disability, or health insurance owned approximately $1.9 billion in stock in the five largest fast-food companies. Its an Alice-in-Wonderland conflict of interest that defies all logic. As you can see, the health of our children is suffering due to the glut of unhealthy foods. The good news is that many people are becoming increasingly aware that the problem exists. Awareness is certainly the first step toward change. Once we become aware, we can begin educating ourselves toward a better future for all of our children.

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Chapter One

Childhood Diabesity

ere is a shocking fact: 16 percent of children between the ages of 6 and 19 are overweight or obese. Thats triple the number documented in 1980. Another 15 percent are at risk for becoming overweight. Add them together and almost one third of American children are obese or overweight. The obesity rate for children ages 2 to 5 has increased from 5 percent to 12.4 percent. And these kids wont outgrow their baby fat. Studies show that about 80 percent of children who are overweight at 10 to 15 years remain obese at age 25. The CDC knows theres a problem. In July, 2009, Director Thomas Frieden told attendees at the Weight of the Nation Conference that obesity, and with it diabetes, are the only two health problems that are getting worse in this countryand they are getting worse rapidly.

Obesity Leads to Diabetes

There are two main types of diabetes. Type 1 accounts for about 10 percent of diabetics and usually develops during childhood. Its thought to be caused by a viral infection of the pancreas, resulting in impaired or absent insulin production. Because of this, type 1 diabetics require lifelong insulin injections to replace their loss. Type 2, or adult-onset, diabetics tend to be non-insulin-dependent, overweight, and between 50 and 70 years old when the disease is first diagnosed. In type 2 diabetes, insulin is readily availablein fact, it is usually elevatedbut the cells of the body are resistant to it. This means that the insulin is unable to do its job of opening up the cell membrane and allowing glucose to enter the cell. This effectively thwarts the creation of the cellular energy our bodies need to survive. A new term, diabesity, was coined to reflect the fact that over 80 percent of type 2 diabetes is related to being overweight. An increasing number of teenagers are developing diabetes, with 7 percent of that population at risk. Adult-onset diabetes is no longer confined to adults. In fact, children as young as 8 are being diagnosed with type 2 diabetes. In 2010, there will be 10 times more diabetes in children than there was in 1990. In 1956, T.L. Cleave, Surgeon-Captain of the Royal Navy and the former director of medical research at the Institute of Naval Medicine in the United Kingdom, published his groundbreaking theory that many of the major diseases afflicting modern civilization are due to the effects of consuming refined carbohydrates. In 1974, he published The Saccharine
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Disease. Saccharine simply means related to sugar, and saccharine disease refers to all those conditions that arise from the ingestion of sugar and refined starches. He believed that Westerners have experienced a profound change in their diets in a very short period of time, which has not permitted evolutionary adaptation.

Burn the Fiber

When you refine sugar to remove the sucrose, all the plants fibrous material is burned away. Because I live in Maui, I see this first-hand when the sugarcane and sugar beets are harvested. Once the plants have been processed in the field, they are taken to the local sugar incinerator. As the plants are burned and refined into table sugar, black smoke billows over the whole island. It is during this process that approximately 90 percent of the plants fiber is removed, along with 93 percent of the chromium, 89 percent of the manganese, 83 percent of the copper, and 98 percent of the cobalt, zinc, and magnesium. Whats left is an addictively sweet substance with no nutritional value whatsoever.

Sugar Consumption
The concentration of refined carbohydrates deceives the taste buds and the feeling of fullness. If one were to eat the dozen apples required to produce five ounces of fruit sugar, the normal distention of the stomach and the feeling of fullness would limit the quantity of sugar eaten. But, because refined sugar is so highly concentrated, people often dont realize when they should stop eating this high-calorie food. Refined sugar is not a requirement for health. Before the refining of sugar, people satisfied their sweet tooth with fruit, honey, and maple syrup. Now it appears that we are drowning in sugar. Data from the USDA shows an increase in annual intake from 123.3 pounds per year in 1970 to the current 170.5 pounds per year in 2008. If you do the math, youll be shocked to discover thats 50.5 teaspoons of sugar a day. This equates to more than one full cup of sugar each and every day!

Developing Diabetes
Type 2 diabetes doesnt just strike out of a clear blue sky; it develops over time. It was thought to take 15 to 20 years for diabetes to develop in a population consistently exposed to refined sugar. But that estimate doesnt seem accurate anymore. Presently, our children are developing diabetes at a much faster rate than ever before. In a 2002 landmark study reported in the journal Diabetes, researchers concluded that childhood obesity is a powerful predictor of risk of developing diabetes, hypertension, and high cholesterol later in life.
12 K I D S H E A L T H

What Are We up Against?

Presently, U.S. dietary recommendations from the Institute of Medicine (IOM) allow for a whopping 25 percent of calories to come from added sugar. The IOM states, Higher intakes [than 25 percent of the diet] are associated with a dramatic decrease in micronutrient intakes, especially calcium. The IOM panel determined no other adverse effects. Imagine four meals in one daythree squares and one snack. Thats about 2,000 calories. Take one-quarter of that amount and make it all sugar. Thats what the IOM is allowing500 calories of sugar, or about 33 teaspoons of sugar a day! Its shocking, but heres whats even more unbelievable: The average American is presently exceeding that amount.

The Soda Pop Problem

As early as 1951, Dr. Clive McCay, a Naval nutritionist in charge of nutritional research for the U.S. Navy during World War II, testified before a congressional committee on the consumption of cola beverages, which were found to contain about 10 percent sugar. Dr. McCay also noted that the beverages contained substantial amounts of phosphoric acid. His team at the Naval Medical Research Institute submerged human teeth in a cola beverage and found that they softened and started to dissolve after just a short period of timenot surprising, since the acidity of cola is about the same as vinegar. But because the sugar content masks this acidity, children and parents have no idea they are drinking this strange brew of phosphoric acid, sugar, caffeine, chemical coloring, and artificial flavoring.

His team at the Naval Medical Research Institute submerged human teeth in a cola beverage and found that they softened and started to dissolve after just a short period of time.
K I D S H E A L T H 13

Many carbonated beverages and processed foods (luncheon meats and hot dogs, for instance) contain phosphates. I learned from my magnesium research that phosphates bind with magnesium to make insoluble magnesium phosphate, a compound that is not absorbed by the body. So, not only do kids eat magnesium-deficient foods, the foods they do eat rob their bodies of this much-needed mineral. Youll read more about magnesium in Chapter 4, but among the potential side effects of magnesium deficiency are elevated blood sugar and diabetes.

Handling Sugar
Eating a sugary meal or drinking a soda containing 10 to 20 teaspoons of sugar stimulates an excessive pancreatic insulin response in order to normalize blood sugar levels. Too much insulin makes blood sugar plummet as it drives sugar into the cells. In reaction to the drop in blood sugar, adrenaline from the adrenal glands is stimulated to raise blood sugar levels back to normal. A constant high intake of simple dietary sugar keeps this roller coaster going and eventually overworks or burns out normal pancreatic and adrenal function, leading to what is called insulin resistance. Insulins main job is to open the channels in cell membranes to allow an influx of blood sugar. When there is too much insulin, which can be stimulated by 10 teaspoons of sugar, too many insulin molecules can cause a traffic jam at the cells receptor sites. Insulin also plays a role in storing any excess sugar that hasnt gone into the cells. The best way to keep insulin from surging and to keep the body from storing the excess as fat is to eat a diet that does not trigger insulin with every meal. That means reducing the amount of sugar, fruits, and carbohydrates you eat. In fact, the best diet contains a lot of protein, a moderate amount of fat, and a small amount of carbohydrates to keep insulin levels low. After years of being bombarded by high insulin levels, the cell receptors can shut down. This means that sugar cannot get into the cells where it is needed to create energy. This scenario also creates elevated glucose in the blood. Over the long term, this can cause type 2 diabetes, which ultimately can damage the eyes, kidneys, and heart.

What About Fruit Juice?

I learned about the damaging power of fruit juice when I saw a new young patient whose baby teeth were rotten to the gum line. His mother was a vegetarian and said she only fed her baby organic foods. But she put him to bed every night with a bottle of fruit juice. He not only developed an incredible sweet tooth, but the sugar dissolved his own teeth.
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Because everyone thinks fruit is healthy, fructose sweeteners were first looked upon as natural. But most fruit juice on the market today is sweetened with high fructose corn syrup instead of fructose. This has a very unhealthy effect on blood lipid levels and weight gain.

Dont Substitute Aspartame

For consumers worried about calories, food and drink makers have turned to artificial sweeteners like aspartame. Aspartame has three components: phenylalanine, aspartic acid, and methanol (wood alcohol). The Environmental Protection Agency (EPA) defines safe consumption of methanol as no more than 7.8 mg per day. Yet, a one-liter beverage, sweetened with aspartame, contains about 56 mg of wood alcohol, or seven times the EPA safety limit. The irony of diet products containing aspartame is that they can actually cause weight gain. Phenylalanine and aspartic acid stimulate the release of insulin. Rapid, strong spikes in insulin remove all glucose from the blood stream and store it as fat. This can result in hypoglycemia (low blood sugar) and sugar cravings. Additionally, phenylalanine has been demonstrated to inhibit the synthesis of serotonin, a neurotransmitter that tells the body that it is full. This can cause you to eat more than you normally would and, ultimately, gain weight. In 2007, researchers from the University of Texas Health Science Center reported that adults who drank one can of diet soda a day did not lose weight. The researchers also found that there was a 41 percent increase in the risk of being overweight for every can or bottle of diet soda consumed daily. As you can clearly see, sugarwhether from sugar cane, sugar beets, fruit corn, or a test tubesimply fuels the dual obesity and diabetes epidemics. But once you know the facts, you can make conscious choices to provide your children with healthy, wholesome food. In Chapter Three, Ill offer some basic diet strategies to get kids interested in good food.

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Chapter Two

Attention Deficit and Hyperactivity

ttention deficit hyperactivity disorder (ADD/ADHD) is labeled a mental disorder that develops in children. The National Institute of Mental Health (NIMH) estimates that between 3 and 5 percent of preschool and school-age children have ADHD. That translates to about two million children in the U.S. In a class of 25 to 30 students, at least one child will have this condition. Many important studies, like those cited below, have shown the relationship between sugar consumption and behavioral changes in children. Mainstream science and media has systematically ignored most of these studies. This leaves parents without the guidance or guidelines they need to provide the best food for their children. It also leaves the door wide open for the food industry to continue to advertise unhealthy foods and snacks to our kids. And it provides a continuous stream of patients for our sick-care system. Children with behavioral problems are plied with medications by a willing drug industry. It seems everyone benefits, except our children.

ADHD and Diet

Between 1973 and 1977, Dr. William Crook, a well-known pediatrician, saw 182 new pediatric patients diagnosed with hyperactivity, ADD, and other behavioral and learning problems. He engaged each child in a food elimination diet. The items eliminated were food coloring and additives, sugar, wheat, eggs, milk, corn, chocolate, and citrus. If a child showed improvement after avoiding these ingredients, she/he was challenged with one eliminated food per day. Of the 182 patients, the parents of 128 children reported that they were certain their childs condition was related to one or more of the dietary ingredients. Dr. Stephen Schoenthaler, professor of criminal justice at the California State University in Stanislaus, has studied childrens diets for almost 30 years. His original studies eliminated sugar and junk foods from the lunch programs of one million school children in more than 800 New York schools during a seven-year period (19761983). Learning performance was established first, and then in 1979, dietary changes were introduced. High-sucrose foods were gradually eliminated or reduced, and there was a gradual elimination of synthetic colors, artificial flavors, and selected
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preservatives (BHA and BHT). There was a 15.7 percent gain (from 39.2 to 55 percent) in learning ability compared with other schools during the years in which these food changes were introduced. Schoenthaler also noted that out of the 124,000 children who were unable to learn grammar and mathematics at the start of the study, 75,000 were able to perform these basic tasks after dietary changes alone.

Schoenthaler also placed thousands of juvenile delinquents on junk-free diets and saw dramatic improvements in their mood and behavior.
Schoenthaler also placed thousands of juvenile delinquents on junkfree diets and saw dramatic improvements in their mood and behavior. Schoenthaler worked with the Los Angeles Probation Department DietBehavior Program and observed 1,382 incarcerated delinquents at three juvenile detention halls. They showed a 44 percent drop in antisocial behavior after being placed on a low-sugar diet. The greatest reductions were seen in repeat offenders (86 percent), narcotics offenders (72 percent), rape offenders (62 percent), burglars (59 percent), murderers (47 percent), and assault offenders (43 percent). The second part of Schoenthalers study followed 289 juvenile delinquents at three juvenile rehabilitation camps. They exhibited a 54 percent reduction in antisocial behavior after sugar consumption was reduced. During a similar study, dubbed the Alabama Diet Behavior Study, Schoenthaler observed 488 incarcerated delinquents for 22 months. The decline in antisocial behavior resulting from a reduction in sugar consumption averaged 45 percent, depending upon gender, race, and type of offender. In 2003, I interviewed Schoenthaler and asked him why the hugely successful New York studies had not garnered headline news. He said the school officials would never acknowledge the findings and attributed the
K I D S H E A L T H 17

results to hiring extra teachers in the period of the study. Schoenthaler said they seemed to be embarrassed by the study and felt the higher test scores couldnt possibly be just due to a change in the students diets.

Medicating Our Kids

Robert Whitaker is an award-winning reporter for the Boston Globe and the author of four books, including the recently published Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America (2010). Whitaker states that mental illness disability rates have doubled since 1987 and increased six-fold since 1955. In the same time frame, psychiatric drug use increased in the 1950s and 1960s, then skyrocketed after 1988 when Prozac hit the market. The financial outcome is an annual $25 billion antidepressant and antipsychotic drug market in the United States. Whitaker raises serious questions about the use of psychiatric medication in children and teens: When you research the rise of juvenile bipolar illness in this country, you see that it appears in lockstep with the prescribing of stimulants for ADHD and antidepressants for depression. Once psychiatrists started putting hyperactive children on Ritalin, they started to see prepubertal children with manic symptoms. The same thing happened when psychiatrists started prescribing antidepressants to children and teenagers. In fact, I think that the number of children and teenagers that have ended up bipolar after being treated with a stimulant or an antidepressant is now well over one million. It has been said of conventional medicine that when all you have is a hammer, everything looks like a nail. When doctors are allowed to treat ADHD with drugs without looking at the greater picture of diet and supplements, our children become the nails. But hammering them with medication doesnt address the root problem. It just makes matters worse.

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Chapter Three

The Carbohydrate Revolution

2010 study in the journal Health Affairs showed that junk food makes up more than one quarter of most kids daily calories. In her book What to Eat, author Marion Nestle reveals that onethird of all vegetables consumed in the United States come from just three sources: French fries, potato chips, and iceberg lettuce. You may think its just fast food restaurants that are to blame, but lets look at the school lunch program.

More Than Empty Calories

Because refined dietary sugars are devoid of vitamins and minerals, the body must draw upon its micronutrient stores to metabolized them. When our nutrient storehouses are depleted, fatty acids and cholesterol are not properly metabolized. Improper digestion of fats leads to higher blood levels of triglycerides and cholesterol. It also promotes obesity.

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As I mentioned earlier, Jamie Olivers Food Revolution has done more to open our eyes to what exactly kids are being served at school than any government effort. His Web site provides even more information about his school lunch experiment in Huntington, W.V. In the Facts & Figures section, he notes that 31 million kids are being fed lunch at school, and 11 million also receive breakfast there. Sixty percent of those meals are provided free of charge. But heres where things get really interesting: Schools are reimbursed $0.25 per meal that students pay for and $2.68 for free meals. The School Nutrition Association estimates that the cost per meal is $3.00. The extra money needed to run the program comes from selling junk food in vending machines. While these statistics show how school food dollars are spent, the longterm impact these foods have on our children is alarming. While the school lunch program costs $11.9 billion annually, the healthcare costs associated with obesity are $147 billion.

The Sugar Experiment

In my practice, when a parent says her child eats too much sugar and junk food, I invite the child to do The Sugar Experiment. Its a simple experiment. Here are the rules: Avoid all junk food and sugar for six days. On the seventh day, allow the child to eat all the unhealthy food he wants. Kids groan when they hear they have to avoid all junk food for six days, but they are excited about the prize at the end of the experiment. During the first three days, the kids can be a bit gnarly and irritable as they go through withdrawal. From days four through six, most kids actually feel better, sleep better, and are in a better mood. Then on Day 7, the kids think theyve hit the jackpot. They wolf down candy, ice cream, pizza, soda, and cookies like theyre going out of style. But it isnt long before they start to feel the effectsheadaches, nausea, wooziness, sluggishness, or hyperactivity. And thats when kids realizeon their own what this food does to them. Surprisingly, they often make their own decision to cut back. Treatment for ADHD, autism, or any illness in children should begin with a diet that avoids gluten and casein. When not completely digested, casein and gluten produce brain-disrupting hallucinogens or brain depressants. In my telephone consulting practice, I tell parents that a proper diet is not just a matter of giving your child healthy food, its a matter of identifying and eliminating foods that could be poisoningthem. Sugar is another important food restriction. Sugar feeds yeast in the intestinal tract, which is often stimulated by the overuse of antibiotics
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The Autism-Diet Connection

Autism affected one in 110 children in 2010 compared to one in 2,000 in the 1970s. Going beyond the behavioral model of autism, there is a pivotal metabolic insult to infants who develop this condition. The specific insult is damage to an enzyme that may affect about 10 percent of the population. The damage can be caused by heavy metals (mercury in childrens vaccines, flu shots, and dental amalgams), antibiotics, alcohol, and acetaminophen. This metabolic insult was first found in Alzheimers and has now been identified in autism. This enzyme, called kinase PI3, is important because it helps break down gluten (a protein in wheat, rye, and barley) and casein (a milk protein). This same enzyme allows the processing of certain B vitamins. Without proper processing of B12 into methylcobalamin and folic acid into folinic acid, hundreds of functions are impaired. For example, if you dont have methylcobalamin, your liver cant make glutathione (a powerful antioxidant). Without glutathione, the body is not able to detoxify heavy metals. The vicious cycle is complete. Heavy metals that damage the gene are not excreted as they should be and continue to accumulate, causing more damage. These pathways are so intricate that giving children the wrong kind of folic acid or B12 can make matters worse. Damage to kinase PI3 may be important for ADHD kids as well as autistic kids. Kids with ADHD may be expressing the damage in a lesser form. Also, the dietary treatment (avoiding gluten and casein) often works with kids with ADHD.

for colds and flu. Yeast produces up to 178 different toxins that cause or aggravate rashes, brain irritation, hypothyroidism, and irritable bowelsyndrome.

Foods to Avoid
All of the following foods should be avoided for two or three weeks to see if your childs behavior improves. When reintroduced, add just one new food at a time and assess your child for reactions and symptoms.

Sugar
Parents should limit their childrens consumption of added sugar (soda, fruit drinks, sweets, and white sugar treats). Dietary sugars feed harmful
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intestinal yeasts, fungi, toxic organisms, and even cancer cells. Vitamin C and other natural antioxidants protect against the damage caused by sugar. But heres the rub: Sugar and vitamin C utilize the same transport system, and excess sugar can tie up the available transport molecules and stop vitamin C from getting to where it is needed.

Dairy and Wheat

If your child has ADHD symptoms, the most allergenic foods are dairy and wheat. As noted in the discussion about diet and autism, disruption in the kinase PI3 enzyme leads to incomplete digestion of these foods. This is why it is critical to eliminate both dairy and wheat during a food challenge.

Soy
There is increasing evidence that soy is not as healthy as once thought, especially for kids. Eighty percent of the soy grown in America is now genetically engineered. Soyeven organic soyalso contains estrogenic phytochemicals that may have a hormonal effect on our kids. Whats more, soy is very difficult to digest and can cause constipation, diarrhea, gas, and bloating. Try eliminating all soy products for a week, then feed your children soy burgers and soy milk. You may be surprised at their reaction.

Food Additives
Foods containing artificial coloring or additives are damaging to the brain. The worst are the excitotoxins aspartame and monosodium glutamate (MSG), which excite brain neurons to the point of cell death. Many researchers are calling for a ban on aspartame due to its 92 documented side effects. In the initial testing of this artificial sweetener, laboratory animals experienced seizures, as well as several types of cancer, including brain tumors. Chewing a single stick of aspartame-sweetened gum has induced seizures in susceptible children. MSG is a modified form of glutamic acid with one sodium atom added to the molecule. John Olney, MD, a neuroscientist at Washington University in St. Louis, MO, found that MSG is toxic to the retina, and a single

Non-Sucrose Sweeteners
Stevia, xylitol, and agave are natural sweeteners that do not spike insulin levels like refined table sugar. They also do not have the dangerous chemical make-up of synthetic sweeteners. Agave should be organic. Watch out for non-organic agave products that are counterfeits and are made from high fructose corn syrup.
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dose can destroy specific cells in the hypothalamus. Its responsible for dozens of symptoms that often cant be traced back to the source. Be sure to check ingredient labels for MSG and avoid hydrolyzed protein, which also contains MSG. Since the late 1970s, MSG and hydrolyzed protein have been voluntarily removed from baby food. Its not illegal to use these additives, so they can sneak back into the food supply. Ben Feingold, MD, was among the first to identify food additives as a cause of hyperactivity. Thousands of children have benefited from his book, Why Your Child Is Hyperactive, as well as Is This Your Child? Discovering and Treating Unrecognized Allergies in Children and Adults, by pediatrician Doris Rapp, MD. Both of these books help parents understand the role allergies and food additives play in childhood allergies and ADHD.

Foods to Include
As a general rule of thumb, choose organic foods whenever possible.

Animal Products
Animals raised organically are not fed hormones or antibiotics, and their products do not contain antibiotic residue. These antibiotics can lead to resistance and the rise in food-borne bacteria. In her book Good Germs, Bad Germs, science writer Jessica Snyder Sachs notes, Analysis of supermarket meat and eggs show that at least some of this drug-resistant microflora also ends up shrink-wrapped with the meat we buy and trapped inside eggs before their shells form. Whenever possible, search out organic beef, chicken, lamb, and eggs. You can also get plenty of protein from non-animal sources like nuts, seeds, lentils, and legumes.

Organic Vegetables
Vegetables are key to good health, but not just any vegetable will do. A study in the February 2010 issue of the journal HortScience found a 5 to 40 percent lower mineral content of supermarket vegetables compared to 50 years ago. Todays vegetables may look bigger and grow faster than the ones our grandparents ate, but they are bred for looks and shelf lifenot nutrients. Organic vegetables are grown without pesticides and herbicides, and often in richer soil than that used by agribusiness. Visit your local farmers market. You can usually find organic farmers or non-spray farmers who may not be able to afford organic certification but who guarantee they dont use chemicals on their land. You can also join or start a CSA
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Organic vegetables are grown without pesticides and herbicides, and often in richer soil than that used by agribusiness.
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(Community Supported Agriculture) group in your neighborhood. Go to www.localharvest.org/csa to find out more.

Fruit
When nonorganic fruit is concentrated into juice, the pesticides and herbicides can become concentrated as well and can have negative health effects. Organic berries, apples, and pears have a high antioxidant content, a low allergy potential, and are not overly sweet.

Grains
The gluten in wheat and rye is a trigger for a condition called celiac disease, which occurs in 1 in 133 people. Kids can also be allergic to other proteins in wheat. Going gluten-free can be a challenge, but you wont know if your child can properly metabolize gluten unless he or she completely avoids wheat and rye for two to three weeks. As with the sugar experiment, you might not notice the difference until you start bringing wheat and rye back into the diet. Fortunately, your child can safely enjoy the following whole grains to obtain the nutrient and high fiber benefits that grains can provide. Oats dont contain gluten but can become contaminated with  gluten molecules when stored and packaged in the same location as wheat and rye. But, unless someone is extremely allergic to gluten, oats are usually safe to eat. white rice. It takes about 35 minutes to cook.

Rice is typically safe; however, brown rice is a better choice than  Quinoa is a high-protein grain that cooks within 10 minutes.  Amaranth is a very small, nutty-tasting grain that cooks within 20  minutes. Millet becomes fluffy and tastes like corn when cooked for about  25 minutes. Providing and encouraging a healthy diet can be a big challenge for busy parents. In some homes, a childs diet is not negotiable because it is so important for health. If you have trouble convincing your children of the importance of a good diet, do the Sugar Experiment. That should help them realize that healthy is better.

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Chapter Four

Childrens Nutrients

fter his very successful diet intervention studies, Schoenthaler began researching the effects of nutrient supplementation on children. For him, it was the next logical step. He found that children receiving supplements uniformly performed better on nonverbal IQ tests than those taking placebo. Their behavior also improved. A 2003 review of the literature found that certain risk factors for ADHD clustered around the following areas. These are also the major areas that affect most children and the ones I place emphasis on in my patient consultation work. Food allergies. The most common are dairy, wheat, sugar, corn,  andsoy. Amino acid deficiency. This arises because of diets that lack  protein and favor carbohydrates. Essential fatty acid (EFA) deficiency. EFAs are absent in the  standard American diet and are often replaced by trans fats. animal protein, vegetable greens, and eggs. Vitamin B deficiency. B vitamins are found in whole grains,  Heavy metal toxicity. Metals build up from vaccines and 

environmental pollution. They are naturally chelated by mechanisms driven by magnesium, B vitamins, and the intake of vegetable greens. school lunch programs, and the farm-subsidized, genetically modified soy and corn industry.

High-carbohydrate diet. Such a diet is reinforced by TV ads, 

Hard to Swallow
Im always asked by parents, What supplements can I give my kids? They know their kids are existing on peanut butter and jelly sandwiches, hot dogs, pizza, and French fries in spite of their best efforts. And they know that nutrients are missing. Ive had parents buy supplements they have to crush and hide in applesauce, liquid fish oils that their children gagged on, and capsules that had to be opened up and disguised forconsumption.
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Over the years, Ive challenged supplement companies to come up with a safe product that kids will actually take. In my books, Ive listed the following requirements for a good kids supplement: Magnesium: 200 mg per day  Calcium in balance with magnesium: 200 mg per day  Zinc: 25 mg per day  Essential fatty acids EPA and DHA: 150200 mg per day of each  B vitamins in methylated form  Vitamin C: 200 mg per day  A multiple containing: vitamins A, D, and E, as well as  traceminerals Non chewable, liquid form  Non-sucrose sweeteners 

A Kids Supplement That Works

Currently only one company meets my criteria. Kids Natural Calm Multi from Peter Gillhams Natural Vitality provides a good-tasting liquid supplement using organic flavors and organic non-sugar sweeteners. The multi includes Natural Calm magnesium, zinc, EFAs, methylated B vitamins (B6, B12), vitamin C, and a trace mineral complex. Plus, theyve added a blend of 24 organic vegetables and fruits most kids dont get in their current diet.

What Kids Need

Let me go into the details of why these various ingredients and requirements are important in a formula for your child.

Magnesium
Magnesium is the mineral that relaxes muscles and nerves. It allows an exact amount of calcium to enter cells and cause a contraction. Then magnesium removes excess calcium to prevent buildup. Without enough magnesium, calcium floods muscle and nerve cells, creating spasms and irritability. The following is from my book, The Magnesium Miracle: Its not just adults who get anxious because they are on magnesium- deficient diets. Most foods that kids eat are magnesium-deficient. The phosphates in soda actually bind magnesium, making it unavailable. The stress on kids sometimes seems more intense than on their parents. Peer pressure, academic and athletic performance pressures, worries about body image, the changes and

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hormonal uctuations of puberty, exposure to negative events, and violence through the media also contribute to an excess requirement for magnesium. ADHD, autism, juvenile delinquency, and childhood depression are associated with magnesium deciency, and some say these conditions can be caused by it. Because of these factors, supplementing with magnesium has become increasingly important.

Calcium in Balance with Magnesium

I often have to tell parents to eliminate dairy from their childrens diet. Their immediate reaction is, What about calcium for their growing bones. I remind them that magnesium is actually just as important for kids because there is less of it in the diet. Based on the scientific literature and my own clinical experience I feel children should actually be given more magnesium than calcium.

Zinc
At puberty, zinc could be considered an essential mineral for kids. If they have asthma or allergies, get frequent colds and flu, and their cuts and scrapes seem to take too long to heal, its likely they are getting too little zinc. Zinc is required for sexual development and often becomes deficient at puberty, making zinc supplements necessary. White spots on the nails and a poor sense of taste are signs of a zinc deficiency. Poor sense of taste means that a child will crave sugar, because most other tastes seem bland. Once zinc is introduced, kids miraculously start trying other foods. Zinc deficiency can be found using a zinc taste test in your naturopathic doctors office. Hair analysis can also provide this information. The foods that supply zinc are sunflower seeds, pumpkin seeds, and oysters.

Essential Fatty Acids

Omega-3 EFAs, specifically EPA and DHA, are necessary for physical, emotional, and mental health. All the cells in the body have a cell membrane thats partly made up of EFAs. They create flexible and naturally permeable cells that receive nutrients easily. EFAs are important in the prevention and treatment of allergies and asthma and in promoting healthy brain function.

Vitamin B Complex
The B vitamins are important as cofactors for thousands of metabolic functions in the body, including the complex functioning of the brain. They also help control mood swings at puberty. Methylated (partially metabolized) forms of the B vitamins are very important in autism and ADHD to overcome specific enzyme blocks. And since they are the most bioavailable form, they are good for everyone.
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Adequate vitamins and minerals, in the proper balance, support kids physical and emotional health.
Vitamin A
Vitamin A is a fat-soluble vitamin found in meat, liver, eggs, milk, and cheese. Its essential for the formation of healthy teeth, bones, soft tissue, mucous membranes, and skin. Its also called retinol because it produces the natural coloration in the retina of the eye. It enhances good vision, especially in dim light.
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Vitamin D
Vitamin D is another fat-soluble vitamin found in fish, eggs, fortified milk, and cod liver oil. However, the fortified milk thats sold in stores contains synthetic vitamin D2. I recommend either taking natural vitamin D3 supplements or spending 20 to 30 minutes a day in the sun. VitaminD is actually a hormone, not a vitamin, and it acts on over 2,000 genes in the body (about 10 percent of the human genome). Vitamin D has gotten a lot of media lately because research shows how vital it is for the immune system and bone health.

Vitamin E
Vitamin E protects the body from damage caused by free radicals. It protects the heart, lungs, and brain. Its also important in the formation of red blood cells and helps utilize vitamin K, which plays an important role in proper clot formation. Vitamin E is very low in the standard American diet, so its important to supplement. But make sure its a natural form. On a supplement label, natural vitamin E is listed as d-alpha tocopherol, whereas synthetic forms of vitamin E are labeled with a dl- prefix.

Trace Minerals
There are up to 80 different minerals used by the body. They include potassium, sodium, manganese, zinc, iron, copper, iodine, selenium, molybdenum, and chromium. When we just focus on one mineral like calcium, we are throwing the whole body off balance. Trace minerals can be obtained from vegetables grown in enriched soil and from sea salt or Himalayan salt.

Final Thoughts
You may be relieved to discover that there are environmental and dietary reasons that explain your childs poor health or behavior. Sometimes hearing the bad news about the American diet and our environment can be overwhelming. I hope the final two chapters have provided you ways to improve your childs diet and informed you about which supplements you should give to make things better. Ive seen health improvements with these simple changes over and over again in my patients. Stopping whole wheat and white bread, limiting sugar, and avoiding dairy can make a huge difference in a childs health. Taking magnesium provides the biggest improvement in sleep, bowel movements, and mood. The other vitamins that I recommend add further benefits in overall health.

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Selected References
Belluck P. Childrens life expectancy being cut short by obesity. New York Times. March 17, 2005. http://www.nytimes.com/2005/03/17/health/17obese.html. Accessed July 14, 2010. Bouchard MF, Bellinger DC, Wright RO, Weisskopf MG. Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides. Pediatrics. 2010; 125(6):e1270-1277. Centers for Disease Control and Prevention. Prevalence of Overweight and Obesity Among Children and Adolescents: United States, 1999-2002. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2004. Cleave TL. The Saccharine Disease. Bristol: John Wright & Sons; l974. Crook WG. Sugar and childrens behavior. N Engl J Med. 1994;330(26):1901-1902. Davis DR. Declining fruit and vegetable nutrient composition: what is the evidence? HortScience. 2009;44:15-19. Duffy W. Sugar Blues. New York: Grand Central Publishing; 1986. Feingold B. Why Your Child Is Hyperactive. New York: Random House; 1985. Harding KL, Judah RD, Gant C. Outcome-based comparison of Ritalin versus foodsupplement treated children with AD/HD. Altern Med Rev. 2003;8(3):319-330. Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids. Washington, D.C.: Institute of Medicine, National Academy of Sciences; 2002. Levine BE. Are Prozac and other psychiatric drugs causing the astonishing rise of mental illness in America? AltNet. http://www.alternet.org/module/printversion/146659. Published April 28, 2010. Accessed July 14, 2010. Olshansky SJ, Passaro DJ, Hershow RC, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352(11):1138-1145. Nestle M. What to Eat. New York: North Point Press; 2007. Piernas C. Trends in snacking among U.S. children. Health Affairs. 2010;29:398-404. Pollan M. Big food vs. big insurance. New York Times. September 9, 2009. http://www.nytimes.com/2009/09/10/opinion/10pollan.html. Accessed July 14, 2010. Rapp D. Is This Your Child? Discovering and Treating Unrecognized Allergies in Children and Adults. New York: Harper Paperbacks; 1992. Srinivasan SR, Myers L, Berenson GS. Predictability of childhood adiposity and insulin for developing insulin resistance syndrome (syndrome X) in young adulthood: the Bogalusa Heart Study. Diabetes. 2002;51(1):204-209. Schoenthaler SJ, Doraz WE, Wakefield JA. The impact of a low food additive and sucrose diet on academic performance in 803 New York City public schools. Int J Biosocial Res. 1986;8(2):185-195. Schoenthaler SJ. Detention home double-blind study: sugar goes on trial. Int J Biosocial Res. 1982;3:1-9.

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Schoenthaler SJ. The Los Angeles Probation Department Diet-Behavior Program: an empirical analysis of six institutional settings. Int J Biosocial Res. 1983;5:88-89. Schoenthaler SJ. Alabama Diet-Behavior Program: an empirical evaluation at Coosa Valley Regional Detention Center. Int J Biosocial Res. 1983;5:78-87. Schoenthaler SJ. Can diet change IQ? Crime Times. 2000;6:5-6. http://www.crimetimes. org/00a/w00ap7.htm. Accessed July 14, 2010. Schoenthaler SJ. School study: supplementation decreases delinquent behaviors, raises IQ. Crime Times. 2000;6:3-6. http://www.crimetimes.org/00b/w00bp3.htm. Accessed July 14, 2010. Snyder-Sachs J. Good Germs, Bad Germs: Health and Survival in a Bacterial World. New York: Hill and Wang; 2007. Stattin P. Prospective study of hyperglycemia and cancer risk. Diabetes Care. 2007;30:561567. History of use of MSG andother ingredients that contain processed free glutamic acid. Truth in Labeling Web site. http://www.truthinlabeling.org/IVhistoryOfUse.html. Accessed July 14, 2010. Whitaker R. Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America. New York: Crown Publishing Group; 2010.

For more information about the products mentioned in this booklet, visit www.petergillham.com. For more information about the author of this booklet, visit www.drcarolyndean.com.

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KIDSHEALTH

magazine presents

PHYSICIAN-RECOMMENDED DIET, EXERCISE, AND SUPPLEMENT PLAN

cross America, pediatricians are seeing an alarming increase in lifestyle-related illnesses in childrensome of which were until recently seen only in adults. Obesity,

diabetes, attention-deficit disorder, and other problems are interfering with childrens well-being and enjoyment of life. Many of these diseases can be traced back to inadequate exercise, poor nutrition, and environmental toxins. Luckily, all those factors can be changed. With this simple and straightforward plan of diet, lifestyle, and supplements, parents can turn their childrens health around and give them the foundation they need to grow into healthy adults.

ABOUT THE AUTHOR OF THIS BOOKLET

Carolyn Dean, MD, ND, author of The Magnesium Miracle (Ballantine Books, 2007) and 19 other books and eBooks, has been at the forefront of natural medicine for more than 30 years. She holds a medical license in California and is medical director of the Nutritional Magnesium Association (www.nutritionalmagnesium.org). She has a complimentary newsletter and an online wellness program called Future Health Now!, which is her answer to the current healthcare crisis. Her web site is www.drcarolyndean.com.

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