Restriction Elimination Diet Helps ADHD Without Medication

Photographs courtesy of

The INCA study was a placebo controlled study carried out in the Netherlands that showed a hypoallergenic diet helps treat hyperactivity, inattentiveness and oppositional defiant behavior (such as temper tantrums!) in children not on stimulant medication.

The restriction elimination diet included turkey, lamb, rice, water, salt and pepper, and many vegetables, including cauliflower and cabbage. Children were then challenged with foods, added back one by one, to see which foods caused worsening attention and behavior symptoms. Surprisingly, foods that worsened symptoms in an individual child did not correlate to high IgG immunoglobulin levels as would be expected in food allergy/intolerance. IgE allergy to food was not tested. The authors recommend that food allergy testing not be used to guide food therapy in children with ADHD, instead eliminating food that clinically caused problems in a particular child.

The details of the restriction elimination (RED) diet and the Food Journals used by families enrolled in the study are included n the appendix of the journal The Lancet.

An important detail of this study is that all children were screened to determine if they actually met criteria for ADHD, were of school age and did not take any stimulant medication.

Remember that many kids with ADHD have been found to have zinc deficiency, so it is a good idea to supplement with a multivitamin/mineral. High doses of zinc are not recommended.

Here is my WJXT Morning Show interview discussing a hypoallergenic diet and ADHD.


Dr Lidy M Pelsser MSc, Klaas Frankena PhD, Jan Toorman MD, Prof Huub F Savelkoul PhD, Prof Anthony E Dubois MD, Rob Rodrigues Pereira MD, Ton A Haagen MD, Nanda N Rommelse PhD, Prof Jan K Buitelaar MD. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. The Lancet, Volume 377, 5 February 2011 doi:10.1016/S0140-6736(10)62227-1.

Last updated by Dr. Vee on October 22, 2012

Leptin, the Body Fat Hormone

Photograph of Assorted Nuts Courtesy of Stephen Orsillo
Photograph of Citrus and Parsley Courtesy of Sandra Cunningham
Photograph of Man Exercising Courtesy of Suhendra Utet
Photograph of Measuring Tape Courtesy of Irma Marren

Leptin is a protein secreted by adipose (fat) tissue. It was named after the Greek word leptos, meaning “thin.” The more stored fat a person has, the more leptin is secreted. Of course we used to think that fat just sort of, well, grew around the midline and thighs, and was inert. Now scientists know that fat is actually an active organ and makes hormones such as leptin.

Leptin binds specific receptors in the body tissues and organs. High leptin levels also signal the brain to decrease appetite and food intake. Leptin also interacts with the areas of the brain that involves motivation to eat and reward for eating as well as the feeling of being full.

Overeating, high sugar levels, high insulin levels, internal steroids and estrogens all increase leptin levels in the bloodstream.

Losing weight, a lack of body fat such as in patients with anorexia, HIV related weight loss, fasting state, adrenaline, thyroid hormones, testosterone all decrease leptin levels in the body.

Many of us think we have a hormonal reason for being overweight. The truth is that leptin deficiency is exceedingly rare. Rare cases of leptin deficiency are seen in childhood when children eat tremendous amounts of food and become morbidly obese. Because of their leptin deficiency, these children do not enter puberty. It is essential in obese children to determine if leptin deficiency is playing a role. These children respond to pharmaceutical replacement with leptin.

So how about the rest of us? Can leptin injections help with weight loss? Well, the truth is, most people who are obese already have very high levels of circulating leptin. They should lose weight due to the effects of leptin on the appetite and satiety centers in the brain but they don’t! Unfortunately, most people’s brains become resistant to the effects of chronically elevated leptin levels, just like diabetics become resistant to the effects of high insulin in their bloodstream. The exact mechanisms for this leptin resistance is unknown.

So it turns out that leptin is not the magic weight loss drug we thought it could be. Early studies with high dose leptin admininstration did not lead to significant weight loss. Some researchers propose that the addition of a pancreatic hormone called amylin may sensitize the body’s response to leptin. Preliminary studies suggest that the addition of an analogue of amylin called pramlintide may help aid weight loss, although like most weight loss studies, the patient withdrawal rate in this study was high, making conclusions difficult to interpret.

Where leptin may play a role is in the maintenance of weight loss. It is hypothesized that decreasing leptin levels in people who have lost weight increases their appetite and reverses the weight loss they attained. Hence the yo-yo weight loss/weight gain cycle that is so familiar to many of us. So in the future, it may be possible to maintain that hard earned weight loss with the use of exogenous leptin. For right now though, eating healthy portions and exercising are the best way to maintain that weight loss!

Last updated by Dr. Vee on February 27, 2011

Super Foods for Kids

Photograph of Pumpkin Soup Courtesy of Egal

Superfoods are foods packed with higher than average nutrients and antioxidants to fight cancer and heart disease

1. Berries. Blackberries, blueberries, strawberries, raspberries and cranberries—rich in antioxidants.

• Chokeberries and elderberries (difficult to find) are berries with the greatest antioxidant content

2. Pumpkin—use canned pumpkin (not pumpkin pie mix).

• Has antioxidants vitamin A, E and beta carotene.
• Use in pumpkin pancakes, soup, pumpkin ravioli (fun to make with the kids).

3. Dark Chocolate

• Avoid chocolate with refined sugar, milk fats and hydrogenated oils.
• Want high purity cocoa powder that is high in antioxidants. Avoid cocoa that has been alkalinized by the Dutching process (boils away nutrients). Label should state cocoa/dark chocolate has not been alkalized, has been dried and cold pressed rather than roasted.
• Should consist of at least 70% cocoa
• use cocoa butter instead of milk fats or hydrogenated oils
• contain natural, low glycemic sweeteners such as raw sugar cane rather than refined sugars

4. Nuts have omega 3 Fatty acids.

• Almonds and walnuts are the healthiest source. Almond butter.
• Child’s handful daily.

5. Popcorn—lots of fiber.

• Use unsalted and unbuttered.
• No more than three cup serving (not the huge bag at the theater!).
• It is better to pop popcorn yourself (and more fun with the kids!) than to eat pre-packaged microwave kind. Microwave containers have perfluorooctanoic acid (PFOA), a fluorotelmer in the lining of the bag. Can leak into popcorn during microwave cooking. to infertility, liver, testicular, and pancreatic cancer. Popcorn manufacturers have promised to voluntarily phase out PFOA by 2015 under a voluntary EPA plan. Accumulates in the body and stays there for years.
• Wait until age one to serve corn and age four for popcorn to avoid choking hazard

6. Antioxidant Lycopene in tomatoes (and tomato ketchup—does that make it a health food????).

•prevention of cancers of the prostate, pancreas, stomach, breast, cervix and lung
•prevention of heart disease
•Better available when tomatoes are cooked, packed in oil or in tomato juice (but these forms have high levels of sodium or dietary salt)
Whole wheat pasta with marinara sauce is a good source of lycopene

7.Cruciferous (like a cross) vegetables (cauliflower, broccoli, Brussel Sprouts)—steam lightly–nutrients remain even after cooking. (Nutritious value of broccoli INCREASES when cooked).

Vitamin C and K, beta carotene (powerful antioxidant converted to vitamin A in the body), iron, folic acid and potassium.

Contains phytochemicals which prevent cancer by preventing damage to cell DNA. Sulphorophanes prevent damage from carcinogens.

Broccoli sprouts have more sulphorophanes than bean sprouts.
Healthiest cruciferous plant is kale, which is a superfood because it is a great source of antioxidant vitamin C, vitamin A, vitamin K, and micronutrients that help eye health (lutein and zeaxanthin). Mix a little in a fruit smoothie or mix in cooked dishes.

8. Beans/lentils-Black beans have the highest concentration of the antioxidant anthocyanin phytonutrients. Other beans with high levels of antioxidants include soybeans, navy beans, split peas, lentils, pinto beans and garbanzo beans.

•Can make soups and hummus.
•Packed with protein, complex carbohydrates (low glycemic index) and fiber.
•Good source of iron, magnesium, folate, calcium, potassium, and zinc. Use in hummus, soups.

9. Sweet potatoes
•twice the recommended daily allowance of vitamin A
•42 percent of the recommendation for vitamin C
•four times the RDA for beta carotene,
•When eaten with the skin, sweet potatoes have more fiber than oatmeal.
•130 to 160 calories for small to medium sweet potato
•Cinnamon added to sweet potato helps stabilize blood sugar.
•Sweet potato digests more slowly than white potatoes so they are lower glycemic load.

10.Whole grain breads instead of wheat or white bread. Whole grains are rich in fiber and vitamin E

•very low in fat
•The germ and outer coating in wheat and other grains has most nutritional value. Avoid refined grain foods such as white bread and certain breakfast cereals.
•Whole grains typically fortified with folic acid, B vitamins, iron, and whole grain breakfast cereals contain added calcium and vitamin D, too.
•Give kids whole grain breakfast cereals instead of highly processed, sugary cereals. Use whole grain breads for toast and sandwiches, whole grain crackers for snacks, oat bran muffins.
•brown rice instead of white
•quinoa, buckwheat, barley
•whole wheat pasta.
•Add roiled oats to meat loaf

11. Red grape juice—has resveratrol (a flavenoid antioxidant that protects agains blood clots and heart disease) like in red red wine.

• Be careful of sugar—dilute with water and limit intake, especially in toddlers.
•Cranberries and pomegranate juice provides antioxidants, but be careful of the concentrated sugar in juices.

Fatty Cold Water Fish– heart healthy omega-3 fatty acids.

• Choose wild-caught Alaska salmon over farmed salmon. Farmed salmon has been shown to contain 10 times more toxins, including Polychlorinated biphenyls (PCB) and dioxin, than wild salmon. Farmed salmon are fatter, and the PCBs are stored in this fat. In addition, salmon farms can harbor parasites. Some salmon farms use artificial colorings, which may be harmful to health.
• No more than two or three ounces fish/week for children between the ages of two and six years old.
• Canned tuna is composed of smaller tuna types such as skipjack and albacore (more mercury in albacore than white tuna). In general, the smaller the fish, the less potential for mercury.
• Stick with one tuna fish sandwich weekly in children
• Careful with tuna steaks (made from larger, older tuna which have accumulated mercury).
• Avoid fish such as grouper, tilefish, shark due to high mercury content

Last Updated by Dr. Vee on February 14, 2011