Tuesday, March 13, 2007

Fish to the rescue -- again

Fish seems to be as popular as McDonalds is unpopular. In the study below, fish oil supplements were shown to alter brain chemistry and behaviour also improved but connecting the two is mere theory. In the absence of a double-blind trial, the behaviour improvement was most likely a "Hawthorne" effect.. Prof. Puri is a fatty acids evangelist with a huge number of academic publications extolling their benefits but I could not find the study mentioned below in the maze of his publication list so I presume that it is as yet unpublished.

Fatty acids can help children in exams and improve their behaviour in class and at home, a study suggests. Overweight children who took fatty acid dietary supplements showed dramatic improvements in concentration, reading, memory and mental agility. The advances that their brains made in three months would normally take three years, researchers found. One teenage boy who was hooked on watching television and hated books before the experiment became an avid reader after and dismissed programmes as too boring to bother with.

Researchers said that the results, while based on a small sample, supported recent findings that fatty acids boost brain development and suggest that fast food may stunt mental growth, because processed foods do not contain these acids.

Improvement were made in every area of academic activity but the most surprising change, said researchers, was in levels of Nacetylaspartate, or NAA, a biochemical indicator of brain development. According to brain scans carried out at St George's Hospital, southwest London, the levels of NAA rose far more than expected in the three boys and one girl taking a supplement containing the omega-3 and omega-6 fatty acids. "The results were astonishing," said Professor Basant Puri, who led the study. "In three months you might expect to see a small NAA increase. But we saw as much growth as you would normally see in three years. It was as if these were the brains of children three years older. It means you have more connections and greater density of nerve cells, in the same way that a tree grows more branches. "For all the children there was a marked change, but in the three boys there was a massive, massive increase in NAA. I was quite startled by what I saw."

The children taking part in the research were classified as overweight. Zach, aged 8, weighed 8st (51kg), George and Rachael, both aged 11, weighed 11st, and Gareth, who was 13, weighed 12st. At the start of the pilot study, the children were given a supplement called VegEPA. They took two capsules a day and were encouraged to cut down on fatty snacks and fizzy drinks and be more active. After three months the children's reading abilities were a year ahead, their handwriting was neater and more accurate and they paid more attention in class.

"Gareth's parents told me how he had suddenly found TV boring, as he wanted to read. Three months earlier he was saying he couldn't understand people who loved books," said Professor Puri, of the Division of Clinical Sciences at Imperial College, London. "The concentration of all the children improved enormously and they seemed a lot calmer and happier. Even before I started testing them their parents were saying how much better they were."

The children were asked to change their diet but there was no evidence that they did to any great extent and Professor Puri believes that the changes were caused by the supplement, which is derived from oily fish and evening primrose oil. It contains an essential fatty acid called EPA, but significantly, another type of fatty acid, DHA, is absent. Previous studies by Professor Puri have shown this formula can improve brain function in adults. His study features in a Five TV documentary, Mind the Fat: Does Fast Equal Food Slow Kids?, to be broadcast on Thursday.

Professor Kishore Bhakoo, of the the Clinical Sciences Centre at Imperial, said: "The thing that amazed me was how much change in biochemistry you could see in three months . . . You'd expect some variation, but they were all going in the same direction." He said that the results had implications for the "junk food" debate: "Processed food doesn't contain these substances."


Taking the drugs out of ADHD

An about-face by the godfather of attention deficit hyperactivity disorder has renewed debate about medicating children, writes Angela Kamper below. The Dore program mentioned below got a critical mention here on Feb. 16th.

US Professor of psychiatry Dr Robert Spitzer has been a saviour for thousands of parents around the world who want answers for their child's frequent outbursts of clumsiness and bad behaviour. While others just called them brats he gave parents a label for the erratic symptoms, placing attention deficit hyperactivity disorder (ADHD), attention deficit disorder (ADD) and other conditions on a chart they could all follow. The groundbreaking classification table, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-III), meant doctors could diagnose with greater confidence and prescribe medication that would produce instant results.

Now, more than 25 years since his global revelation, Dr Spitzer's own attitude towards doctors using his chart has taken a dramatic turn. He says 30 per cent of children diagnosed with a mental disorder don't actually have it and are instead showing perfectly normal signs of being happy or sad. "Many of these conditions might be normal reactions which are not really disorders," Dr Spitzer said. He also acknowledged that some parents could pressure doctors to diagnose and prescribe drugs. "We don't know to what extent that's been happening inappropriately," he added.

His latest views have renewed debate over the diagnosis of children and use of prescription drugs as well as questions whether DSM-III, designed to be more specific and objective, still has major flaws.

About one in every 100 Australian kids are on medication for ADHD. The two main stimulant drugs are dexamphetamine and methylphenidate, or Ritalin. Some are also on the adult depression drug Risperdal.

Many scientists argue ADHD is a genetic disorder that continues into adulthood. However others say it is an excuse - developed from a culture that is too eager to medicate any supposedly antisocial behaviour. Glynis Howard, medical services manager for Sydney's Dore Achievement Centres, which use a drug-free alternative approach, says you cannot diagnose a child based on filling out a form with the right criteria. "The whole picture needs to be taken into account," she said. "You need to look at the child's environment or things that have recently occurred that may have caused the disorder."

The registered nurse says a death in the family, parents separating or even an allergy can trigger some of the supposed symptoms. "His (Dr Spitzer's) comments are very significant for us," Mrs Howard said. "When we started what we were doing it was really taboo. We were treated like outcasts but now people are starting to see the results and question things."

The Dore method, which has been available for five years, addresses the issue by taking the child through ten-minute daily exercises which stimulate the cerebellum in the brain instead of using drugs. The process is believed to increase the child's ability to process information more rapidly. Mrs Howard said the centre, which has no government funding, has more than 10,000 children on its books and boasts an 80 per cent success rate. "It's alarming when you see these kids - it amazes me that they have been given this medication," she said. "About three out of 10 kids can go off this medication and stay off it."

Don Ulich says his 12-year-old daughter Kristina has returned to mainstream school having used the Dore program. Kristina was diagnosed with Asperger's syndrome - a type of autism-dyspraxia - and ADHD. She had a short memory span, difficulty expressing herself verbally, poor co-ordination and difficulty making friends. When first diagnosed she was more than four years behind other kids in her school year. But after six months on the program her parents noticed a dramatic improvement. "In her most recent assessment she was learning at the same rate as the other kids in her year," Mr Ulich says. "We didn't want to put Kristina on any drugs so we're very happy with her improvement. We've noticed a dramatic change in her confidence, having friends, participating in sport and generally opening up."

Sydney Children's Hospital paediatric psychiatrist Florence Levy says we have to be careful how we medicate - and there must be guidelines. "I've always been a conservative medicator. I believe there certainly has to be a rule for medication and it has to be carefully administered," Dr Levy said. She also argues we cannot generalise between Australia and the US because in NSW only paediatricians and psychiatrists can diagnose a child, while in the US, most GPs are permitted to diagnose. "Diagnosis is not restrained in the way it is here," she said.

Dr Levy does not discount the Dore program but says she needs to see more evidence before making any comment. She admits medicating is a much cheaper alternative for parents instead of using methods like Dore. "I haven't seen any evidence that any of it works," she said.

Despite the debate over his controversial chart, Dr Spitzer says he is not too concerned about children being misdiagnosed. "By and large the treatments for these disorders don't have serious side effects," he said. "I mean some do but they're not that serious, whereas the failure to treat can often be very hard on the child and on the family." [Making a kid into a druggie is not a serious side-effect?]


Britain: Most spiking cases 'just drunk'

Most patients who believe they have had their drinks spiked test negative for drugs, research at Wrexham Maelor Hospital has found. The study aimed to assess the scale of drink-spiking in the area and identify problems at specific clubs and pubs. But the year-long investigation of hospital patients found fewer than one in five showed any trace of drugs. The research concluded the patients' symptoms were more likely to be the result of excess alcohol.

So-called "date rape" drugs include ketamine, Rohypnol and GHB. During the 12-month study there were 75 alleged cases of drink-spiking. Patient samples were analysed for alcohol and drug levels, and information was recorded about where the alleged spiking had happened. The alleged incidents took place in 23 different locations, although two locations accounted for 31% of the cases. Only 14% of the patients had informed the police. The research, which was published in the Emergency Medicine Journal, found 65% were twice the legal drink-driving limit, and 24% were three times the drink-drive limit.

Dr Peter Saul, a GP in Wrexham, said the report's findings "should not belittle the danger" people faced either from drink-spiking or drinking too much alcohol. He told BBC Radio Wales: "There had always been a suspicion that people would say that their drinks had been spiked when perhaps they had misjudged how much alcohol they were taking. "If you go home and your parents are there, and you are vomiting on the path, and you come in in a terrible state, you get sympathy if you say 'oh, my drink was spiked.' "You don't get sympathy if you say 'we spent too long in the bar'."

Dr Saul said the report did not make it clear if people's drinks had been spiked by alcohol, as opposed to drugs. He said: "It could explain the figures of people with very high alcohol levels." He added: "The message has to be to be careful, not just about having your drink spiked but the total amount of alcohol you have when you are going out for the night."

Professor Jonathan Shepherd is a Cardiff-based surgeon who has pioneered a method for hospital casualty units to compile statistics on the drink-related assaults. He told the same programme: "It really puts to bed a myth that's very widely held that drinks are spiked when in reality they are not." Prof Shepherd's research has included breathalysing up to 900 late-night drinkers in Cardiff city centre. He said: "There is certainly a sizeable minority who are drinking huge amounts of alcohol. "For all of us, it's a cautionary tale - we ought to be deciding beforehand how much are going to drink on a night out."

However, Prof Shepherd acknowledged that drink-spiking was a still a risk, which he said was easier to prevent by drinking from a bottle rather than a large glass. Dr Hywel Hughes, who led the study at the Wrexham Maelor Hospital, said the survey's results should not obscure the risks of drink spiking, as one-in-five people tested showed signs of "drugs of abuse". He said: "The bigger picture is probably the alcohol but spiking does go on, so people do need to take precautions against that."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.