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The paper "Attention Deficit and Hyperactivity Disorder" states that The four articles summarized above explore the issues surrounding ADHD, including the risks associated with ADHD and the diet factors, and also underlines that AFCS has a possible harmful behavioral effect on children with ADHD…
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Article Title: ADHD drugs and serious cardiovascular events in children and young adults.
Authors: Cooper WO, Habel LA, Sox CM, Chan KA, Arbogast PG, et al
Year: 2011
The aim of this article was to find out whether children who use drugs for attention deficit-hyperactivity disorder are at high risk of contracting chronic cardiovascular diseases. The researchers conducted a survey of four health plans, Washington State Medicaid; OptumInsight Epidemilogy; Tennessee Medicaid; and Kaiser Permanente California. They relied on automated data of these four health plans. The sample size of this study was large as it included 1, 200, 438 children and adolescents aged between 2 and 24 years old. The researchers also carried out a follow-up of 2, 579,104 individual-years as well as 373, 667 individual-years of present use of ADHD drugs in this group.
After the researchers analyzed the data they collected from the health plans and other vital records, they found out that chronic cardiovascular events, such as acute myocardial infarction, sudden cardiac death and stroke, are common in children and adolescents using attention deficit-hyperactivity disorder’s drugs. These findings were also supported by medical-record analysis. The researchers used Cox regression models to compare the events between current users and nonusers. The results of this study showed that current users were not at high risk of contracting chronic cardiovascular events. This study found no evidence to link the use of ADHD’s drugs and adolescents among children to chronic cardiovascular events. Hence, this study concluded that children and adolescents who use ADHD drugs are not at high risk of chronic cardiovascular events compared to those who do not use the ADHD drugs.
Article Title: Blood pressure and heart rate over 10 years in the multimodal treatment study of children with ADHD
Authors: Vitiello B, Elliott GR, Swanson JM, Arnold LE, Hechtman L, et al.
Year of Publication: 2012
The authors of this study set out to find out whether there is a relationship between stimulant drugs and blood pressure as well as heart rate among children with ADHD. The authors used random sampling to select their study sample which consisted of 579 children between the ages of 7-9. These children were put on 14 months of behavioral treatment, medication treatment, the combination of these two and usual community treatment. This study also included a control group which was put on natural treatment and observed periodically. The authors used linear regression models to analyze the blood pressure as well as heart rate data they had recorded. The authors compared currently medicated patients with those who have never or previously treated patients. They also assessed the relationship between cumulative stimulant medication and blood pressure. The authors found no treatment effect on both diastolic and systolic blood pressure. The results also showed a higher heart rate among children who were assigned to medication treatment as well as those who were treated using both medication and behavioral therapy while those treated using behavioral therapy and usual community treatment had lower heart rate. The authors found out that stimulant exposure is not linked to higher risk of tachycardia, however, higher accumulative stimulant exposure was linked to an increased heart rate. The authors therefore concluded that stimulant treatment is not associated with high rate of blood pressure among children with ADHD, but it had adverse effect on heart rate.
Article Title: The diet factor in attention-deficit/hyperactivity disorder
Authors: Millichap JG, Yee MM
Year of Publication: 2012
The aim of this article is to offer a detailed overview about the role of nutritional methods in treating children with ADHD where pharmacotherapy has failed. The authors of this article analyzes recent studies and compare them with previous studies. They found out that diets can be used to decrease signs associated with ADHD. These diets include additive-free, sugar-restricted, oligoantigenic as well as fatty acid supplements. According to this article, the latest dietary treatment that has shown positive reports of efficiency is Omega-3. This article has also found out that the 1970s’ additive-free diet is being increasingly taken into consideration in this modern era. The authors emphasized on the ADHD-linked western-style diet that has refined sugars and high in fat as well as a healthy diet which is free of ADHD, containing omega-3 fatty acids, fiber and folate.
The authors reviews literature on ADHD and diets while paying attention to current controlled studies. The authors examines recent opinion of published studies and relies on their practice experience to come up with their recommendations. From their analyzes, they found out that there are symptoms for dietary therapy, such as iron deficiency, medication failure, patient preference and shift from an ADHD- associated Western diet to an healthy diet free from ADHD. The authors have listed the ADHD-associated foods to be avoided as well as ADHD-free foods that are recommended. The authors also found out that oligoantigenic and additive-free diets are inefficient as well as disruptive to the families as only a few patients use them. Zinc and Iron are recommended for patients with known deficiencies. They can also be used to enhance the efficacy of stimulant therapy. Omega-3 supplements can be recommended for patients who fail to respond or who do not want to use medication. This article highly recommend educating parents and children as regards healthy dietary pattern as the best way of treating ADHD.
Article Title: Artificial food colors and attention-deficit/hyperactivity symptoms: conclusions to dye for.
Authors: Arnold LE1, Lofthouse N, Hurt E
Year of Publication: 2012
This article set out to explore the controversial issue about the impact of artificial food colors on the behaviors of children. To come up with reliable and valid results, the authors analyzed the numerous studied that had been conducted as regard this issue. The authors found flaws in several studies that include nonstandardized diagnosis, flawed blinding, questionable sample selection and nonstandaridized result measures. Current data indicate a small though considerable harmful impact of artificial food colors on the behaviors of children which is not restricted to those with suffering from ADHD. AFCs is not an ADHD problem but seem to be a public health issue. AFCS cannot be solely attributed to ADHD as findings show that children without or with ADHD are affected by AFCs. However, aggregated evidence indicate that children with ADHD exhibits significant indications improvement when eating diet free from AFC as well as reacts with ADHD-type indicators on challenge by AFCs. The article highlights the potential biological mechanisms with literature evidence including the impacts on genetic susceptibility, nutrient levels, and variations in electroencephalographic beta-band influence. Children suffering from ADHD show extreme lack of concentration, hyperactivity and impulsivity. The authors provide a table illustrating the AFCs’ global naming systems, with cross-referencing. The authors conclude that AFCs does not affect the behavior of children with ADHD.
Conclusion
The four articles summarized above explore the issues surrounding ADHD, including the risks associated with ADHD and the diet factors. The first two articles are somehow related as they set out to identify whether ADHD is linked to heart diseases and chronic cardiovascular diseases. The second articles show that ADHD is not associated with high blood pressure and high heart rate, which are considered high risk factors for serious cardiovascular diseases. Hence, the findings and conclusions of these two articles seem to agree that children suffering from ADHD are not exposed to risks of high blood pressure and high health rate. The findings of these two articles are in agreement with other previous studies as evident in the literature, which show that ADHD is not associated with high blood pressure and high heart rate and consequently high risk of chronic cardiovascular diseases, although they differ with one study carried out by Habel. Habel’s study showed that ADHD medication is linked to high risk of chronic cardiovascular diseases. The researchers of these both articles can be said to ensure reliability and validity of data collected as they relied on data from a large sample size. A large sample size widens the range of expected data and creates a good picture of analysis thereby reducing the probabilities of discovery failure. A large sample size reduces sampling error and hence ensure quality sampling and accurate statistical analysis of the data collected, yielding accurate results. Moreover, both articles use random sampling to select their sample. Random sampling makes it easy to obtain a sample and gives each member an equal opportunity of being included in the sample. Therefore, it is a fair method for selecting a sample of the study. Moreover, the sample obtained from random sampling is more representative of the entire population and it allows for unbiased sample selection and hence, it can draw good conclusions as regards the population from the sample’s results. When a sample is representative it makes it reasonable to generalize the results obtained from the sample to the entire population. Furthermore, both articles used regression models to analyze their data. Regression analysis helps the researcher to accurately predict the value of dependent variables given the values of multiple independent variables. The conclusion that children using ADHD drugs are safe and free from conditions which can cause cardiovascular disease is accurate. Hence, children should not be restricted to use ADHD drugs due to issues related to cardiac events.
An examination of available literature shows that there is uncertainty as regards the association attention-deficit/hyperactivity disorder and artificial food coloring. Existing literature neither support nor refute the relationship between ADHD and artificial food coloring. The last two articles are also related as the authors aim to find out whether diet plays a significant role when it comes to ADHD. Both articles found out that food is not the major cause of behavior changes in children suffering from ADHD although certain foods, preservatives and food coloring may have a negative impact on the symptoms of children with ADHD. Hence, the symptoms of ADHD can be reduced by consuming a diet which is free from additives and artificial food colors. Dietary factors can play an important part in the etiology of most children suffering from ADHD. These two articles shows a useful effect of removing reactive foods as well as artificial colors in kids with ADHD. From these two studied, we can conclude that dietary supplements can be used along with other therapies for ADHD treatment. However, it is critical to note that the findings of these two studies were limited by small sample size, lack of a standard method to study dietary supplements, co-morbid conditions, and seriousness of the symptoms as well as a combination of both medication and behavioral therapy. From these two articles, we find that AFCS have possible harmful behavioral effect on children with ADHD, hence, it is critical to carry out further research to find out why some children might reacts more to artificial food coloring than others. It is also important to conduct more research to find out the bearable higher limits of exposure to children at high risk and children in general.
References
Arnold LE1, Lofthouse N, Hurt E. 2012. Artificial food colors and attention- deficit/hyperactivity symptoms: conclusions to dye for
Cooper WO, Habel LA, Sox CM, Chan KA, Arbogast PG, et al. 2011. ADHD drugs and serious cardiovascular events in children and young adults. N Engl J Med, 17;365(20):1896–904.
Millichap JG, Yee MM. 2012. The diet factor in attention-deficit/hyperactivity disorder. Pediatrics; 129(2):330–7. Epub 2012 Jan 9. Review.
Vitiello B, Elliott GR, Swanson JM, Arnold LE, Hechtman L, et al. 2012. Blood pressure and heart rate over 10 years in the multimodal treatment study of children with ADHD. Am J Psychiatry. 169 (2):167–77. PMID: 21890793.
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