Nutritional Strategy for Treating ADHD

Happy children

Can a change in diet affect ADHD? Is hyperactivity sometimes misdiagnosed? Some feel that too often a quick assessment, diagnosis and prescription is given to children or adults with stress, anxiety, shakiness, and poor attention span, when maybe a change in nutrition can make a difference. Lisa Ow, Nutritionist shares her views on this controversial subject. Continue reading

Pregnancy and Fetal Risk: Preventing Opiate-Addicted Babies

Fetal Risk and Prescription DrugsWhat Does Research Tell Us About Fetal Risk?
Any factor that may jeopardize the health of the fetus and subsequent neonatal amid pregnancy and post-birth constitutes a fetal risk. A recent study (Desai, et al, 2014) of 1.1 million Medicaid-enrolled women with completed pregnancies revealed that 21.6% had filled a prescription for an opioid during pregnancy. An opioid is an opium-like compound. It is a narcotic that has the potential to be addictive and dangerous when misused. The most commonly prescribed drugs in the study were codeine and hydrocodone. Studies show that oxycodone (Oxycontin) and hydrocodone (Vicodin) cause more deaths per year than heroin and cocaine combined (Center for Disease Control and Prevention, CDC, 2011).


Woman and Doctor PrescriptionAnother study (Bateman, et al, 2014) focused on the opioid utilization of another large (534,500) cohort of women who had completed pregnancies and were commercially insured. Among this population, 14.4% were dispensed an opioid at some point in their pregnancy. Again the most common drugs were codeine, hydrocodone and oxycodone. Both studies conclude that exposure to opioids during pregnancy is common, especially among Medicaid-enrolled women. Opioids were dispensed during all three trimesters, and in a small percentage of the cohort, dispensed three or more times during pregnancy. Also notable was the high regional variation with which the drugs were dispensed. Rates were highest in the South and lowest in the Northeast. Only about 10% of the total prescriptions were related to surgical procedures and 1% was related to women who had been using opioids chronically before pregnancy. If opioid use is justified in this 11%, it is questionable whether or not opioid use was a necessity in the other 89%. With such a high rate and degree of exposure, and the small, inconsistent body of literature on the safety of their administration during pregnancy, more research should be conducted to determine whether or not such an administration of these drugs is sound.


Fetal Development and Drugs

Prescription drug opioid use during pregnancy has harmful effects during the critical stages of fetal development

FDA Safe Drug Classifications

The FDA-assigned pregnancy categories as used in the Drug Formulary are as follows:

  • Category A: There is adequate evidence that there is no risk to fetuses.
  • Category B: Animal studies have failed to show a risk to fetuses; no well-controlled studies have been completed in humans.
  • Category C: Animal studies have shown a risk to fetuses; there are no well-controlled studies in humans. However, “potential benefits may warrant use of the drug in pregnant women.”
  • Category D: There is evidence of fetal risk, but “potential benefits may warrant use of the drug in pregnant women.”
  • Category X: There is too much evidence of risk to prescribe these drugs to pregnant women.

Two categories (B & C) illustrate no research in humans. Opioids likely fall into a grey area somewhere around Category D. The point is that current knowledge and understanding of which drugs are safe during pregnancy is rudimentary. Not only is the medical and pharmaceutical literature naive about pregnancy, but it is grossly misinformed about dosages for women in general.

Differences in Prescription Drugs for Men and Women Differences in Metabolism of Men and Woman
Biological differences among sexes can be extremely relevant and critical to proper administration of drugs, but these nuances are often ignored. Earlier this year the FDA finally lowered the recommended dose of Ambien (zolpidem) for women – it was cut in half. This astonishing revelation comes after the drug has been on the market for 14 years. Women metabolize the drug differently than men and need far less to achieve the same effects. Women prescribed Ambien have likely been overdosing on it, the drug still active in their bodies as they get up in the morning and drive to work. Another example – low dose aspirin lowers the risk of heart attack in healthy men, yet does not lower the risk of heart attack in women, but may protect against stroke instead.

Laboratory RatsDr. Melina Kibbe is a vascular surgeon who runs a lab at Northwestern University Medical School. She notes that the vast majority of animal studies across the country are done on male rats; only male rats – as the control.  Animal studies comprise much of the medical literature, and all of the animal studies are male dominant. Much of women and men’s biology, not even counting our obviously opposing reproductive biology, is fundamentally different where drug dosages are concerned. This fact is completely ignored or not even understood in much of the medical community. If women themselves aren’t accounted for in the literature with regards to drug dosages, is it to be expected that the dosages during a sensitive time like pregnancy are any better understood?

According to Cheryl S. Broussard, “Fewer than 10 percent of medications approved by the F.D.A. since 1980 have sufficient data to determine fetal risk.”   Moreover, pregnant women are taking more prescription drugs now than at any time in the past 30 years. A study (Broussard, et al, 2011)  showed an association between early maternal opioid use and certain birth defects. Maternal opioid use may increase the risk of certain congenital defects such as neural tube defects (NTD’s) which affect the brain, spine and spinal cord. Mothers with pregnancies affected by an NTD reported opioid use more often during the first two months of pregnancy than mothers of babies without an NTD. 3.9 % of mothers of children with NTD’s reported using opioids early in pregnancy, compared to just 1.6 % of mothers of children without NTD’s.

Baby drug withdrawl“Opioid use in very early pregnancy is associated with an approximate doubling the risk of neural tube defects,” said Martha M. Werler, the senior author and a professor of epidemiology at the Boston University School of Public Health. “About half of pregnancies are not planned, so that’s a big chunk of women who may not be thinking about possible risks associated with their behavior.” Not only might opioids increase the fetal risk by way of defects, but in cases where the drug use is more prolonged, infants may be born with what is known as neonatal abstinence syndrome (NAS). Opioids and other substances may pass through the placenta to the fetus during development. As the baby is born it may be dependent on the drug and have withdrawal symptoms without treatment.

Opiate Baby

One study (Patrick, 2012)  found that babies with NAS were more likely than any other hospital births to have a low birth weight. It also found a substantially increased incidence of NAS from 2000 to 2009, as well as hospital charges that were relatedly high. Even over-the-counter drugs that are commonly used for pain management could pose risks to fetuses. It was well-publicized that the active ingredient in Tylenol (acetaminophen) was the leading cause of acute liver failure in Americans between 1998 and 2003.

Tylenol - AcetaminophenNewer data has suggested that maternal use of acetaminophen can result in an increased risk for the development of hyperactivity disorders like ADHD or hyperkinetic disorders (HKD’s) in children. The children of women who took acetaminophen during pregnancy had a 30% increased risk of developing ADHD and a 37% increased risk of developing HKD by age 7. The etiology of a disorder like ADHD is complex and assuming complete causality with regard to environmental exposures may be an oversimplification. Acetaminophen currently has no FDA classification for use in pregnant women. However, the associations have been clearly observed and should render public health relevance (Liew, Ritz, et al, 2014). Pain is a common side-effect of pregnancy because of weight gain, postural changes and pelvic floor dysfunction. Women who are pregnant or nursing could choose to be cautious in using drugs, and instead look to complementary and alternative methods of pain management.

Acupuncture WomanAlternative and Complimentary Treatment
Dr. Pamela Flood and Dr. Srinivasa N. Raja, a professor in anesthesiology at Johns Hopkins University School of Medicine, noted that  the most common forms of pain (back, abdominal and joint) were not even substantially helped by opioids, but were more thoroughly ameliorated by non-drug interventions like physical therapy. They note that while taking drugs may be easier, the more time-intensive use of other therapies is often more effective.  One recent study (Pennick and Liddle, 2013) concluded that both acupuncture and exercise are effective in treating low back pain and pelvic pain during pregnancy.  Another study   details  the case of a 23-year-old at 27 weeks whose chronic pelvic pain was “incapacitating” on narcotics. The use of acupuncture allowed her to limit her use of narcotics and maintain normal activities of daily living until her subsequent delivery of a healthy infant without complications.

Father Baby MotherEarlier this year, the Centers for Disease Control and Prevention unveiled a new website for its Treating for Two initiative. It seeks to provide a better framework for expecting mothers and their clinicians to make choices about medication use, while aiming to prevent birth defects and minimize the harm of exposure. Our understanding of the implications of drug use during pregnancy is fundamentally lacking, while the specter of opioid abuse continues to loom. It would behoove expecting parents to learn about the fetal risks associated with the treatment of their pain and discomfort. Alternative forms of treatment such as acupuncture, exercise and other modes of therapy may yield enormous benefits, while reducing the need to use potentially harmful drugs.


Bateman BT; Hernandez-Diaz S; Rathmell JP; Seeger JD; Doherty M; Fischer MA; Huybrechts KF. Patterns of opioid utilization in pregnancy in a large cohort of commercial insurance beneficiaries in the United States. Anesthesiology. 201 PubMed

Broussard CS; Rasmussen SA; Reefhuis J; Friedman JM; Jann MW; Riehle-Colarusso T; Honein MA. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstetrics & Gynecology. 2011 Apr; 204(4):314.e1-11.PubMed

Desai, Richi J; Hernandez-Diaz, Sonia; Bateman, Brian T; Huybrechts, Krista F. Increase in opioid use during pregnancy among medicaid-enrolled women. Obstetrics & Gynecology. 2014 May; 123(5):997-1002.

FDA Pregnancy Categories, University of Washington(UW) Medicine Online Formulary Categories

Liew Z; Ritz B; Rebordosa C; Lee P; Olsen J. Acetaminophen use during pregnancy, behavioral problems and hyperkinetic disorders. JAMA Pediatric. 2014;168(4):313-320. doi:10.1001/ jamapediatrics.2013.4914

Patrick SW; Schumacher RE; Benneyworth BD; Krans EE; McAllister JM; Davis MM. Neonatal abstinence syndrome and associate health care expenditures: United States, 2000-2009. JAMA 2012 May;9;307(18):1934-40. PubMed

Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database syst rev 2013; 8:CD001139 PubMed

Prescription painkiller overdoses at epidemic levels, Center for Disease Control and Prevention, CDC, 2011 Nov 1.

Thomas CT; Napolitano PG. Use of acupuncture for managing chronic pelvic pain in pregnancy. A case report. J ReprodMed. 2000 Nov; 45(11):944-6. PubMed

Yazdy MM, Mitchell AA, Tinker SC, Parker SE, Werler MM. Periconceptual use of opioids and the risk of neural tube defects. Obstetrics & Gynecology. 2013 Oct;122(4):838-44. PubMed




Kevin McMahan3This article is written by Kevin McMahan, a Health and Wellness Educator for the Monterey Bay Holistic Alliance. Kevin has had a lifelong interest in health and wellness. After graduating from Carmel High School he went on to get an associates degree in social sciences from Monterey Peninsula College, and a bachelors in kinesiology from California State University Monterey Bay. He is a certified personal trainer through the American College of Sports Medicine. “Your health is your wealth”, is something that he always likes to say. The Monterey Bay Holistic Alliance is a registered 501 (c) 3 nonprofit health and wellness education organization. For more information about the Monterey Bay Holistic Alliance contact us or visit our website at

The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)3 organization and does not endorse any particular products or practices. We exist as an educational organization dedicated to providing free access to health education resources, products and services. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. The statements about organizations, practitioners, methods of treatment, and products listed on this website are not meant to diagnose, treat, cure, or prevent any disease. This information is intended for educational purposes only. The MBHA strongly recommends that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition.


Food Dyes – A Rainbow of Risks

Danger of Food Dyes

Are food dyes, or artificial colorings dangerous? What is being done?

Are Food Dyes or Artificial Coloring Dangerous?

Food dye cereal

Children are eating food dye in candy and cereal.

Yes. Watch out. You know them as food coloring, food dyes, or artificial coloring, but Yellow 5, Yellow 6, Red 40, Blue 1, Blue 2, Citris Red 2, Red 3, and Red Green 3, are made from petroleum and pose a “rainbow of risks.”

Food Dye Dangers

Graphic Source:

What Are Some of the Risks? According to the latest research, those risks include hyperactivity in children, cancer (in animal studies), immune system tumors, brain gliomas, adrenal tumors, bladder tumors, and allergic reactions. In 2008, because of the problem of hyperactivity, the Center for Science in the Public Interest (CSPI) petitioned the Food and Drug Administration to ban the use of these dyes. A letter was sent to the Honorable Rosa L. DeLauro, US House of Representatives, Washington, DC on June 3, 2008, and to other members of Congress, stating that “The undersigned “physicians and researchers are concerned about the effects of food ingredients, especially food dyes, on children’s behavior, including children with hyperactivity and attention-deficit/hyperactivity disorder (ADHD), and are troubled by federal inaction.” The Food and Drug Administration (FDA) did not take action. The letter can be viewed here: Letter to House of Representative and Congress.  The petition can be viewed here:  Citizen Petition to the FDA.

Food dye in Twizzlers

The food dye content in Twizzler twists.

In August 2010, the U.S. Environmental Protection Agency announced it planned to initiate rulemaking to regulate 48 benzidene-based dyes under the Toxic Substances Control Act. The act has authority for nonfood uses of these dyes in products such as textiles and inks. The Action Plan from the U.S. Environmental Protection Agency can be viewed here. Do Other Countries Also Allow Food Dyes? The British government and European Union have taken actions that are virtually ending the use of dyes throughout Europe. In 2010, CSPI released an extremely comprehensive collection of scientific data discussing metabolism and toxic effects of artificial dyes in their report “Food Dyes: A Rainbow of Risks.” A summary can be found here: CSPI Food Dyes Report.


Kraft Macaroni and Cheese Food Dye

A comparison between USA and UK Kraft Macaroni and Cheese

Kraft Macaroni and Cheese in the United States has totally different ingredients than it’s cousin, Kraft Cheesey Pasta in the United Kingdom.   Kraft Cheesey Pasta is made with natural food colorings and no GMO products, whereas the USA produced product is made with petroleum chemical food dyes and GMO foods.

Kraft on Kids Menus

Kraft Macaroni and Cheese is being microwaved and served in restaurants. It is listed as an item choice on children’s menus.

Food dyes are found in cheese puffs, colored sugary cereals, and even foods advertised as “healthy,” such as strawberry Nutri-Grain bars, for example, which continue to have:  Natural and Artificial Flavors, Red 40.  However, Nutri-Grain bars in Britain DO NOT contain the dyes and artificial food colorings. Why is this?

Why Does Britain Use Natural Ingredients and the United States Does Not? This photo of Nutrigrain bars was taken in 2010, when Nutri-Grain bars were strikingly different in U.S. compared to Britain.

NutriGrain Britain and US

Why does Britain use natural ingredients and US uses food dyes?

Let’s take a look at strawberry Nutri-Grain Cereal Bars.  As you can see, two different packages are used and different ingredients.  Although, yellow #6 and blue #1 is no longer listed in the United States strawberry flavored Nutri-Grain bars, Nutri-Grain bars (advertised as healthy) in the United States continue to use the RED 40 food dye. Red 40 was listed in the study by CSPI as one of the dyes that has produced harmful and very serious side effects in mice including tumors. You can find the current ingredients here:  Nutri-Grain Product Details.  Today, food dyes are found in many products in the United States. Nutri-Grain and Kraft are not alone.  

Food dye products

Food dye can be found in breakfast cereals, packaged pastries, cupcake frosting, fruit juice drinks, candies, ice cream and much more.

Statement by the American Academy of Pediatrics The American Academy of Pediatrics (AAP)  issued a statement in 2008 in response to the Lancet study:

“For many of the assessments there were small but statistically significant differences of measured behaviors in children who consumed the food additives compared with those who did not. In each case increased hyperactive behaviors were associated with consuming the additives. For those comparisons in which no statistically significant differences were found, there was a trend for more hyperactive behaviors associated with the food additive drink in virtually every assessment. Thus, the overall findings of the study are clear and require that even we skeptics, who have long doubted parental claims of the effects of various foods on the behavior of their children, admit we might have been wrong.

Candy store food dye

Candy store in the United States displaying candies, all containing food dyes.

What Can We Do to Protect Ourselves? It’s important for everyone to take responsibility by checking labels to make sure there is no food dye or food coloring in the product.  We are responsible for making healthy choices.  What do you think about the FDA and food colorings? Do you think food dyes should be banned?


Artificial Food Dyes May Cause Cancer, ADHD, Whole Foods Magazine, September 2010 Bateman, B.J.O. Warner, et al (2004) The effect of a double blind, placebo controlled, artifical food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children, Archives of Disease in Childhood 89:506=511

Borzelleca JF, Goldenthal EI, Wazeter FX, Schardein JL, Evaluation of the potential tertogenicity of FD & C Blue No. 2 in rats and rabbits, Food and Chemical Toxicology : an International Journal Published for the British Industrial Biological Research Association [1987, 25(7):495-497]

CSPI Says Food Dyes Pose Rainbow of Risks, Cancer Hyperactivity, Allergic Reactions, Center for Science in the Public Interest, June 29, 2010 Curran, Laurel, Food Dyes Linked to Cancer, ADHD, Allergies, Food Safety News, July 8, 2010 Food Standards Agency.

Compulsory Warnings on Colours in Food and DrinkLondon: Food Standards Agency; Jul 22, 2010.

Freeman, DW, Food Dyes Linked to Allergies, ADHD and Cancer: Group Calls on US to Outlaw Their Use, CBS News, June 29, 2010

Kobylewsk, S, Jacobson, MF, Food Dyes: A Rainbow of Risks, Center for Science in the Public Interest, June 2010, Washington DC, (pdf)

Lancaster FE, Lawrence JF. Determination of benzidine in the food colours tartrazine and sunset yellow FCF, by reduction and derivatization followed by high-performance liquid chromatography. Food Additives Contaminants,. 1999;16(9):381–390. doi: 10.1080/026520399283867.

Mercola, Dr. Joseph, Are You or Your Family Eating Toxic Food Dyes? February 24, 2011,

Opinion on Risk of cancer caused by textiles and leather goods coloured with azo-dyes expressed at the 7th CSTEE plenary meeting, Brussels, 18 January 1999, Health and Consumers Scientific Committees, European Commission

Peiperl MD, et al. Determination of combined benzidine in FD&C Yellow No. 6 (Sunset Yellow FCF).Food Chem Toxicol. 1995;33(10):829–839. doi: 10.1016/0278-6915(95)00051-3. 

Potera, C, Diet and Nutrition: The Artificial Food Dye Blues, Environ Health Perspectives, Oct 2010, 118(10): A426, PMC2957945


Jean E. DartThis article is written by Jean Voice Dart, M.S. Special Education from Illinois State University. Jean is a published author and has written hundreds of health articles as well as hosting a local television program, “Making Miracles Happen.” She is a Registered Music Therapist, Sound Therapist, and Master Level Energetic Teacher, and is the Executive Director, founder and Health and Wellness Educator of the Monterey Bay Holistic Alliance. The Monterey Bay Holistic Alliance is a registered 501 (c) 3 nonprofit health and wellness education organization. For more information about the Monterey Bay Holistic Alliance contact us or visit our website at

The Monterey Bay Holistic Alliance is a charitable, independent registered nonprofit 501(c)3 organization and does not endorse any particular products or practices. We exist as an educational organization dedicated to providing free access to health education resources, products and services. Claims and statements herein are for informational purposes only and have not been evaluated by the Food and Drug Administration. The statements about organizations, practitioners, methods of treatment, and products listed on this website are not meant to diagnose, treat, cure, or prevent any disease. This information is intended for educational purposes only. The MBHA strongly recommends that you seek out your trusted medical doctor or practitioner for diagnosis and treatment of any existing health condition.