Editor’s Note: We’ve gone on a search-and-rescue mission to find amazing stories and essays published in earlier print editions of Rootstock. Today’s throwback, “Brain Food for Your Kids: How do you score?” was written by Alan Green, M.D. for the Fall 2006 edition of Rootstock.
Each day at school, millions of children are faced with
a lunch that works against them. Unhealthy versions of French fries, chips, hot dogs, burgers, and pizza fill school cafeterias; high-fat, over-sweetened snacks fill lunch bags brought from home. The crusts and buns of popular menu items are likely to be made from over-processed white flour. The vegetables are likely to be overcooked and under-appetizing. The beverages are even worse.
Each day, a growing number of other schoolchildren enjoy delicious lunches that help put them ahead. Their school cafeterias may feature healthy items they will actually choose to eat, while keeping junk foods and beverages out of arm’s reach. Or, their parents might send them to school with a tasty, healthy lunch that nourishes their bodies and their brains.
What’s on your child’s plate today?
It is my strong conviction that children deserve a healthy breakfast to start the school morning right and a healthy school lunch to fuel their growing and their learning. I have come to believe that nutrition plays a key role, by providing them with a critical physiological foundation to help them succeed in school. Behavior and academic performance are significantly affected by the quantity and quality of the foods we provide children during the school years.
From Backyard Gardens to Kindergartens
When I was growing up, my father grew tomatoes in our backyard. These carefully tended, vine-ripened tomatoes were the tastiest I can remember – and it was all thanks to the rich, organically managed soil. All of a tomato plant’s growth is made from materials that are available in the soil. This is why plants grown in depleted soils are just not the same. Commercial fertilizers may add back nitrogen and basic minerals, but they cannot replicate the rich spectrum of nourishment in soil that is organically maintained. The plant will just do the best it can with whatever materials are available.
When my daughter Claire was born, she weighed 7 pounds 6 ounces. Today, she is 15 years old and weighs over 100 pounds. All of the materials for Claire’s dramatic growth have come from the food she has eaten. Like the tomato plant, my daughter’s body does the best it can with what’s available. Food is the building block for every part of a child’s body, from bones and skin and muscles to organs, including the brain and its complex, ever growing network of neural connections. Children’s bodies are very forgiving—but why not offer them the best building blocks during the school years? And why not protect them from chemicals and junk ingredients in what they eat and drink, or from foods that have the nourishment processed out of them?
Today in the United States, 1 in 6 children suffers from a disability that affects their behavior, memory, or ability to learn. We spend more than $80 billion each year to treat neurodevelopmental disorders. Diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) alone up are up 250% since 1990. 1 How much of a role does modern food play in this increase?
Children’s brains are built differently depending on what they are fed when they are rapidly growing. Healthy brains are about 60% structural fat (not like the flabby fat found elsewhere in the body). As the brain grows, it selects building blocks from among the fatty acids available in what the child eats. The most prevalent structural fat in the brain is DHA (docosahexaenoic acid), one of the omega 3 fatty acids. DHA is also a major structural component of the retina of the eye. A large number of studies have suggested that low DHA levels are associated with problems with intelligence, vision, and behavior. 2
DHA is the most prevalent long chain fatty acid in human breast milk, which suggests that it’s intended for babies to consume a lot of it. Studies have shown that babies who have not gotten DHA in their diets have significantly less of it in their brains than those who have. 3
My point here is not about the superiority of breast milk, but that growing children quite literally are what they eat. When you think about this, you begin to feel differently about “cheap” food.
How Our Food Is Grown
We’ve established that kids develop differently depending on how they are nourished. Now let’s return to how the food they eat is, in turn, affected by what materials are available to grow it.
For instance, cheese, milk, and meat can provide high levels of DHA and other of omega 3’s (as well as providing high levels vitamin E and beta carotene) if it’s produced from pasture-fed organic cows, but not from grainfed confinement cows. 4 Simply put, fresh grass provides the building blocks for a different quality of product.
Iron is another nutrient that is essential to optimal brain function. Here’s a very interesting study reported in the December 2004 Archives of Pediatrics and Adolescent Medicine – the first to connect children’s iron levels and ADHD. 5
ADHD has increasingly affected school classrooms in recent years. Between March 2002 and June 2003, 110 children from the same school district in Paris, France were referred to a university hospital to be evaluated for school-related problems. Researchers analyzed blood samples from the 53 of these children who met the diagnostic criteria for ADHD, and from 27 of the children who did not. The average ferritin (iron) level in the non-ADHD kids was normal, but the average level in the children with ADHD was about half that of the other children. Fully 84% of the children with ADHD were iron deficient. And the lower the iron levels, the worse the ADHD symptoms – worse hyperactivity, worse oppositional behavior, and worse cognitive scores.
The stunning part of this study was that none of the children had iron levels low enough to indicate anemia. The iron deficiency was subtle enough that all tested normal on the hemoglobin or hematocrit blood tests used in doctors’ offices to screen for iron problems. I suspect that inadequate iron in the diet is also affecting the attention, focus, and activity of many children who don’t meet the full definition of ADHD.
When other researchers fed appropriate iron to children with ADHD, their test scores and ADHD symptoms improved.
We know from a large body of previous research that school-aged children who are iron deficient don’t learn as well. School performance is worse; memory is weakened. ADHD is more often seen in boys, but girls are also seriously affected by low iron. Today in the U.S., we are seeing that iron deficiency impacts intellectual growth in as many as 1 in 6 girls sometime in their school careers. Other studies have shown that teen girls with low iron are more than twice as likely to score below average in math achievement tests as are similar girls with normal iron status – even if they have no signs of anemia. 6
The amount of iron children get from foods depends not just on what types of food they choose, but on how that food is grown. Recent evidence has shown that conventional, chemical farming has resulted in depleted nutrients in common food crops. Levels of vitamins and minerals (including iron) have fallen over the last fifty years, as this type of agriculture prevailed.
Kids need more than isolated, individual nutrients to boost their brains and school performance. There are big-picture benefits to eating a balanced diet rich in fruits and vegetables, whole grains, and fiber. Antioxidants include a large variety of compounds found in a large variety of whole foods. Antioxidants in foods have been linked to improved memory and brain function. 8
Even in the same food, antioxidant levels can vary depending on how the food is grown. Organic foods, on average, are about 30% higher in antioxidants than are their non-organic counterparts. 9 That means each organic serving may be packed with more valuable nutrients. Talk about extra credit!
Organophosphates are the most commonly used insecticides in conventional, chemical agriculture. These chemicals act as nerve agents, and have been linked to neurodevelopmental problems. 10 Organically-grown foods are produced without the use of toxic pesticides such as organophosphates. Choosing organic foods for children can immediately and significantly decrease their exposure to organophosphate pesticides. 11 That’s good protection for the developing brain—it’s elementary.
Some are afraid that school children would have to eat unfamiliar or unappetizing foods in order to make a difference. Not so! A February 2006 study 12 conducted by Dr. Chensheng Lu and colleagues demonstrated an immediate and dramatic ability to reduce organophosphate pesticide exposure by making simple diet changes in elementary school children.
The researchers conducted this study with typical suburban children. They collected morning and evening urine samples daily from each child. Pesticide breakdown products appeared routinely in the urine samples.
Then the researchers made a simple change: the elementary school kids began eating organic versions of whatever they were eating before. For example, if they typically ate apples, now they got organic apples. Only if there was a simple organic substitution available for what the kids were already eating, did they make a switch. The kids didn’t have to learn to like any new foods.
Within 24 hours, pesticide breakdown products found in the urine plummeted! They continued this way for five days, with clean urine samples morning and night. Then the kids went back to their typical, non-organic diets, and immediately the pesticides returned. These elementary school children went back to a chronic low-level exposure to organophosphate pesticides from the diet.
How Our Food Is Processed
Researchers at the University of Southampton studied over 1800 three-year-old children, some with and some without ADHD, some with and some without allergies. After initial behavioral testing, all of the children got one week of a diet without any artificial food colorings and without any chemical preservatives. The children’s behavior measurably improved during this week. But was this from the extra attention, from eating more fruits and vegetables, or from the absence of the preservatives and artificial colors?
To answer this question, the researchers continued the diet, but gave the children disguised drinks containing either a mixture of artificial colorings and the preservative benzoate, or similarly colored drinks from natural, food sources. The weeks that children got the hidden chemicals, their behavior was substantially worse. This held true whether or not they had been diagnosed with hyperactivity, and whether or not they had tested positive for allergies.13
Removing artificial colors and preservatives from the diet was dramatically effective at reducing hyperactivity—somewhere between the effectiveness of clonidine and Ritalin, two prescription ADHD drugs. How much better to support children’s mood and behavior with healthy food, than with drugs! Some children may still need medicine, but with a healthy diet, we may be able to use lower doses. And it stands to reason that this diet would be better for all children, whether or not they have behavior problems.
Refined sugars and flours
Food processing can have other negative effects on kids’ brains. In the 1800s the average American consumed 12 pounds of sugar per year. Due to the overwhelming success of the refined-food industry, however, by 1975 sugar consumption had jumped 1000% to 118 pounds per capita, and continued increasing to an average of 137.5 pounds for every man, woman, and child by 1990.
Where are all these sugars coming from? It’s not just cookies, candies, and other sweet treats! Sugars—and more recently, high fructose corn syrup 14 show up on an astonishing variety of food labels, and high on the list of ingredients in the sweetened beverages that kids guzzle. They are ubiquitous in many convenience foods and fast foods, and you will find them in much of the processed food served in school lunches.
The effect of sugar intake is a hotly debated topic in pediatrics. Parents and educators often contend that sugar and other carbohydrate ingestion can dramatically impact children’s behavior, activity and attention. However, physicians looking at controlled studies of sugar intake do not find hypoglycemia or other blood sugar abnormalities in the children who are consuming large amounts of sugar.
The Journal of Pediatrics 15 reported that there is a more pronounced response to a glucose load in children than in adults. In children, hypoglycemia-like symptoms (including shakiness, sweating, and altered thinking and behavior) may occur at a blood sugar level that would not be considered hypoglycemic. The authors reason that the problem is not sugar, per se, but highly refined sugars and carbohydrates, which enter the bloodstream quickly and produce more rapid fluctuations in blood glucose levels.
Serving a breakfast with complex carbohydrates (like oatmeal, shredded wheat, berries, bananas, or whole-grain pancakes) and packing a lunch with delicious fiber-rich treats (such as whole-grain breads and fresh fruit) will help keep your child’s adrenaline levels more constant, which may increase their ability to pay attention in school.
When foods are cooked, their nutrient profile changes. For instance, overcooking can destroy beta-carotene, an important antioxidant. Overcooked carrots have significantly lower antioxidants overall than do raw or gently cooked carrots. The same is true for broccoli and asparagus. Baked or boiled russet potatoes have higher nutrient levels than do raw potatoes—but frying the potatoes destroys important nutrients. Peeling some foods (such as apples, potatoes, or cucumbers) can also decrease antioxidant power.
School Fuel: Homework for Parents
Kids’ brains are high-performance engines, and if we want them to do their best in school, we need to provide them with clean, high-quality fuel. For growing children this means a balanced diet of delicious whole foods, grown in a nutrition-enhancing way without toxic pesticides, and prepared in an appealing manner that also preserves nutrients.
As a pediatrician, it is my strong conviction that kids need and deserve a healthy breakfast before school. Several studies have shown that a good breakfast can result in better academic performance in the classroom and higher standardized test scores in math, reading, and vocabulary. 17
And the need for quality food doesn’t stop when your kids leave the house in the morning. Every child deserves to have a balanced, nutritious lunch at school, every day. Organic dairy products, proteins (beans, nuts, eggs, or lean meat), whole grains and fresh fruit and vegetables are all recommended parts of the school lunch curriculum.
What can you do as a parent to make this happen? Here’s your homework:
• Model healthy eating and drinking behavior for your kids.
• Start each day with a healthy breakfast with your family (and when possible, end each day with a shared sit-down dinner).
• Pack healthful lunches with less-processed, organic foods.
• Ask and research what your kids are served at school. Take a field trip to the lunchroom if you can, to observe and sample the lunch options.
• Show and Tell: Share your concerns about school food with administrators, school boards, politicians. They need to hear from you to make healthy food a school policy priority. Use your voice and your votes to make a difference.
Solid science has shown that food affects kids’ memory, attention, and cognitive skills. Even whether or not they eat breakfast changes their test scores. What they eat, how their food is grown, and how their food is processed can all help their brains to operate at their very best. Let’s give our kids the edge they deserve.
1. Szpir M. 2006. New thinking on neurodevelopment. Environmental Health Perspectives. 114(2):a100-107.
2. Anderson GJ, Connor WE, Corliss JD. 1990. Docosahexaenoic acid is the preferred dietary n-3 fatty acid for the development of the brain and retina. Pediatr Res 27:89–97.
Birch EE, Garfield S, Hoffman DR, Uauy R, Birch DG. 2000. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Dev Med Child Neurol 42:174–181.
Makrides M, Neumann MA, Byard RW, Simmer K, Gibson RA. 1994. Fatty acid composition of brain, retina, and erythrocytes in breast- and formula-fed infants. Am J Clin Nutr 60:189–194.
Makrides M, Neumann MA, Simmer K, Gibson RA. 2000b. A critical appraisal of the role of dietary long-chain polyunsaturated fatty acids on neural indices of term infants: A randomized controlled trial. Pediatrics 105:32–38.
3. Farquharson J. 1994. Infant cerebral cortex and dietary fatty acids. Eur J Clin Nutr 48:S24–S26.
Farquharson J, Cockburn F, Patrick WA, Jamieson EC, Logan RW. 1992. Infant cerebral cortex phospholipid fatty-acid composition and diet. Lancet 340:810–813.
Farquharson J, Jamieson EC, Abbasi KA, Patrick WJA, Logan RW, Cockburn F. 1995. Effect of diet on the fatty acid composition of the major phospholipids of infant cerebral cortex. Arch Dis Child 72:198–203.
Jamieson EC, Abbasi KA, Cockburn F, Farquharson J, Logan RW, Patrick WA. 1994. Effect of diet on term infant cerebral cortex fatty acid composition. World Rev Nutr Diet 75:139–141.
Jamieson EC, Farquharson J, Logan RW, Howatson AG, Patrick WJA, Weaver LT, Cockburn F. 1999. Infant cerebral gray and white matter fatty acids in relation to age and diet. Lipids 34:1065–1071.
4. Bergamo, P, et al. 2003. Fat-soluble vitamin contents and fatty acid composition in organic and conventional Italian Dairy products. Food Chemistry 82625-631.
Dewhurst R, Fisher W, Tweed J, Wilkins R. 2003. Comparison of grass and legume silages for milk production. Journal of Dairy Science. 86, 2598-2611.
Ellis KA, Innocent G, Grove-White D, Cripps P, McLean WG, Howard CV, Mihm M. 2006. Comparing the fatty acid composition of organic and conventional milk. Journal of Dairy Science. 89:1938-1950.
Holm J. March 2, 2005. Danish Institute of Agricultural Sciences. New research proves organic milk is higher in vitamins and antioxidants than non-organic milk. Soil Association Release.
Robertson J and Fanning C. University of Aberdeen. December 8, 2004. Omega 3 Polyunsaturated Fatty Acids in Organic and Conventional Milk. University of Aberdeen Press.
5. Konofal E, Lecendreux M, Amulf I, Mouren MC. 2004. Iron deficiency in children with attention deficit hyperactivity disorder. Archives of Pediatrics and Adolescent Medicine. 158:1116-1124.
6. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (2000) Food and Nutrition Board (FNB) Institute of Medicine (IOM)
Hatteman JS, et al. 2001. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics.
IOM. 1993. Iron Deficiency Anemia: Recommended Guidelines for the Prevention, Detection, and Management Among U.S. Children and Women of Childbearing Age. Washington, DC: National Academy Press.
Lozoff B, Jimenez E, Hagen J, Mollen E, Wolf AW. 2000. Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics 105:E51.
Nokes C, van den Bosch C, Bundy DAP. 1998. The Effects of Iron Deficiency and Anemia on Mental and Motor Performance, Educational Achievement, and Behavior in Children. The International Nutritional Anemia Consultative Group. Washington, DC: ILSI Press.
Walter T, Kovalskys J, Stekel A. 1983. Effect of mild iron deficiency on infant mental developmental scores. J Pediatr 102:519–522.
7. Davis D, Epp, M, Riordan H. Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999.Journal of the American College of Nutrition, 23(6) Dec 2004.
8. Jama JW, Launer LJ, Witteman JC, den Breeijen JH, Breteler MM, Grobbee DE, Hofman A. 1996. Dietary antioxidants and cognitive function in a population based sample of older persons. The Rotterdam Study. Am J Epidemiol 144:275–280.
9. Benbrook, C. 2005. Elevating antioxidant levels in food through organic farming and food processing. The Organic Center State of Science Review.
10. Slotkin TA, Levin ED, Seidler FJ. 2006. Comparative developmental neurotoxicity of organophosphate insecticides: effects on brain development are separable from systemic toxicity. 114(5):746-751.
11. Benbrook, Greene, Landrigan, Lu. Opportunities to Reduce Children’s Exposures to Pesticides: A Truly Grand Challenge. A Symposium at the American Association for the Advancement of Science Annual Meeting. February 2006.
12. Lu C, et al. 2006. Organic Diets Significantly Lower Children’s Dietary Exposure to Organophosphorus Pesticides. Environmental Health Perspectives. 114(2):260-263.
13. Bateman B, Warner JO, Hutchinson E, Dean T, Rowlandson P, Gant C, Grundy J, Fitzgerald C, Stevenson J. 2004. The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Archives of Disease in Childhood. 89:512-515.
14. Ivaturi R, Kies C. 1992. Mineral balances in humans as affected by fructose, high fructose corn syrup and sucrose. Plant Foods Hum Nutr 42:143–151.
15. Jones TW, Borg, WP, Boulware SD, McCarthy G, Sherwin RS, Tamborlane WV. 1995. Enhanced adrenomedullary response and increased susceptibility to neuroglycopenia: mechanisms underlying the adverse effects of sugar ingestion in healthy children. Journal of Pediatrics. 126(2):171-7.
16. Wu X, Beecher GR, Holden JM, Haytowitz DB, Gebhardt SE, Prior RL. 2004. Lipophilic and hydrophilic antioxidant capacities of common foods in the United States. J Agric Food Chem. 52(12):4026-37.
17. Kleinman RE, et al. 2002. Diet, breakfast, and academic performance in children. Annals of Nutrition Metabolism.
Meyres AF, Sampson AE, Weitzman M, Rogers BL, Kayne H. 1989. School breakfast program and school performance. American Journal of Diseases of Children. 143:1234-39.
Michaud C, et al. 2001. Effects of breakfast size on short term memory, concentration, mood, and blood glucose. Journal of Adolescent Health.
18. American Heart Association/American Academy of Pediatrics. Policy Statement. 2006. Dietary guidelines for children and adolescents: a guide for practitioners. Pediatrics 117(2)544-559.