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It's MORNING EDITION from NPR News. I'm David Greene. Steve Inskeep is up in New Hampshire ahead of tomorrow's primary there. In Your Health today, we'll talk about how to properly take care of contact lenses. But first we turn to Attention Deficit Disorder and diet. Families struggling with ADD often pin their hopes on changes in diet, whether it's adding fish oil supplements or eliminating sugar and food coloring. NPR's Allison Aubrey looks at whether these strategies really work.

ALLISON AUBREY, BYLINE: If you cross the hungry with the word angry what do you get? Hangry. A hangry kid is one who steps off the bus ravenous, irritable, and fidgety. This can happen to anyone, but for kids with Attention Deficit Disorder the effect is even more dramatic. Mother Linda Brauer says with her son, she realized it had little to do with what he was eating. It was that he hadn't eaten enough.

LINDA BRAUER: He's always gotten hangry. You know, when he is wanting something to eat and he can't even articulate it, it was really hard to stave him off until we had something to eat.

AUBREY: Kids with ADD burn lots of calories. They're moving their bodies all the time and often won't sit still long enough to eat. So Brauer says she realized that managing her son's diet was very important, but not in the way she'd been led to believe. She says back in the 1980s when her son was diagnosed, lots of parents were experimenting with elimination diets - removing sugar, food colorings, preservatives, certain kinds of fruits and meats. And she did try this.

BRAUER: I really tried hard to control his diet when he was little, just because that was what good mothers were supposed to do.

AUBREY: But she says it finally dawned on her that the diet made no difference. She recalls reports from her son's preschool.

BRAUER: He was grabbing toys from other children. He wouldn't wait his turn. He was interrupting.

AUBREY: And home wasn't any easier. Brauer says her son's behavior was so impulsive she couldn't leave him alone for a moment. Feeling very worn down, she took the advice of doctor and put her son on the stimulant medication Ritalin.

BRAUER: It was so amazing to me. I could really see night and day. So, yes, it was very helpful.

AUBREY: Unlike diet, the medicine clearly worked. Brauer's story turns out to be pretty typical. For most kids diagnosed with ADD, stimulant medication is very effective, whereas diet changes alone are usually not enough. This is the conclusion of a paper published in the journal Pediatrics. It evaluates lots of studies over three decades. And psychiatrist Jefferson Prince of the Massachusetts General Hospital, who was not involved in the study, says the author's findings certainly fit with his own experience in treating children.

JEFFERSON PRINCE: There may be a small percentage of people for whom changing diet will have enough of an effect to be used alone.

AUBREY: Probably fewer than 10 percent of kids, he says. The rest will need medication. But Prince says this is not to say that diet is irrelevant.

PRINCE: Its main role in my practice, is as a complimentary treatment.

AUBREY: Lots of research suggests that diets rich in refined sugars and processed carbohydrates - think sodas and chips - are bad for all of us, not just kids with ADD. So Prince's nutrition advice is simple. Eat as much fresh whole food and healthy fats as possible.

PRINCE: I think if we have more processed stuff we don't feel as good as if we have less processed stuff.

AUBREY: And in terms of specific advice for ADD kids, Prince says there's been a fair amount of research on the value of omega 3s from fish oil - also known as long-chain, polyunsaturated fatty acids.

PRINCE: We think that there's some link between having low amounts of long-chain, polyunsaturated fatty acids and ADD.

AUBREY: So go ahead and get some fish in your diet or even take fish oil supplements. Prince says, even though the evidence isn't conclusive that this will help kids with ADD, given the heart benefits, he says it can't hurt. And his other bit of specific advice, eat lots of protein.

PRINCE: Having protein is really, really important.

AUBREY: Why? Well, he says lots of kids with ADHD aren't good eaters to begin with, and the medicine can suppress their appetites, so they still go long stretches without eating.

PRINCE: And they get hangry.

AUBREY: And need food quick. Prince says one way to keep this in check is to start the day with a high protein breakfast that sticks.

PRINCE: So if you can have a glass of milk and peanut butter sandwich, that's going to help carry you through the day.

AUBREY: Linda Brauer says she swears by the breakfast tip. She opted for egg sandwiches for her son. And she says it's made a big difference.

Allison Aubrey, NPR News.

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