Nancy J. Powell

Have a great day.

REMARKS BY U.S. AMBASSADOR TO INDIA, NANCY J. POWELL

ALL CHILDREN READING GRAND CHALLENGE AWARDS

Thursday, November 29, 2012

The Oberoi Hotel

New Delhi

(AS PREPARED FOR DELIVERY)

Good morning, ladies and gentlemen.  I am delighted to be here today to participate in the launch of five new activities to strengthen early grade reading across India.  The five organizations that we are honoring here today – Pratham Education Foundation, PlanetRead, Pragya, Sesame Workshop Initiatives India, and the American Institutes for Research – are winners of the All Children Reading Grand Challenge, a highly competitive global competition supported by the United States through the U.S. Agency for International Development, or USAID, in partnership with the Australian Agency for International Development (AusAID) and World Vision.

We are excited to have former Chairperson of the Children’s Film Society of India, renowned filmmaker, and actress Nandita Das with us today.  We all know that Ms. Das wears many hats – she is an award-winning actor, director, playwright, activist, and loving mother.  Over the years, she has actively supported important social issues including human rights, gender equality, children’s rights, and rights of the disabled.  Her mother, Dr. Varsha Das, is an eminent writer of children’s books and the former Director for the National Book Trust.  And so, it is hardly surprising that Ms. Das too has a love of books and reading, and we are delighted to have her with us today. 

We are also honored to have with us Australian Deputy High Commissioner, Dr. Lachlan Strahan.  The U.S. partnership with Australia is strong and close.  Our two countries share a traditional friendship, similarities in culture and historical background, democratic values, common interests, and similar views on most major international questions.  Among other collaborations and international commitments, our two government foreign assistance agencies – AusAID and USAID – are working together to help developing countries achieve the Millennium Development Goals, move toward sustainable and private sector-led growth, reap the benefits of technological change and innovation, and escape conflict and instability.  Dr. Strahan, I welcome you and wish this partnership a great success.

It's also my pleasure to welcome Mr. Jomon Baby from World Vision India and Ms. Michelle Halse from World Vision Australia, without whose support the All Children Reading partnership would not be possible.

Finally, I am also so pleased to see such diversity among the guests here today – including officials and representatives from the Government of India, private sector companies, civil society groups, international organizations, and academia.  It is an honor to welcome you all here this morning.

Since the launch of the Millennium Development Goals in 2000, the world has seen significant strides in education through the efforts of education ministries and their partners around the world.  Developing countries have moved nearly 28 million more children into classrooms over the last decade by abolishing school fees, building new facilities, and relentlessly ensuring that every child born anywhere has access to school.

In fact, today more than 90 percent of children in developing countries are enrolled in some form in primary school.  But our job as government leaders and development professionals is to always ask the question: to what end?  Our responsibility does not end when a girl first steps through the doors of a classroom. We have to make sure that when she steps out of the classroom, she has acquired the tools she needs to reach her full potential. 

Unfortunately, a focus on universal access has come to some extent at the expense of children receiving a high quality education everywhere around the world.  Even as we have seen these record numbers of children enter classrooms, we have seen the quality of learning sharply drop.  Today, over 60 percent of all school children around the world – nearly 200 million girls and boys – are learning so little that they are struggling to read basic words. 

The Government of India has taken several positive steps towards making basic education available to every child in the country through the Right to Education Act.  According to the latest reports, today over 96.6 percent of children in India ages 6 to14 years old are enrolled in school.  However, quality of education remains a concern and a major challenge across the entire education system.   As recent international assessments and national surveys have concluded, learning levels in India are very low at the primary level.  The 2011 Annual Status of Education Report, conducted by Pratham, revealed that basic reading levels have shown a marked decline in many states across North India, with the number of children in class five able to read at a class two level dropping from 54 percent in 2010 to 48 percent in 2011.  It is critical to provide children not only with a classroom but also with the right kind of instruction and environment to teach them to read.  

If the gap in reading ability is not addressed and learning levels are not improved at the primary level, particularly by grade 2, children continue to lag behind in all subjects as they move through the education system.  The future economic potential of millions of children depends on their ability to learn to read, and read effectively, during their primary school years.

USAID fundamentally transformed its approach to education to help address this crisis in quality.  We're not going to measure our success by the number of children in school; we're going to measure it by the number of children who can read by the time they leave primary school.  We are not going to measure our success by the number of teachers we train in international conferences.  We're going to measure it by the effectiveness they demonstrate in the classroom as measured by child outcomes. 

This was the vision behind the new education strategy which USAID launched in February.  As part of the new education strategy, USAID has developed early grade reading assessments designed to help teachers understand the specific needs of their students and their classrooms.  These tools are already making a difference on the ground, changing the way entire nations approach education.  By focusing on literacy and measuring impact, USAID’s new strategy will help improve the reading skills of 100 million children by 2015.

To meet this goal, in November of 2011, USAID, jointly with AusAID and World Vision, announced a competition entitled the “All Children Reading Competition” focusing on identifying and supporting game-changing innovations with the potential to dramatically improve reading skills among primary grade children with low literacy rates.

Five of the 32 awardees of this competition are implementing activities in India and we are privileged to have them here with us today.  All are highly credible organizations with an impressive track record in education.  Each of these organizations proposes innovative and scalable activities both in and outside the classroom that will produce concrete reading outcomes over the next two years.  I am sure that all of you will benefit from hearing directly from them about the innovative activities they are supporting.  I would like to take this opportunity to congratulate them for their awards and hope that all of us together create an early grade reading movement in India.  I look forward to hearing more about the results of their activities over the next two years.

The United States believes the most strategic impact it can make in basic education is to address early grade reading as an outcome that is critical to sustain and ensure learning for children.  I am happy that, through the All Children Reading Grand Challenge, local organizations in India with innovative ideas are being encouraged to drive this effort. 

Once again, I welcome you all and wish you the best for today’s discussions and in your endeavors in strengthening early grade reading in India.

Thank you.

Diet

Have a great day.

"Many professionals in restaurants and eateries are using or consuming the entire lemon and nothing is wasted.

"How can you use the whole lemon without waste?

"Simple.. place the lemon in the freezer section of your refrigerator. Once the lemon is frozen, get your grater, and shred the whole lemon (no need to peel it)and sprinkle it on top of your foods.

"Sprinkle it to your vegetable salad, ice cream, soup, noodles,spaghetti sauce, rice, sushi, fish dishes.

"All of the foods will unexpectedly have a wonderful taste,
something that you may have never tasted before. Most likely, you only think of lemon juice and vitamin C. Not anymore.

"Now that you've learned this lemon secret, What's the major advantage of using the whole lemon other than preventing waste and adding new taste to your dishes?

"Well, you see lemon peels contain as much as 5 to 10 times more vitamins than the lemon juice itself. And yes, that's what you've been wasting.

"But from now on, by following this simple procedure of freezing the whole lemon, then grating it on top of your dishes, you can consume all of those nutrients and get even healthier.

"It's also good that lemon peels are health rejuvenators in eradicating toxic elements in the body.

"So place your lemon in your freezer, and then grate it on your meal every day. It is a key to make your foods tastier and you get to live healthier and longer! That's the lemon secret! Better late than NEVER! The surprising benefits of lemon!
Lemon (Citrus) is a miraculous product to kill cancer cells. It is 10,000 times stronger than chemotherapy.

"Why do we not know about that? Because there are laboratories interested in making a synthetic version that will bring them huge profits.

"You can now help a friend in need by letting him/her know that lemon juice is beneficial in preventing the disease. Its taste is pleasant and it does not produce the horrific effects of chemotherapy.

"How many people will die while this closely guarded secret is kept, so as not to jeopardize the beneficial multimillionaires large corporations?

"As you know, the lemon tree is known for its varieties of lemons and limes.

"You can eat the fruit in different ways: you can eat the pulp, juice press, prepare drinks, sorbets, pastries, etc... It is credited with many virtues, but the most interesting is the effect it produces on cysts and tumors.

"This plant is a proven remedy against cancers of all types. Some say it is very useful in all variants of cancer. It is considered also as an anti microbial spectrum against bacterial infections and fungi, effective against internal parasites and worms, it regulates blood pressure which is too high and an antidepressant, combats stress and nervous disorders.

"The source of this information is fascinating: it comes from one of the largest drug manufacturers in the world, says that after more than 20 laboratory tests since 1970, the extracts revealed that It destroys the malignant cells in 12 cancers, including colon, breast, prostate, lung and pancreas...

"The compounds of this tree showed 10,000 times better than the product Adriamycin, a drug normally used chemotherapeutic in the world, slowing the growth of cancer cells.

"And what is even more astonishing: this type of therapy with lemon extract only destroys malignant cancer cells and it does not affect healthy cells."

Happiness

Have a great day.

We are happy to inform you that our seven days programme (November 18 -24) called "Sharad Sangam" concluded very well. The programme attended by approx 1500 devotees from all the states of India and all over the world, including US, UK, Australia, Belgium, Canada, Germany, Greece, Hong Kong, Jordan, Spain, Thailand, Sri Lanka, Malaysia, Nepal etc. 

Sharad Sangam, is a week long immersion in the sacred, soul-liberating Kriya Yoga teachings of our Guru Paramahansa Yogananda – that brings forth profound peace, bliss, and blessings of the Great Ones to all those participate in this sacred gathering. The Sangam Schedule includes review of Gurudeva’s techniques of meditation and Energization Exercises, discourses, group meditations, bhajan sessions, video shows, spiritual counselling by sannyasis, and Kriya Yoga diksha.

The teachings of Paramahansa Yogananda offer a direct means of stilling the natural turbulence of thoughts that prevents us from knowing what we really are. By practicing these step-by-step methods, we come to know our oneness with the Infinite Intelligence that gives life to all and is the essence of our own Self. These techniques reverse the outward flow of energy and consciousness so that the mind becomes a dynamic centre of direct perception — dependent no longer on the fallible senses but capable of actually experiencing Truth. The highest of these methods of meditation is the science of Kriya Yoga that reinforces and revitalizes subtle currents of life energy in the body. Consciousness is drawn to higher levels of awareness, gradually bringing about an inner awakening. Referring to the sure and methodical efficacy of Kriya Yoga practice, Paramahansaji declared: “It works like mathematics; it cannot fail.”

Paramahansa Yoganandaji’s method of disseminating these teachings is ingenious. One does not have to go to any classes or meet any instructors. One learns and practices these teachings at one’s home, at one’s own time. Under Paramahansaji’s direction, classes and lectures he gave on the art of balanced spiritual living were compiled to form theYogoda Satsanga Lessons. These Lessons are available to sincere seekers for study and practice at home.

Another major aspect of Paramahansaji’s teachings is the emphasis on balanced spiritual living. Apart from the very few who might choose to devote their entire lives to loving and serving God, devotees are taught how to maintain a balance between their worldly duties and spiritual upliftment — how God-consciousness can make them better human beings.

 Paramahansaji strongly advised his disciples to meditate together in groups. He said, “Group meetings strengthen the individual Self-realization that one has acquired in private at home,” adding that, “meditating together increases the degree of Self-realization of each member of the group by the law of invisible vibratory exchange of group magnetism.” It is a measure of the success of the efforts of YSS that there are over 200 such meditation centres all over India today. In addition, there are four Ashrams: at Ranchi, Kolkata, Noida, and Dwarahat (near Ranikhet) where Yogoda devotees can spend a few days in spiritual solitude to deepen their sadhana and to receive personal guidance from YSS sannyasis. Such guidance is also made available when the Swamis tour different parts of India. YSS publishes at affordable prices the writings and lectures of Paramahansaji and his seniormost disciples.

YSS also undertakes various activities of service to mankind. The Society oversees some 20 educational institutions. The school founded by Paramahansaji at Ranchi with a handful of students has developed into a complex of schools and colleges with thousands of students. YSS serves tens of thousands of patients every year through allopathic and homeopathic dispensaries. Specialized clinics, free eye camps, and helping orphanages and leprosy colonies are some of its other regular charitable activities. And these are apart from providing emergency relief throughout India, to people ravaged by natural disasters such as earthquake in Kashmir to Tsunami in Tamil Nadu.

As it completes 95 years of its existence, YSS can legitimately have the satisfaction of not only safeguarding the legacy of its founder but also carrying his message to an ever increasing number of thirsty souls yearning for spiritual solace. 

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Gulzar

Have a great day.

"kehne waalo'n ka kuch nahi 

jaata, sehne waale kamaal karte 

hain //kaun dhoo'nde jawaab 

dardo'n ke, log toh bas sawaal 

karte hain---by 

Gulzar

Chhath Puja

Have a great day.

         Happy Chhath Puja !

US Visa

Have a great day.

U.S. MISSION IN INDIA EXPANDS INTERVIEW WAIVER PROGRAM

       

In March of 2012, the United States Mission to India unveiled the Interview Waiver Program (IWP) which allows qualified individuals to apply for additional classes of visas without being interviewed in person by a U.S. consular officer. 

Following the success of the IWP, as part of continuing efforts to streamline the visa process, and to meet increased visa demand in India, the U.S. Mission is pleased to announce an expansion of the IWP.  We expect this expansion to benefit thousands of visa applicants in India.

         Under the current Interview Waiver Program, Indian visa applicants who are renewing visas that are still valid or expired within the past 48 months may submit their applications for consideration for streamlined processing, including waiver of a personal interview, within the following visa categories:

·         Business/Tourism (B1 and/or B2);

·         Dependent (J2, H4, L2)

·         Transit (C) and/or Crew Member (D) - including C1/D.

·         Children applying before their 7^th birthday traveling on any visa class

·         Applicants applying on or after their 80^th birthday traveling on any visa class

Under the expanded program, the following Indian applicants may also be considered for streamlined processing:

·         Children applying before their 14^th birthday traveling on any visa class

·         Students returning to attend the same school and same program

·         Temporary workers on H1-B visas

·         Temporary workers on Individual L1-A or Individual L1-B visas

The renewal application must be within the same classification as the previous visa. If the previous visa is annotated with the words “clearance received,” that applicant is not eligible for a waiver of a personal interview.

Not all applications will be accepted for streamlined processing.  As always, consular officers may interview any visa applicant in any category. 

Applicants who are renewing their visas may still need to make an appointment for biometrics (fingerprint and photograph) collection, and all applicants must submit all required fees and the DS-160 application form.

         This initiative is one of many steps the Department of State is taking to meet increased visa demand in India.  In 2011, consular officers in India processed nearly 700,000 nonimmigrant visa applications, an increase of more than 11 per cent over the previous year. 

Presently, applicants wait fewer than ten days for visa interview appointments and spend less than one hour at U.S. consular facilities in India. 

In September 2012, the U.S. Diplomatic Mission to India implemented a new visa processing system throughout India that further standardizes procedures and simplifies fee payment and appointment scheduling through a new website at www.ustraveldocs.com/in. 

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Do you Know?

Have a great day.

People who ride on roller coasters have a higher chance of having a blood clot in the brain.
	People with blue eyes see better in dark.
	Money isn’t made out of paper, it is made out of cotton.
	A tiny amount of liquor on a scorpion will make it go mad instantly and sting itself to death.
	Chewing gum while peeling onions will keep you from crying.
	A huge underground river runs underneath the Nile, with six times more water than the river above.
	The USA uses 29% of the world's petrol and 33% of the world's electricity.
	Wearing headphones for just an hour will increase the bacteria in your ear By 700 times.
	The animal responsible for the most human deaths world-wide is the mosquito.
	Right handed people live, on average, nine years longer than left-handed people.
	We exercise at least 30 muscles when we smile.
	Our nose is our personal air-conditioning system: it warms cold air, cools hot air and filters impurities.
	Our brain is more complex than the most powerful computer and has over 100 billion nerve cells.
	When a person dies, hearing is usually the first sense to go.
	There is a great mushroom in Oregon that is 2,400 years old. It Covers 3.4 square miles of land and is still growing.
	German Shepherds bite humans more than any other breed of dog.
	The pupil of the eye expands as much as 45 percent when a person looks at something pleasing
	Men's shirts have the buttons on the right, but women's shirts have the buttons on the left.
	The reason honey is so easy to digest is that it's already been digested by a bee.
	It cost 7 million dollars to build the Titanic and 200 million to make a film about it.
	The sound you hear when you crack your knuckles is actually the sound of nitrogen gas bubbles bursting.
	The only part of the body that has no blood supply is the cornea in the eye. It takes in oxygen directly from the air.

By Marianne Glanzman

Have a great day.

What Should I Feed My Child with ADHD?

by Marianne Glanzman, MD

RECENTLY, THERE HAS BEEN RENEWED INTEREST in the question of whether dietary interventions can be useful for children with ADHD. This article is not intended to be a review of the relative merits of different approaches, but rather a roadmap for how to implement approaches for which there is some positive evidence, safely and effectively. ADHD is not caused by your child’s diet, but increasing evidence suggests that some symptoms, particularly mood and self-control, may be affected by what she or he eats.

Eating and nutrition in childrenThe US Department of Agriculture provides Dietary Guidelines for Americans about every five years. In 2005, the familiar Food Guide Pyramid, showing the recommended number of servings per day for each food group, was modified and replaced by the first of two icons. MyPyramid showed portion sizes in cups and ounces instead of number of servings, with tables of specific recommendations for different age groups. MyPyramid was replaced by MyPlate in June 2011.

MyPlate is a simple guide showing that for each meal, one-half of the plate should consist of fruits and vegetables, one-quarter of protein, and one-quarter of carbohydrates, along with a serving of dairy or calcium-rich substitute. Highlights include:
    Emphasis is placed on vegetables, fruit, whole grains, and low-fat dairy products.
    At least half of grain intake should come from whole, not processed, grains.
    Daily protein should come from a variety of lean meats and poultry, fish, cooked dry beans, eggs and nuts.
    Some oil is important for health, and should ideally come from fish, nuts, and liquid oils.
    Saturated and trans fats, cholesterol, salt and added sugars should be minimized.

The Food and Nutrition Board establishes the recommended daily allowance (RDA) for each nutrient for each age group. The RDA is the amount of a given nutrient that meets the needs of over ninety-seven percent of the population. Some nutrients do not have an RDA because insufficient information is available. RDAs are shown on labels of supplements and supplemented foods. Will eating according to these guidelines help ADHD? Possibly.

A recent study in teens suggests that a "Western" diet—high in total fat, saturated fat, refined sugars, and sodium—is associated with double the likelihood of a person’s having ADHD compared with eating a "healthy" diet, higher in omega-3 fatty acids, fiber, and folate and low in total fat, saturated fat, and refined sugars. This study certainly doesn’t prove that the Western diet "causes" ADHD, but in the meantime, aiming to follow the guidelines is an important goal for health in general. Let’s look at some specifics.

Protein and carbohydratesProtein, made from chains of amino acids, comes from meats, fish, eggs, dairy, beans, nuts and seeds. Proteins are structural components of cells and catalysts (enzymes) for the chemical reactions. Amino acids are also precursors for the synthesis of neurotransmitters, the chemicals brain cells use to communicate. Starches and sugars are carbohydrates, our main energy source. Glucose, the simplest sugar, is essentially the only energy source for the brain.

Children who eat a substantial breakfast spend more time on task later in the morning than those who eat minimal or no breakfast. The inclusion of protein with carbohydrate is best for sustained cognitive performance over several hours. Studies looking at the effects of sugar in a meal or in the diet in the short term show little effect on cognitive performance or behavior in children with or without ADHD. A sugar drink can actually improve attention, memory, reaction time and mood, but these tend to be short-term effects when glucose levels are rising.

The best overall cognitive effects throughout the morning are achieved with a protein-rich or balanced protein-carbohydrate breakfast. A high-carbohydrate breakfast, especially one consisting of high-glycemic carbohydrates (sweets and refined, rather than whole grains which break down into glucose quickly) is more likely to be followed by a rapid rise and then a rapid fall in glucose level. A rapid fall in glucose level can be associated with adverse symptoms. Over the long term, repeated high-carbohydrate meals can lead to poor glucose utilization (the ability to get glucose into the cells where it is needed), which is associated with poorer performance on a variety of cognitive tasks.

So, how much protein is enough? There isn’t a clear answer. In general, the RDA for protein in children is about forty grams per day, which can be divided into about ten grams per meal and five grams in each of two snacks. There is roughly seven grams of protein in a cup of yogurt, a hot dog, or an egg.

To see if more protein would be helpful, try the following experiment. When your child has an even number of days off from school in a row, alternate a high-protein, low-carbohydrate breakfast one morning (such as eggs, meat, cheese, milk; no juice or fruit) with a high-carbohydrate, low-protein meal the next (pancakes or waffles, syrup, juice; no milk or meat). Give your child some tasks to do that require attention, effort, and self-control later in the morning so you are more likely to be able to tell if there is a difference.

If you see an improvement with the high-protein breakfast, it does not mean that your child must only eat protein for breakfast; some carbohydrate is best for immediate energy. A high-protein meal, if helpful, is meant for breakfast only; go back to MyPlate recommendations for other meals and snacks.

Vitamins and mineralsVitamins and minerals facilitate chemical reactions throughout the brain and body. Several individual nutrients have been associated with ADHD. These include iron, zinc, magnesium, and polyunsaturated fatty acids. Reports of supplementation with these nutrients or multi-nutrient products suggest that cognitive, mood, and antisocial behavior symptoms may be improved with supplementation, but this seems to be true primarily for individuals who are deficient to start with.

It can be difficult to assess nutritional adequacy because we don’t absorb all of the nutrients we ingest, and, while functional levels of some nutrients can be reliably measured (such as ferritin level to check for iron stores), for others, it is not certain that blood or blood cell levels accurately reflect tissue levels. If your child eats a varied, balanced diet, a broad spectrum multivitamin-multimineral supplement containing less than fifty percent of the RDA may make sense because it is very difficult for children to eat enough food to consistently supply one hundred percent of the RDA. For a child with a poor diet, more may be needed, but it would be wise to consult a nutritionist in this situation.

A "typical" multivitamin-multimineral supplement will include vitamins A, B1 (thiamine), B2 (niancin), B3 (riboflavin), B5 (pantothenic acid), B6 (pyridoxine), B12 (cyanocobalamin), C, D, E and zinc, calcium, magnesium, copper, and manganese. Some will include additional nutrients such as biotin, vitamin K, iodine, selenium, trace minerals, choline, inositol, and antioxidants. Fortified breads and breakfast cereals are importance sources of vitamins and minerals for many children. Calcium and magnesium are utilized in a 2:1 ratio in the teeth, bones, and nerves. Children who consume the recommended servings of dairy products may be getting sufficient calcium, but relatively less magnesium, and multivitamin-multimineral supplements don’t usually contain much magnesium. You may need to add some, but not more than twenty-five percent of the RDA.

Minerals and fat-soluble vitamins (A, E, D, K) can accumulate in the body if taken in excess over the long term, with potential negative consequences. Megadoses (several times the RDA) of single or combined nutrients should not be used. They can adversely affect the nervous system or liver, as well as compete with other nutrients for absorption. Since supplements aren’t regulated, it is best to purchase from a company that reports independent testing for quality control. Before using supplements, check with your doctor to insure that they don’t contain anything that may interact with medications, and bring all of your supplements when you visit the doctor.

Omega-3s and omega-6s: polyunsaturated fatty acids (PUFAs)Fatty acids are structural components of brain cell membranes and precursors for cell-to-cell communication molecules in the brain, immune, and endocrine systems. They have a carbon "backbone" that is from eleven to twenty-seven carbon molecules long. "Polyunsaturated" means they contain several double bonds.

The carbon location of the first double bond determines the name omega-3, 5, 6, 7, or 9. Shorter carbon chains are elongated by enzymes that require zinc as a cofactor. Because the same enzymes are used to elongate fatty acids in each number group, an excess in one can limit elongation of others. The 18-carbon omega-6, linoleic acid and the 18-carbon omega-3, linolenic acid are considered "essential" fatty acids because they can’t be made by the body; they must be ingested. From these, the longer carbon chain fatty acids are synthesized.

Omega-3s are found in algae, seeds (flax, hemp, sunflower, and chia), walnuts, leafy greens, and fatty fish such as salmon. Omega-6s (particularly arachidonic acid) are found in meat, dairy, eggs, and several vegetable oils. A dietary ratio of 4:1 (omega-6 to omega-3) is ideal, but the standard "Western" diet is closer to 20:1, so it is presumed that many individuals are relatively omega-3 deficient.

The omega-3’s DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), and the omega-6 GLA (gamma-linoleic acid) are most important for brain function. Children with ADHD have lower levels of these compared with children without ADHD. Studies using single supplements (either an omega-6 or DHA alone) have not shown positive treatment effects on ADHD symptoms, but studies using a combination of DHA, EPA, and GLA with a predominance of EPA have shown somewhat more promising results. Fish oil is the primary source of EPA and DHA together, and evening primrose or borage oil are sources of GLA.

Although RDAs for omega-3s do not yet exist, the Food and Nutrition Board determined Recommended Adequate Intakes for total omega-3 fatty acids in 2002. These range from 700–1600 mgs per day in children and teens. This should be given with about 50 mg of GLA. It takes about three to four months in order to replete deficient levels in cell membranes, so effects are not seen quickly, are likely to be subtle, and may be more prominent for mood or anxiety than core ADHD symptoms.

Though generally felt to be safe, PUFAs, like any supplement, should be treated like a medication, with monitoring of positive and negative effects, and without other simultaneous changes. I am aware of one young child who became aggressive after starting an omega-3 supplement, and was later found to have relatively high omega-3 levels and relatively low omega-6 levels. There are also anecdotal reports of behavioral deterioration in children taking 4000-5000 mg per day over several years. Red blood cell fatty acid levels are becoming easier to obtain and may help to guide treatment. If using fish oil, it is important to use a brand that reports independent testing to document the absence of mercury and other toxins.

Elimination dietsThere are two broad elimination strategies: the Feingold Program (elimination of artificial colors, flavors, certain preservatives, and salicylates) and elimination of specific foods.

To test the Feingold Program, all artificial colors, all artificial flavors, the preservatives BHT (butylated hydroxytoluene), BHA (butylated hydroxyanisole), and TBHQ (tertiary butylhydroxyquinone), aspirin and other non-steroidal anti-inflammatory medications, synthetic sweeteners, and naturally occurring salicylates are entirely eliminated from the diet for six weeks. Naturally occurring salicylates include oranges, tangerines, clementines, apples, grapes, raisins, berries, cherries, peaches, nectarines, apricots, plums, prunes, currants, tomatoes, cucumbers, chili and bell peppers, pickles, almonds, oil of wintergreen, birch, cloves, rose hips, chili powder, paprika, cider and cider vinegar, coffee, and tea. Allowed fruits include all melons, pineapple, banana, grapefruit, lemons, limes, all tropical fruits, such as mangoes, papaya, guava, and passionfruit. All other vegetables, nuts, spices, seeds, oils, and all meats, dairy products and grains without eliminated additives are allowed.

If an improvement is seen, the naturally-occurring salicylate foods are added back one at a time to see which, if any, provoke re-occurrence of symptoms. If an improvement is not seen, guidance through the Feingold Association can be provided about other food additives, inhaled additives, or foods that may be contributing. An adequate trial requires use of the materials from the Feingold Association that delineate acceptable and non-acceptable prepared products, since some of the eliminated items do not need to be listed on labels, and even a small amount can provoke a reaction.

Parents of children who respond typically report improvements in adaptability/flexibility, mood, and quality of sleep, and bedwetting or other physical symptoms in addition to core ADHD symptoms. Although the additives and salicylates eliminated on the Feingold Program are widely believed to affect only a small percentage of children, studies are commonly flawed in several ways that would minimize positive results. For example, one flaw is that the majority of studies evaluate the effects of dyes alone. (A British version eliminates dyes and sodium benzoate). The Feingold Program is most likely to be useful in preschoolers with sleep, irritability/mood issues, and allergic or other symptoms because they are both most likely to respond and most difficult to medicate without adverse effects.

The oligoantigenic (or "few foods") diet has been used to identify children whose neurobehavioral symptoms might be triggered by specific foods. For up to two weeks, only a limited number of low-allergen foods are allowed (for example: two meats, two starches, two fruits, certain green vegetables, oil, and vitamin/calcium supplements). If improvements are seen, foods are reintroduced singly to identify those which triggered behavior deterioration.

In one study, offending foods were eliminated again, and the subject was challenged in a blinded fashion with either a placebo or the disguised suspect food. Behavior deteriorations occurred more often with the food than placebo challenge. All children who reacted to foods reacted to more than one, and all who reacted to foods also reacted to tartrazine (yellow #5) and sodium benzoate (a preservative). The most common offending foods identified in twenty percent or more of subjects were (in decreasing order) tartrazine/benzoate, soy, cow milk, chocolate, grapes, wheat, oranges, cheese, eggs, peanuts, corn, fish, oats, melons, tomatoes, and ham/bacon. Interestingly, these are predominantly the foods that cause most classic food allergies (dairy, wheat, soy, eggs, nuts, fish) or Feingold’s high-salicylate foods (grapes, oranges, tomatoes).

Unfortunately, there is no test to identify foods that might cause behavior symptoms short of an oligoantigenic diet trial, although it may not need to be as extreme as the form used in research. The top offenders listed above may be sufficient. Neither the type of immediate-reaction IgE allergy tests typically done in the allergist’s office nor IgG-mediated ELISA blood tests can reliably identify provoking foods.

When your child won’t eat a healthy dietIf your child has a very limited diet, if you are considering supplementing with more than fifty percent of the RDA of several nutrients, if you are using an oligoantigenic diet, or if you have any other concerns about your child’s nutritional intake, it is best to seek the advice of a nutrition professional, either a nutritionist or nutritionally knowledgeable physician. A careful diet history can be analyzed to determine deficiencies or excesses.

If your child also has gastrointestinal symptoms, such as gagging, difficulty swallowing, persistent reflux or vomiting, loose stools or constipation, abdominal pain, or blood in the stool, or if he or she is not gaining weight or growing as expected, a pediatric gastroenterologist should be consulted for a thorough evaluation. An evaluation may reveal a structural, mechanical, infectious, inflammatory, metabolic, or allergic cause for poor movement of food through the GI tract or poor digestion. Children sometimes show limited food choices as their most obvious symptom of one of these conditions.

A speech or occupational therapist with feeding expertise can determine whether the skills for chewing and the oral sensory motor system are intact. If not, treatment may help; however, this does not preclude an underlying medical condition.

When the presence of a medical condition has been eliminated, a structured, repeated exposure plan using positive reinforcement can help to introduce new foods into the diet. This kind of feeding behavior management is best done during the summer without the added stress of school, and with the assistance of a psychologist or other clinician with expertise in this area.

Sometimes, nutritional or diet changes can be part of a comprehensive treatment plan to help your child with ADHD experience success. As with other interventions, a clinician who will help you evaluate the positive and negative effects is an invaluable ally.

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