Recently a salesperson visited our office with info on what she was calling a “medical food for ADHD”. It is a pill available only by prescription.
Sigh. Don’t fall for it.
When I looked at the literature for this product, there was a lot of slick pharma-esque marketing material, clearly created to appeal to pediatricians or psychiatrists accustomed to the ease of prescribing stimulant medications for children (and not familiar with the strategy of simply helping families enjoy actual whole food to feel better). It was to be sold via prescription only, even though it’s not terribly different from dozens if not hundreds of other preparations already out there that you can buy yourself.
The product that the salesperson brought in was simply a pill supplement of omega 3 fatty acids (think fish oils) and phosphatidyl serine, two things found in many other supplements, in some foods, and in healthy brains. Though the “white paper” for this product made it sound as though this was a breakthrough that only this manufacturer had studied, many authors have found the same thing that the scientist giving a lecture (and free dinner, in true, woo-the-prescriber fashion) on this product found: Clinical trials show these two compounds to be effective for many things, including inattention, dyslexia, low mood, impulsivity, sensory processing, and hyperactivity, while improving dark adaptation and tracking for the eyes. Yes, a child’s brain and eyes need DHA (docohexasanoic acid, an omega 3 fatty acid we know and love from fish oil) and phosphatidyl serine, a ubiquitous molecule in healthy brains that is part amino acid (from protein) and part lipid (from fats). I just recently posted on the crucial importance of ample, varied, and traditional fats in kids’ diets for this very reason.
No, these guys aren’t the first ones down the pike to notice that kids with ADHD benefit from these lipids (a fancy word for fats). Enzymotec, the company behind this, seems late in lipids-for-ADHD game at best – but they are definitely jumping on the increasingly popular pharma industry bandwagon to beef up their earnings by claiming special pharmaceutical status for “new” products that are just… a fancy word for food. While there’s no question that supplements of these deliver a benefit that is difficult to get by eating enough from foods, especially for omega 3 fatty acids, these are still naturally occurring substances that don’t necessarily need a slick, patented liposomal bubble around them to get absorbed into your child’s brain.
But what really irked me was the claim that this is a “medical food for ADHD” that offers a “whole new way to think about health” – as if using whole foods and high quality, standardized-dose, toxin-free fish oil, or liposomal supplements is new.
In order for anything to be a medical food, it has to be disease or condition specific, and it has to be something that a person can’t obtain from food or other naturally occuring sources. Here’s the FDA criteria for medical foods quoted on the website promoting this product:
Medical foods are artificial foods, formulated into complexes of fats, proteins, carbohydrates, vitamins and minerals, that are FDA-approved to replace real, actual food. Besides vitamins or minerals, they have calories and protein in them. They are intended to substitute for food, meaning, a child could literally not eat any food and could have basic nutritional needs met with just the medical food version if necessary. If you fed your child nothing but these miraculous ADHD pills, you would surely have a problem, and you surely would not “cure” their ADHD, because they would be dying of malnutrition. And, having ADHD is not a condition that prevents anyone from eating or metabolizing DHA, omega 3 fatty acids, or phosphatidyl serine from a variety of foods or supplements. So, I am puzzled by the “medical food” status reportedly granted here.
Though artificial medical foods may sound a little horrifying, there is a place for this stuff: Kids who have had bowel surgeries or procedures, kids with an inability to eat orally for whatever reason, kids who have severe malnutrition and failure to thrive, infants with special situations that make usual feeding impossible, kids with severe inflammatory bowel disease or eosinophilic esophagitis or severe multiple food protein intolerance .. any of these can warrant using a prescribed medical food, in the form of a formula with all basic essential nutrients in it, including calories. I’ve used these in my practice many times, and at the right time and place, with monitoring, they are useful and successful. They can make it easy for an injured gut to quickly take in replenishment, because these are in a format that require little to no digestion or enzymatic action to be absorbed. But, because they alter gut bacteria away from what is ideal for humans (some literature shows that they favor growth of nastier gut microbes like Clostridia difficile, Helicobactor pylori, or excessive fungal species), my goal is always to repair a child’s gut to the point where they can eat real food again.
The other irksome thing about this product is that it further demonizes ADHD, which is something I don’t think families need. In order to get the FDA to approve a product as a medical food for ADHD, the manufacturer has to frame ADHD as a diagnosable condition that precludes a patient from getting this nutrient in other ways.
Of course, this isn’t true for ADHD and these lipids.
Many, myself included, consider much of what is diagnosed as ADHD in kids as the net effect of toxic overload from environment and GMO foods, over use of vaccines and antibiotics, and a diet heavy on nutritionally vacant processed foods. This is reversible, as I have witnessed many times in my practice, as many parent anecdotes report, and even as literature studying these lipids have found. You don’t need to fatten the portfolio of a pharmaceutical company to make this happen. Kids eating foods that deliver ample traditional healthy brain fats, varied protein, and minerals are supporting their brains better for learning, growing, and thriving.
I’ve seen products like this before, and have wondered: Do the people creating these realize these products are deceptive, in that equally effective, non-prescription products may be had? That even though they have gone through all the hoops to get FDA approval to sell natural substances from foods in this way, and trumpet claims for having patented them, that people can actually just go buy or eat this stuff on their own? Who knows – but obviously, Enzomytec investors hope you and your doctor believe that ADHD is a mysterious condition that only their magic pill can cure. This company’s own literature admits that the FDA does not require pre-approval for medical food status, a loop hole that many pharmaceutical firms leverage to sell you stuff that may actually be available to you from eating a rich and varied diet, or from good quality supplements that may be cheaper. As it becomes more and more apparent that whole, organic foods plus thoughtful use of naturally occurring food sourced compounds in supplements can work better than a prescription drug for many conditions, pharmaceutical companies are scrambling to come up with these “medical foods” as a way to cash in.
Perhaps this is a win for those among us who only do something when it’s ordered on a prescription pad. We’ve all been there. How many of us have been told to eat differently for a child’s (or our own) health, only to pass on it, in search of that magic bullet pill instead? Fair enough, sometimes that is what it takes. But just so you know: Eating mostly whole food is better for your brain and body, than eating mostly processed food plus a pill or two. For example, you might be amazed to try fermented cod liver oil instead of these prescription pills, and your child may experience far greater benefits. If you like, add a GMO free, soy free phosphatidyl serine pill also once a day, and give it a good two months. Your child will gradually shift with better attention, calming, and focus as these healthy fats re-populate brain, eye, and nerve tissue.