What’s the difference between ADD and ADHD?
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Around one in 20 people has attention-deficit hyperactivity disorder (ADHD). It’s one of the most common neurodevelopmental disorders in childhood and often continues into adulthood.
ADHD is diagnosed when people experience problems with inattention and/or hyperactivity and impulsivity that negatively impacts them at school or work, in social settings and at home.
Some people call the condition attention-deficit disorder, or ADD. So what’s the difference?
In short, what was previously called ADD is now known as ADHD. So how did we get here?
Let’s start with some history
The first clinical description of children with inattention, hyperactivity and impulsivity was in 1902. British paediatrician Professor George Still presented a series of lectures about his observations of 43 children who were defiant, aggressive, undisciplined and extremely emotional or passionate.
Since then, our understanding of the condition evolved and made its way into the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM. Clinicians use the DSM to diagnose mental health and neurodevelopmental conditions.
The first DSM, published in 1952, did not include a specific related child or adolescent category. But the second edition, published in 1968, included a section on behaviour disorders in young people. It referred to ADHD-type characteristics as “hyperkinetic reaction of childhood or adolescence”. This described the excessive, involuntary movement of children with the disorder.
In the early 1980s, the third DSM added a condition it called “attention deficit disorder”, listing two types: attention deficit disorder with hyperactivity (ADDH) and attention deficit disorder as the subtype without the hyperactivity.
However, seven years later, a revised DSM (DSM-III-R) replaced ADD (and its two sub-types) with ADHD and three sub-types we have today:
- predominantly inattentive
- predominantly hyperactive-impulsive
- combined.
Why change ADD to ADHD?
ADHD replaced ADD in the DSM-III-R in 1987 for a number of reasons.
First was the controversy and debate over the presence or absence of hyperactivity: the “H” in ADHD. When ADD was initially named, little research had been done to determine the similarities and differences between the two sub-types.
The next issue was around the term “attention-deficit” and whether these deficits were similar or different across both sub-types. Questions also arose about the extent of these differences: if these sub-types were so different, were they actually different conditions?
Meanwhile, a new focus on inattention (an “attention deficit”) recognised that children with inattentive behaviours may not necessarily be disruptive and challenging but are more likely to be forgetful and daydreamers.
Why do some people use the term ADD?
There was a surge of diagnoses in the 1980s. So it’s understandable that some people still hold onto the term ADD.
Some may identify as having ADD because out of habit, because this is what they were originally diagnosed with or because they don’t have hyperactivity/impulsivity traits.
Others who don’t have ADHD may use the term they came across in the 80s or 90s, not knowing the terminology has changed.
How is ADHD currently diagnosed?
The three sub-types of ADHD, outlined in the DSM-5 are:
- predominantly inattentive. People with the inattentive sub-type have difficulty sustaining concentration, are easily distracted and forgetful, lose things frequently, and are unable to follow detailed instructions
- predominantly hyperactive-impulsive. Those with this sub-type find it hard to be still, need to move constantly in structured situations, frequently interrupt others, talk non-stop and struggle with self control
- combined. Those with the combined sub-type experience the characteristics of those who are inattentive and hyperactive-impulsive.
ADHD diagnoses continue to rise among children and adults. And while ADHD was commonly diagnosed in boys, more recently we have seen growing numbers of girls and women seeking diagnoses.
However, some international experts contest the expanded definition of ADHD, driven by clinical practice in the United States. They argue the challenges of unwanted behaviours and educational outcomes for young people with the condition are uniquely shaped by each country’s cultural, political and local factors.
Regardless of the name change to reflect what we know about the condition, ADHD continues to impact educational, social and life situations of many children, adolescents and adults.
Kathy Gibbs, Program Director for the Bachelor of Education, Griffith University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Gut-Healthy Labneh Orecchiette
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Labneh (a sort of yogurt-cheese made from strained yogurt) is a great probiotic, and there’s plenty of resistant starch in this dish too, from how we cook, cool, and reheat the pasta. Add to this the lycopene from the tomatoes, the ergothioneine from the mushrooms, and the healthful properties of the garlic, black pepper, and red chili, and we have a very healthy dish!
You will need
- 10 oz labneh (if you can’t buy it locally, you can make your own by straining Greek yogurt through a muslin cloth, suspended over a bowl to catch the water that drips out, overnight—and yes, plant-based is also fine if you are vegan, and the gut benefits are similar because unlike vegan cheese, vegan yogurt is still fermented)
- 6 oz wholegrain orecchiette (or other pasta, but this shape works well for this sauce)
- ¼ bulb garlic, grated
- Juice of ½ lemon
- Large handful chopped parsley
- Large handful chopped dill
- 9 oz cherry tomatoes, halved
- 9 oz mushrooms (your choice what kind), sliced (unless you went for shiitake or similar, which don’t need it due to already being very thin)
- 2 tsp black pepper, coarse ground
- 1 tsp red chili flakes
- ¼ tsp MSG or ½ tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Cook the pasta as you normally would. Drain, and rinse with cold water. Set aside.
2) Combine the labneh with the garlic, black pepper, dill, parsley, and lemon juice, in a large bowl. Set aside.
3) Heat a little olive oil in a skillet; add the chili flakes, followed by the mushrooms. Cook until soft and browned, then add the tomatoes and fry for a further 1 minute—we want the tomatoes to be blistered, but not broken down. Stir in the MSG/salt, and take off the heat.
4) Refresh the pasta by passing a kettle of boiling water through it in a colander, then add the hot pasta to the bowl of labneh sauce, stirring to coat thoroughly.
5) Serve, spooning the mushrooms and tomatoes over the labneh pasta.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Making Friends With Your Gut (You Can Thank Us Later)
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- “The Longevity Vitamin” (That’s Not A Vitamin)
Take care!
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Quercetin Quinoa Probiotic Salad
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This quercetin-rich salad is a bit like a tabbouleh in feel, with half of the ingredients switched out to maximize phenolic and gut-healthy benefits.
You will need
- ½ cup quinoa
- ½ cup kale, finely chopped
- ½ cup flat leaf parsley, finely chopped
- ½ cup green olives, thinly sliced
- ½ cup sun-dried tomatoes, roughly chopped
- 1 pomegranate, peel and pith removed
- 1 preserved lemon, finely chopped
- 1 oz feta cheese or plant-based equivalent, crumbled
- 1 tsp black pepper, coarse ground
- 1 tbsp capers
- 1 tbsp chia seeds
- 1 tbsp extra virgin olive oil
Note: you shouldn’t need salt or similar here, because of the diverse gut-healthy fermented products bringing their own salt with them
Method
(we suggest you read everything at least once before doing anything)
1) Rinse the quinoa, add the tbsp of chia seeds, cook as normal for quinoa (i.e. add hot water, bring to boil, simmer for 15 minutes or so until pearly and tender), carefully (don’t lose the chia seeds; use a sieve) drain and rinse with cold water to cool. Shake off excess water and/or pat dry on kitchen paper if necessary.
2) Mix everything gently but thoroughly.
3) Serve:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Tasty Tabbouleh with Tahini ← in case you want an actual tabbouleh
- Making Friends With Your Gut (You Can Thank Us Later)
- Fight Inflammation & Protect Your Brain, With Quercetin
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The Best Kind Of Fiber For Overall Health?
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The Fiber Of Good Health
We’ve written before about how most people in industrialized nations in general, and N. America in particular, do not get nearly enough fiber:
Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Fiber’s important for many aspects of health, not least of all the heart:
What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure
As well, of course, as being critical for gut health:
Gut Health 101: Making Friends With Your Gut (You Can Thank Us Later)
But is all fiber “prebiotic fiber”, and/or are some better than others?
Beta-glucan
A recent study (it’s a mouse study, but promising in its applicability for humans) examined the health impacts of 5 different fiber types:
- pectin
- β-glucan
- wheat dextrin
- resistant starch
- cellulose (control)
As for health metrics, they measured:
- body weight
- adiposity
- indirect calorimetry
- glucose tolerance
- gut microbiota
- metabolites thereof
What they found was…
❝Only β-glucan supplementation during HFD-feeding decreased adiposity and body weight gain and improved glucose tolerance compared with HFD-cellulose, whereas all other fibers had no effect. This was associated with increased energy expenditure and locomotor activity in mice compared with HFD-cellulose.
All fibers supplemented into an HFD uniquely shifted the intestinal microbiota and cecal short-chain fatty acids; however, only β-glucan supplementation increased cecal butyrate concentrations. Lastly, all fibers altered the small-intestinal microbiota and portal bile acid composition. ❞
If you’d like to read more, the study itself is here:
If you’d like to read less, the short version is that they are all good but β-glucan scored best in several metrics.
It also acts indirectly as a GLP-1 agonist, by the way:
The right fiber may help you lose weight
You may be wondering: what is β-glucan found in?
It’s found in many (non-animal product) foods, but oats, barley, mushrooms, and yeasts are all good sources.
Is it available as a supplement?
More or less; there are supplements that contain it generously, here’s an example product on Amazon, a cordyceps extract, of which >30% is β-glucan.
As an aside, cordyceps itself has many other healthful properties too:
Cordyceps: Friend Or Foe? ← the answer is, it depends! If you’re human, it’s a friend.
Enjoy!
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Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
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What’s The Deal With MSG?
There are a lot of popular beliefs about MSG. Is there a grain of truth, or should we take them with a grain of salt? We’ll leap straight into myth-busting:
MSG is high in salt
True (technically) False (practically)
- MSG is a salt (a monosodium salt of L-glutamic acid), but to call it “full of salt” in practical terms is like calling coffee “full of fruit”. (Coffee beans are botanically fruit)
- It does contain sodium, though which is what the S stands for!
- We talked previously about how MSG’s sodium content is much lower than that of (table) salt. Specifically, it’s about one third of that of sodium chloride (e.g. table salt).
MSG triggers gluten sensitivity
False!
Or at least, because this kind of absolute negative is hard to prove in science, what we can say categorically is: it does not contain gluten. We understand that the similar name can cause that confusion. However:
- Gluten is a protein, found in wheat (and thus wheat-based foods).
- Glutamate is an amino acid, found in protein-rich foods.
- If you’re thinking “but proteins are made from amino acids”, yes, they are, but the foundational amino acid of gluten is glutamine, not glutamate. Different bricks → different house!
The body can’t process MSG correctly
False!
The body has glutamate receptors throughout the gut and nervous system.
The body metabolizes glutamate from MSG just the same as from any other food that contains it naturally.
Read: Update on food safety of monosodium l-glutamate (MSG) ← evidence-based safety review
MSG causes “Chinese Restaurant Syndrome”
False!
Racism causes that. It finds its origins in what was originally intended as a satirical joke, that the papers picked up and ran with, giving it that name in the 1960s. As to why it grew and persisted, that has more to do with US politics (the US has been often at odds with China for a long time) and xenophobia (people distrust immigrants, such as those who opened restaurants), including nationalistic rhetoric associating immigrants with diseases.
Read: Xenophobia in America in the Age of Coronavirus and Beyond ← academic paper that gives quite a compact yet comprehensive overview
Research science, meanwhile, has not found any such correlation, in more than 40 years of looking.
PS: we realize this item in the list is very US-centric. Apologies to our non-US subscribers. We know that this belief isn’t so much of a thing outside the US—though it certainly can crop up elsewhere sometimes, too.
Are there any health risks associated with MSG, then?
Well, as noted, it does contain sodium, albeit much less than table salt. So… do go easy on it, all the same.
Aside from that, the LD50 (a way of measuring toxicity) of MSG is 15.8g/kg, so if for example you weigh 150lb (68 kg), don’t eat 2.2lb (a kilogram) of MSG.
There have been some studies on rats (or in one case, fruit flies) that found high doses of MSG could cause heart problems and/or promote obesity. However:
- this has not been observed to be the case in humans
- those doses were really high, ranging from 1g/kg to 8g/kg. So that’d be the equivalent of our 150lb person eating it by the cupful
- it was injected (as a solution) into the rats, not ingested by them
- so don’t let someone inject you with a cup of MSG!
Read: A review of the alleged health hazards of monosodium glutamate
Bottom line on MSG and health:
Enjoy in moderation, but enjoy if you wish! MSG is just the salt form of the amino acid glutamate, which is found naturally in many foods, including shrimp, seaweed, and tomatoes.
Scientists have spent more than 40 years trying to find health risks for MSG, and will probably keep trying (which is as science should be), but for now… Everything has either come up negative, or has been the result of injecting laboratory animals with megadoses.
If you’d like to try it in your cooking as a low-sodium way to bring out the flavor of your dishes, you can order it online. Cheapest in bulk, but try it and see if you like it first!
(I’ll be real with you… I have 5 kg in the pantry myself and use about half a teaspoon a day, cooking for two)
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Bone on Bone – by Dr. Meredith Warner
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What this is not: a book about one specific condition, injury, or surgery.
What this is: a guide to dealing with the common factors of many musculoskeletal conditions, inflammatory diseases, and their consequences.
Dr. Warner takes the opportunity to address the whole patient—presumably: the reader, though it could equally be a reader’s loved one, or even a reader’s patient, insofar as this book will probably be read by doctors also.
She takes an “inside-out and outside-in” approach; that is to say, addressing the problem from as many vectors as reasonably possible—including supplements, diet, dietary habits (things like intermittent fasting etc), exercise, and even sleep. And yes, she knows how difficult those latter items can be, and addresses them not merely with a “but it’s important” but also with practical advice.
As an orthopedic surgeon, she’s not a fan of surgery, and counsels the reader to avoid that if reasonably possible. She also talks about how many people in the US are encouraged to have MRI scans for financial reasons (as in, they can be profitable for the doctor/institution), and then any abnormality is used as justification for surgery, to backwards-justify the use of the MRI, even if the abnormality is not actually the cause of the pain.
Noteworthily, humans in general are a typically a pile of abnormalities in a trenchcoat. Our propensity to mutation has made us one of the most adaptable species on the planet, yet many would have us pretend that the insides of people look like they do in textbooks, or else are wrong. The reality is not so, and Dr. Warner rightly shows this for what it is.
Bottom line: if you or a loved one are suffering from, or at risk of, musculoskeletal and/or inflammatory conditions, this is a top-tier book for having a much easier time of it.
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Astaxanthin: Super-Antioxidant & Neuroprotectant
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Think Pink For Brain Health!
Astaxanthin is a carotenoid that’s found in:
- certain marine microalgae
- tiny crustaceans that eat the algae
- fish (and flamingos!) that eat the crustaceans
Yes, it’s the one that makes things pink.
But it does a lot more than that…
Super-antioxidant
Move over, green tea! Astaxanthin has higher antioxidant activity than most carotenoids. For example, it is 2–5 times more effective than alpha-carotene, lutein, beta-carotene, and lycopene:
Antioxidant activities of astaxanthin and related carotenoids
We can’t claim credit for naming it a super-antioxidant though, because:
Astaxanthin: A super antioxidant from microalgae and its therapeutic potential
Grow new brain cells
Axtaxanthin is a neuroprotectant, but that’s to be expected from something with such a powerful antioxidant ability.
What’s more special to astaxanthin is that it assists continued adult neurogenesis (creation of new brain cells):
❝The unique chemical structure of astaxanthin enables it to cross the blood-brain barrier and easily reach the brain, where it may positively influence adult neurogenesis.
Furthermore, astaxanthin appears to modulate neuroinflammation by suppressing the NF-κB pathway, reducing the production of pro-inflammatory cytokines, and limiting neuroinflammation associated with aging and chronic microglial activation.
By modulating these pathways, along with its potent antioxidant properties, astaxanthin may contribute to the restoration of a healthy neurogenic microenvironment, thereby preserving the activity of neurogenic niches during both normal and pathological aging. ❞
That first part is very important, by the way! There are so many things that our brain needs, and we can eat, but the molecules are unable to pass the blood-brain barrier, meaning they either get wasted, or used elsewhere, or dismantled for their constituent parts. In this case, it zips straight into the brain instead.
See also:
How To Grow New Brain Cells (At Any Age)
(Probably) good for the joints, too
First, astaxanthin got a glowing report in a study we knew not to trust blindly:
…and breathe. What a title that was! But, did you catch why it’s not to be trusted blindly? It was down at the bottom…
❝Conflict of interest statement
NOVAREX Co., Ltd. funded the study. Valensa International provided the FlexPro MD® ingredients, and NOVAREX Co., Ltd. encapsulated the test products (e.g., both FlexPro MD® and placebo)❞
Studies where a supplement company funded the study are not necessarily corrupt, but they can certainly sway publication bias, i.e. the company funds a bunch of studies and then pulls funding from the ones that aren’t going the way it wants.
So instead let’s look at:
Astaxanthin attenuates joint inflammation induced by monosodium urate crystals
and
Astaxanthin ameliorates cartilage damage in experimental osteoarthritis
…which had no such conflicts of interest.
They agree that astaxanthin indeed does the things (attenuates joint inflammation & ameliorates cartilage damage).
However, they are animal studies (rats), so we’d like to see studies with humans to be able to say for sure how much it helps these things.
Summary of benefits
Based on the available research, astaxanthin…
- is indeed a super-antioxidant
- is a neuroprotective agent
- also assists adult neurogenesis
- is probablygood for joints too
How much do I take, and is it safe?
A 2019 safety review concluded:
❝Recommended or approved doses varied in different countries and ranged between 2 and 24 mg.
We reviewed 87 human studies, none of which found safety concerns with natural astaxanthin supplementation, 35 with doses ≥12 mg/day.❞
Source: Astaxanthin: How much is too much? A safety review
In short: for most people, it’s very safe and well-tolerated. If you consume it to an extreme, you will likely turn pink, much as you would turn orange if you did the same thing with carrots. But aside from that, the risks appear to be minimal.
However! If you have a seafood allergy, please take care to get a supplement that’s made from microalgae, not one that’s made from krill or other crustaceans, or from other creatures that eat those.
Where can I get it?
We don’t sell it, but here’s an example product on Amazon, for your convenience
Enjoy!
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