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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I’ve been diagnosed with cancer. How do I tell my children?
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With around one in 50 adults diagnosed with cancer each year, many people are faced with the difficult task of sharing the news of their diagnosis with their loved ones. Parents with cancer may be most worried about telling their children.
It’s best to give children factual and age-appropriate information, so children don’t create their own explanations or blame themselves. Over time, supportive family relationships and open communication help children adjust to their parent’s diagnosis and treatment.
It’s natural to feel you don’t have the skills or knowledge to talk with your children about cancer. But preparing for the conversation can improve your confidence.
Benjamin Manley/Unsplash Preparing for the conversation
Choose a suitable time and location in a place where your children feel comfortable. Turn off distractions such as screens and phones.
For teenagers, who can find face-to-face conversations confronting, think about talking while you are going for a walk.
Consider if you will tell all children at once or separately. Will you be the only adult present, or will having another adult close to your child be helpful? Another adult might give your children a person they can talk to later, especially to answer questions they might be worried about asking you.
Choose the time and location when your children feel comfortable. Craig Adderley/Pexels Finally, plan what to do after the conversation, like doing an activity with them that they enjoy. Older children and teenagers might want some time alone to digest the news, but you can suggest things you know they like to do to relax.
Also consider what you might need to support yourself.
Preparing the words
Parents might be worried about the best words or language to use to make sure the explanations are at a level their child understands. Make a plan for what you will say and take notes to stay on track.
The toughest part is likely to be saying to your children that you have cancer. It can help to practise saying those words out aloud.
Ask family and friends for their feedback on what you want to say. Make use of guides by the Cancer Council, which provide age-appropriate wording for explaining medical terms like “cancer”, “chemotherapy” and “tumour”.
Having the conversation
Being open, honest and factual is important. Consider the balance between being too vague, and providing too much information. The amount and type of information you give will be based on their age and previous experiences with illness.
Remember, if things don’t go as planned, you can always try again later.
Start by telling your children the news in a few short sentences, describing what you know about the diagnosis in language suitable for their age. Generally, this information will include the name of the cancer, the area of the body affected and what will be involved in treatment.
Let them know what to expect in the coming weeks and months. Balance hope with reality. For example:
The doctors will do everything they can to help me get well. But, it is going to be a long road and the treatments will make me quite sick.
Check what your child knows about cancer. Young children may not know much about cancer, while primary school-aged children are starting to understand that it is a serious illness. Young children may worry about becoming unwell themselves, or other loved ones becoming sick.
Young children might worry about other loved ones becoming sick. Pixabay/Pexels Older children and teenagers may have experiences with cancer through other family members, friends at school or social media.
This process allows you to correct any misconceptions and provides opportunities for them to ask questions. Regardless of their level of knowledge, it is important to reassure them that the cancer is not their fault.
Ask them if there is anything they want to know or say. Talk to them about what will stay the same as well as what may change. For example:
You can still do gymnastics, but sometimes Kate’s mum will have to pick you up if I am having treatment.
If you can’t answer their questions, be OK with saying “I’m not sure”, or “I will try to find out”.
Finally, tell children you love them and offer them comfort.
How might they respond?
Be prepared for a range of different responses. Some might be distressed and cry, others might be angry, and some might not seem upset at all. This might be due to shock, or a sign they need time to process the news. It also might mean they are trying to be brave because they don’t want to upset you.
Children’s reactions will change over time as they come to terms with the news and process the information. They might seem like they are happy and coping well, then be teary and clingy, or angry and irritable.
Older children and teenagers may ask if they can tell their friends and family about what is happening. It may be useful to come together as a family to discuss how to inform friends and family.
What’s next?
Consider the conversation the first of many ongoing discussions. Let children know they can talk to you and ask questions.
Resources might also help; for example, The Cancer Council’s app for children and teenagers and Redkite’s library of free books for families affected by cancer.
If you or other adults involved in the children’s lives are concerned about how they are coping, speak to your GP or treating specialist about options for psychological support.
Cassy Dittman, Senior Lecturer/Head of Course (Undergraduate Psychology), Research Fellow, Manna Institute, CQUniversity Australia; Govind Krishnamoorthy, Senior Lecturer, School of Psychology and Wellbeing, Post Doctoral Fellow, Manna Institute, University of Southern Queensland, and Marg Rogers, Senior Lecturer, Early Childhood Education; Post Doctoral Fellow, Manna Institute, University of New England
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Chia Seeds vs Pumpkin Seeds – Which is Healthier?
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Our Verdict
When comparing chia seeds to pumpkin seeds, we picked the chia.
Why?
Both are great! But chia is best.
Note: we’re going to abbreviate them both to “chia” and “pumpkin”, respectively, but we’ll still be referring to the seeds throughout.
In terms of macros, pumpkin has a little more protein and notably higher carbs, whereas chia has nearly 2x the fiber, as well as more fat, and/but they are famously healthy fats. We’ll call this category a subjective win for chia, though you might disagree if you want to prioritize an extra 2g of protein per 100g (for pumpkin) over an extra 16g of fiber per 100g (for chia). Chia is also vastly preferable for omega-3.
When it comes to vitamins, pumpkin is marginally higher in vitamin A, while chia is a lot higher in vitamins B1, B2, B3, B9, C, and E. An easy win for chia.
In the category of minerals, for which pumpkin seeds are so famously a good source, chia has a lot more calcium, copper, iron, magnesium, manganese, phosphorus, and selenium. On the other hand, pumpkin has more potassium and zinc. Still, that’s a 7:2 win for chia.
Adding up the categories makes for a very compelling win for the humble chia seed.
Want to learn more?
You might like to read:
If You’re Not Taking Chia, You’re Missing Out: The Tiniest Seeds With The Most Value
Take care!
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Avoiding/Managing Osteoarthritis
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Avoiding/Managing Osteoarthritis
Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation).
Inflammatory vs Non-Inflammatory Arthritis
Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.
Some forms, such as rheumatoid arthritis, are of the inflammatory kind. We wrote about that previously:
See: Avoiding/Managing Rheumatoid Arthritis
You may be wondering: how does one get non-inflammatory inflammation of the joints?
The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause.
So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can; it’s just not the prime focus.
So, what should we focus on?
First and foremost: avoiding wear-and-tear if possible. Naturally, we all must live our lives, and sometimes that means taking a few knocks, and definitely it means using our joints. An unused joint would suffer just as much as an abused one. But, we can take care of our joints!
We wrote on that previously, too:
See: How To Really Look After Your Joints
New osteoarthritis medication (hot off the press!)
At 10almonds, we try to keep on top of new developments, and here’s a shiny new one from this month:
- Methotrexate to treat hand osteoarthritis with synovitis (12th Oct, clinical trial)
- New research has found an existing drug could help many people with painful hand osteoarthritis (24th Oct, pop-science article about the above, but still written by one of the study authors!)
Note also that Dr. Flavia Cicuttini there talks about what we talked about above—that calling it non-inflammatory arthritis is a little misleading, as the inflammation still occurs.
And finally…
You might consider other lifestyle adjustments to manage your symptoms. These include:
- Exercise—gently, though!
- Rest—while keeping mobility going.
- Mobility aids—if it helps, it helps.
- Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility.
- Only you can decide where to draw the line when it comes to that trade-off.
You can also check out our previous article:
See: Managing Chronic Pain (Realistically!)
Take good care of yourself!
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How much time should you spend sitting versus standing? New research reveals the perfect mix for optimal health
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People have a pretty intuitive sense of what is healthy – standing is better than sitting, exercise is great for overall health and getting good sleep is imperative.
However, if exercise in the evening may disrupt our sleep, or make us feel the need to be more sedentary to recover, a key question emerges – what is the best way to balance our 24 hours to optimise our health?
Our research attempted to answer this for risk factors for heart disease, stroke and diabetes. We found the optimal amount of sleep was 8.3 hours, while for light activity and moderate to vigorous activity, it was best to get 2.2 hours each.
Finding the right balance
Current health guidelines recommend you stick to a sensible regime of moderate-to vigorous-intensity physical activity 2.5–5 hours per week.
However mounting evidence now suggests how you spend your day can have meaningful ramifications for your health. In addition to moderate-to vigorous-intensity physical activity, this means the time you spend sitting, standing, doing light physical activity (such as walking around your house or office) and sleeping.
Our research looked at more than 2,000 adults who wore body sensors that could interpret their physical behaviours, for seven days. This gave us a sense of how they spent their average 24 hours.
At the start of the study participants had their waist circumference, blood sugar and insulin sensitivity measured. The body sensor and assessment data was matched and analysed then tested against health risk markers — such as a heart disease and stroke risk score — to create a model.
Using this model, we fed through thousands of permutations of 24 hours and found the ones with the estimated lowest associations with heart disease risk and blood-glucose levels. This created many optimal mixes of sitting, standing, light and moderate intensity activity.
When we looked at waist circumference, blood sugar, insulin sensitivity and a heart disease and stroke risk score, we noted differing optimal time zones. Where those zones mutually overlapped was ascribed the optimal zone for heart disease and diabetes risk.
You’re doing more physical activity than you think
We found light-intensity physical activity (defined as walking less than 100 steps per minute) – such as walking to the water cooler, the bathroom, or strolling casually with friends – had strong associations with glucose control, and especially in people with type 2 diabetes. This light-intensity physical activity is likely accumulated intermittently throughout the day rather than being a purposeful bout of light exercise.
Our experimental evidence shows that interrupting our sitting regularly with light-physical activity (such as taking a 3–5 minute walk every hour) can improve our metabolism, especially so after lunch.
While the moderate-to-vigorous physical activity time might seem a quite high, at more than 2 hours a day, we defined it as more than 100 steps per minute. This equates to a brisk walk.
It should be noted that these findings are preliminary. This is the first study of heart disease and diabetes risk and the “optimal” 24 hours, and the results will need further confirmation with longer prospective studies.
The data is also cross-sectional. This means that the estimates of time use are correlated with the disease risk factors, meaning it’s unclear whether how participants spent their time influences their risk factors or whether those risk factors influence how someone spends their time.
Australia’s adult physical activity guidelines need updating
Australia’s physical activity guidelines currently only recommend exercise intensity and time. A new set of guidelines are being developed to incorporate 24-hour movement. Soon Australians will be able to use these guidelines to examine their 24 hours and understand where they can make improvements.
While our new research can inform the upcoming guidelines, we should keep in mind that the recommendations are like a north star: something to head towards to improve your health. In principle this means reducing sitting time where possible, increasing standing and light-intensity physical activity, increasing more vigorous intensity physical activity, and aiming for a healthy sleep of 7.5–9 hours per night.
Beneficial changes could come in the form of reducing screen time in the evening or opting for an active commute over driving commute, or prioritising an earlier bed time over watching television in the evening.
It’s also important to acknowledge these are recommendations for an able adult. We all have different considerations, and above all, movement should be fun.
Christian Brakenridge, Postdoctoral research fellow at Swinburne University Centre for Urban Transitions, Swinburne University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Water Water Everywhere, But Which Is Best To Drink?
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Well Well Well…
In Tuesday’s newsletter, we asked you for your (health-related) opinion on drinking water—with the understanding that this may vary from place to place. We got the above-depicted, below-described, set of responses:
- About 65% said “Filtered is best”
- About 20% said “From the mains is best”
- About 8% said “Bottled is best”
- About 3% said “Distilled is best”
- About 3% said “Some other source is best”
Of those who said “some other source is best”, one clarified that their preferred source was well water.
So what does the science say?
Fluoridated water is bad for you: True or False?
False, assuming a normal level of consumption. Rather than take up more space today though, we’ll link to what we previously wrote on this topic:
You may be wondering: but what if my level of consumption is higher than normal?
Let’s quickly look at some stats:
- The maximum permitted safety level varies from place to place, but is (for example) 2mg/l in the US, 1.5mg/l in Canada & the UK.
- The minimum recommended amount also varies from place to place, but is (for example) 0.7mg/l in Canada and the US, and 1mg/l in the UK.
It doesn’t take grabbing a calculator to realize that if you drink twice as much water as someone else, then depending on where you are, water fluoridated to the minimum may give you more than the recommended maximum.
However… Those safety margins are set so much lower than the actual toxicity levels of fluoride, that it doesn’t make a difference.
For example: your writer here takes a medication that has the side effect of causing dryness of the mouth, and consequently she drinks at least 3l of water per day in a climate that could not be described as hot (except perhaps for about 2 weeks of the year). She weighs 72kg (that’s about 158 pounds), and the toxicity of fluoride (for ill symptoms, not death) is 0.2mg/kg. So, she’d need 14.4mg of fluoride, which even if the water fluoridation here were 2mg/l (it’s not; it’s lower here, but let’s go with the highest figure to make a point), would require drinking more than 7l of water faster than the body can process it.
For more about the numbers, check out:
Acute Fluoride Poisoning from a Public Water System
Bottled water is the best: True or False?
False, if we consider “best” to be “healthiest”, which in turn we consider to be “most nutrients, with highest safety”.
Bottled water generally does have higher levels of minerals than most local mains supply water does. That’s good!
But you know what else is generally has? Microplastics and nanoplastics. That’s bad!
We don’t like to be alarmist in tone; it’s not what we’re about here, but the stats on bottled water are simply not good; see:
We Are Such Stuff As Bottles Are Made Of
You may be wondering: “but what about bottled water that comes in glass bottles?”
Indeed, water that comes in glass bottles can be expected to have lower levels of plastic than water that comes in plastic bottles, for obvious reasons.
However, we invite you to consider how likely you believe it to be that the water wasn’t stored in plastic while being processed, shipped and stored, before being portioned into its final store-ready glass bottles for end-consumer use.
Distilled water is the best: True or False?
False, generally, with caveats:
Distilled water is surely the safest water anywhere, because you know that you’ve removed any nasties.
However, it’s also devoid of nutrients, because you also removed any minerals it contained. Indeed, if you use a still, you’ll be accustomed to the build-up of these minerals (generally simplified and referenced as “limescale”, but it’s a whole collection of minerals).
Furthermore, that loss of nutrients can be more than just a “something good is missing”, because having removed certain ions, that water could now potentially strip minerals from your teeth. In practice, however, you’d probably have to swill it excessively to cause this damage.
Nevertheless, if you have the misfortune of living somewhere like Flint, Michigan, then a water still may be a fair necessity of life. In other places, it can simply be useful to have in case of emergency, of course.
Here’s an example product on Amazon if you’d like to invest in a water still for such cases.
PS: distilled water is also tasteless, and is generally considered bad, tastewise, for making tea and coffee. So we really don’t recommend distilling your water unless you have a good reason to do so.
Filtered water is the best: True or False?
True for most people in most places.
Let’s put it this way: it can’t logically be worse than whatever source of water you put into it…
Provided you change the filter regularly, of course.
Otherwise, after overusing a filter, at best it won’t be working, and at worst it’ll be adding in bacteria that have multiplied in the filter over however long you left it there.
You may be wondering: can water filters remove microplastics, and can they remove minerals?
The answer in both cases is: sometimes.
- For microplastics it depends on the filter size and the microplastic size (see our previous article for details on that).
- For minerals, it depends on the filter type. Check out:
The H2O Chronicles | 5 Water Filters That Remove Minerals
One other thing to think about: while most water filtration jugs are made of PFAS-free BPA-free plastics for obvious reasons, for greater peace of mind, you might consider investing in a glass filtration jug, like this one ← this is just one example product on Amazon; by all means shop around and find one you like
Take care!
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Dioscorea Villosa: Hormones, Arthritis, & Skin
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On A Wild Yam Chase?
We recently came across a supplement blend that had wild yam extract as a minor ingredient. Our plucky (and usually very knowledgable) researcher had never heard of its use before, so she set about doing her thing. This is what she found…
What health claims are made?
Wild yam extract (Dioscorea villosa) is traditionally sold and used for:
- Balancing hormones
- Combating arthritis
- Anti-aging effects for the skin
Does it balance hormones?
First, as a quick catch-up, we’ll drop a previous article of ours for your convenience:
What Does “Balance Your Hormones” Even Mean?
We couldn’t find almost any studies into wild yam extract’s hormone-balancing effects, but we did find one study, and:
❝Symptom scores showed a minor effect of both placebo and active treatment on diurnal flushing number and severity and total non-flushing symptom scores, and on nocturnal sweating after placebo, but no statistical difference between placebo and active creams.
This study suggests that short-term treatment with topical wild yam extract in women suffering from menopausal symptoms is free of side-effects, but appears to have little effect on menopausal symptoms❞
…which is a very thorough, polite, sciencey way of saying “wow, this does so many different kinds of nothing”
On the one hand, this was a small study (n=23). On the other hand, it was also literally the only study we could find.
Does it combat arthritis?
Maybe! We again didn’t find much research into this but we did find two in vitro studies that suggests that diosgenin (which can be derived from wild yam extract) helps:
- Diosgenin inhibits IL-1β-induced expression of inflammatory mediators in human osteoarthritis chondrocytes
- Diosgenin, a plant steroid, induces apoptosis in human rheumatoid arthritis synoviocytes with cyclooxygenase-2 overexpression
And we also found a rodent study that found that wild yam extract specifically helped against “acetic acid-induced writhing and formalin-induced pain“, and put that down to anti-inflammatory properties:
So, none of these studies tell us much about whether it would be helpful for humans—with or without arthritis, and hopefully without “acetic acid-induced writhing and formalin-induced pain”.
However, they do suggest that it would be reasonable to test in humans next.
You might prefer:
- Tips For Avoiding/Managing Osteoarthritis
- Tips For Avoiding/Managing Rheumatoid Arthritis
- How to Prevent (or Reduce) Inflammation
Does it keep skin young?
Again, research is thin on the ground, but we did find some! A study with wild-yam-derived diosgenin found that it didn’t make anything worse, and otherwise performed a similar role to vitamin A:
Read: Novel effects of diosgenin on skin aging
That was on rats with breast cancer though, so its applicability to healthy humans may be tenuous (while in contrast, simply getting vitamin A instead is a known deal).
Summary
- Does it balance hormones? It probably does little to nothing in this regard
- Does it combat arthritis? It probably has anti-inflammatory effects, but we know of no studies in humans. There are much more well-established anti-inflammatories out there.
- Does it keep the skin young? We know that it performs a role similar to vitamin A for rats with breast cancer, and didn’t make anything worse for them. That’s the extent of what we know.
Where can I get some?
In the unlikely event that the above research review has inspired you with an urge to buy wild yam extract, here is an example product for your convenience.
Some final words…
If you are surprised that we’re really not making any effort to persuade you of its merits, please know that (outside of the clearly-marked sponsor section, which helps us keep the lights on, so please do visit those) we have no interest in selling you anything. We’re genuinely just here to inform 🙂
If you are wondering why we ran this article at all if the supplement has negligible merits, it’s because science is science, knowledge is knowledge, and knowing that something has negligible merit can be good knowledge to have!
Also, running articles like this from time to time helps you to know that when we do sing the praises of something, it’s with good reason
Take care!
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