Purdue Science and Health Briefs

February 2000 Study suggests tailoring ADHD treatment WEST LAFAYETTE, Ind. – A new study on treatment methods for children with Attention Deficit Hyperactivity Disorder (ADHD) indicates that "one size fits all" is the wrong approach when it comes to helping youngsters manage their problems. Purdue University psychology professor Betsy Hoza was part of the team of researchers that conducted the study for the National Institute of Mental Health. She says the results point to individually tailored doses of medicine together with behavior therapy as the most effective treatment for school-age children and their families. "We found that when given alone, carefully monitored medication treatment performed as well as medication combined with behavior therapy for reducing ADHD symptoms" says Hoza, who was co-investigator at one of six sites where the study was conducted. "Even though medication reduced symptoms when taken alone, it was necessary to add behavior therapy to maximize improvements when problems with parent-child relations, disruptive behavior, poor academic performance, anxiety and social skills were part of the picture." The most commonly diagnosed disorder in children, ADHD is estimated to affect between 3 percent and 5 percent of all school-age youngsters. Mental health experts estimate that on average, at least one child in every U.S. classroom needs help for ADHD. The most common symptoms are inability to sustain attention and concentration, developmentally inappropriate levels of activity, distractibility and inability to control impulsive behavior. The nearly 600 7- to 9-year-old patients involved in the study were randomly assigned one of four treatment programs: medication management; behavioral treatment; a combination of both; or routine care by their own community practitioners. Hoza assisted principal investigator William E. Pelham Jr. at the Western Psychiatric Institute in Pittsburgh, Pa. Other sites were Columbia University in New York; Duke University Medical Center in Durham, N.C.; Long Island Jewish Medical Center in New Hyde Park, N.Y.; University of California, Berkeley; University of California, Irvine; and Montreal Children's Hospital, Canada. Participants who received medication treatments were individually assessed to find the optimal dose needed, and the prescribing clinicians met with the families monthly for half-hour visits. The physicians also sought input from teachers on a monthly basis and used all of this information to make necessary adjustments to treatment. Researchers also noted that this system of treatment delivery was significantly different from that provided by community physicians, who generally saw their patients one or two times a year and for shorter periods of time. "I think the message for doctors is that medication treatment can be made dramatically more effective for children when the stimulants are prescribed at an optimal dose, and patients are monitored closely and regularly," Hoza says. "Monthly office visits with the family and monthly contacts with the child's teachers seem to be indicated. And referral for behavior therapy is necessary when problems extend beyond ADHD symptoms themselves." Two papers detailing the results of the study were published in the December issue of the American Medical Associations' Archives of General Psychiatry. CONTACTS: Betsy Hoza, (765) 494-6996, blaze@psych.purdue.edu; Marilyn Weeks, National Institute of Mental Health, (310) 433-4536. Diet and exercise play critical role in cancer prevention WEST LAFAYETTE, Ind. – Poor diet and lack of exercise are behind just as many cancer cases as smoking, says Dennis Savaiano, dean of Purdue's School of Consumer and Family Sciences and professor of foods and nutrition. "Approximately one-third of cancer cases are related to smoking, one-third to poor diet and lack of exercise, and one-third to genetic or other factors," he says. "Most Americans are already aware of the detrimental effects of smoking, but the rate of obesity and poor diet in this country is cause for alarm." Savaiano, who is chairman of the Food and Nutrition Science Alliance, or FANSA, recently worked with several of the organization's members to review scientific studies on diet and cancer. FANSA is a joint committee of the American Dietetic Association, the American Society for Nutritional Sciences, the American Society for Clinical Nutrition and the Institute of Food Technologists. The group has issued a statement urging Americans to change their diets to help reduce the number of cancer-related deaths. Savaiano notes that though some types of cancer are more influenced by diet than others, nutrition and food scientists agree that there are four practical diet-related ways to lower cancer risk: • Eat plenty of fruits, vegetables, whole grains and legumes in accordance with the U.S. Department of Agriculture's Food Guide Pyramid. • Avoid empty calories from highly processed foods that are high in fat and/or sugar. • Choose activities that involve moderate or vigorous exercise. • Limit or abstain from alcohol. He says that consumers should not let fear of pesticide residues deter them from eating fruits and vegetables, because the benefits of eating these foods appear to outweigh any potential risk. Savaiano attributes Americans' difficulty in developing a healthy lifestyle to several factors, including lack of knowledge on how to implement specific actions and a lack of marketing forces aimed at creating consumer demand for a healthy lifestyle. "Many foods that are widely advertised tend to be high in calories and relatively low in nutrients, while few advertisements appear for less processed foods such as vegetables and fruits or whole grains and beans," he says. Long workweeks also translate into less time for meal preparation, he says, noting that meals often are purchased as takeout or from fast-food restaurants. Savaiano says that in order to effect a change, all food, nutrition, fitness, health and government organizations must work together to promote healthy lifestyles. CONTACT: Savaiano, (765) 494-8213; savaiano@cfs.purdue Compiled by Susan Gaidos, (765) 494-2081; sgaidos@purdue.edu Purdue News Service: (765) 494-2096; purduenews@purdue.edu To the Purdue News and Photos Page