NORTHCENTRAL UNIVERSITY
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Learner: Teka L. Williams

Academic Integrity: All work submitted in each course must be the Learner’s own. This includes all assignments, exams, term papers, and other projects required by the faculty mentor. The known submission of another person’s work represented as that of the Learner’s without properly citing the source of the work will be considered plagiarism and will result in an unsatisfactory grade for the work submitted or for the entire course, and may result in academic dismissal.

Psych 6302-8 Dr. Nickerson
Impact of Psychological Illness on Nutrition Assignment # 6

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Impact of Psychological Illness on Nutrition Healthy nutrition is often a reflection of healthy living in general. Psychosocial behaviors, psychological illness, cognitive deficiencies, and body image are among the many behavioral and psychosocial factors that can have an impact on nutrition. Attention deficit hyperactivity disorder (ADHD) is amongst the most common neurobehavioral disorders in children, with a prevalence rate as high as four percent to twelve percent in school-aged children (Juneja, Jain, Singh, & Mallika, 2010). It has been estimated for school aged boys to be three times more likely to be diagnosed with ADHD than school age girls; no explanation for this disproportional rate has yet to be provided This mental disorder is usually accompanied by depression, mood disorders, anxiety, bipolar disorder and suicidal tendencies. ADHD has been further linked to antisocial problems (i.e. oppositional defiant disorder and conduct disorder.
When combined with these problems, ADHD can lead to antisocial behavior, substance abuse, and borderline personality disorder in late adolescence and adulthood (Biederman, 1997). Due to the complexity of ADHD, it’s difficult to establish the exact cause for this mental disorder. Yet, the biological influence of the dopamine deficit theory has been offered as a possible insight to ADHD. According to Sinn (2008), abnormalities in the dopamine modulated frontal- striatal circuits were evident in functional studies and brain imaging. A link has been established between ADHD and polymorphisms of dopamine receptor D4 gene, dopamine receptor D5 gene and dopamine transporter gene. Dopamine synthesis is reliant on the accessibility of iron. According to research children with ADHD have low iron levels in comparison to non-ADHD children; another phenomenon which has yet to be explained. This leads to the indication of biological influences having a possible link to ADHD; impacting the brain’s development and neurological functioning.
Iron the essential mineral promotes healthy development and functioning of the brain.
It has the vital in the involvement of the structuring and functioning of the central nervous system. Iron further “acts” as the building block of the neurotransmitters (chemicals which dispatch information around the brain and the nervous system). Neurotransmitter systems are maturing during key periods of high risk for iron deficiency (Lozoff, Beard, Connor, Felt,
Georgeiff, & Schallert, 2008). The presence of iron deficiency during the maturing phase will trigger change(s) in the activity of dopamine (a chemical involved in controlling movement). This change has been associated with poor cognitive development and it has been proposed that iron deficiency may affect cognition and behavior via its role as a co-factor fortyrosine hydroxylase, the rate-limiting enzyme involved in dopamine synthesis (Black, 2003).
There was also a trend toward a correlation between the hyperactivity subscore and serum ferritin levels, the children with more severe iron deficiencies suffering from increased more restlessness (Konofal, Lecendreux, Arnulf, & Mouren, 2004). Restless leg syndrome
(sensation to move the extremities) is an associated syndrome of ADHD. According to research, ADHD children who suffer from restless leg syndrome have lower iron levels than children without restless legs syndrome. Konofal & Cortese (2007) suggest iron deficiency is associated with restless legs syndrome, which is a common co-morbid condition in children with
ADHD symptoms, and may, therefore, account for greater variance of symptoms in this subgroup of children. The cause of RLS in children with ADHD and iron deficiency is still under
“investigation” by researchers. But the assumption (for now) alludes to the central nervous system; problems with the dopamine neurotransmitter system. The common link between
Children with ADHD and RLS are the lower levels of dopamine in the subetantia Ingra. Since
Iron is essential to the production of dopamine; it further plays a central role for the studying of
RLS.
It is not uncommon for children with ADHD to suffer with co-occurrence of restless legs syndrome and impaired sleep disturbance. Being that impaired sleep disturbance is one of the symptoms of children with ADHD, cases studies have shown that sleep disorder obstructive sleep apnea could possibly be the cause of ADHD and other learning disabilities.
Sleep apnea has an adverse affect on children’s quality of sleep, leading to inattentiveness, concentration difficulties and irritability the following day at school. Inattentiveness, concentration difficulties and irritability are all traits of ADHD. Children with ADHD have significantly higher daytime sleepiness, apnea-hypopea indexes, and more movements in sleep compared to children who do not suffer from ADHD (Cortese, Konofal, Yateman, Mouren, &
Lecendreux, 2006). The higher daytime sleepiness for children with ADHD in comparison to non- ADHD children offers no feasible explanation. But studies have shown a link between daytime sleep disturbances to ADHD and ADHD to nighttime sleep disturbance as well.
According to Konofal and colleagues the possible link between the sleep disturbances and children with ADHD would be the serum ferritin levels. Serum ferritin is a reliable measure of iron stores in body tissues, including the brain, and low level can detect an early iron deficiency sufficient to cause neurological or behavioral symptoms (Juneja, Jain, Singh, &
Mallika, 2008). It is not uncommon for children with ADHD to have lower levels of serum levels in comparison with non-ADHD children; there was no explanation to the variance. Any time serum ferritin levels are below forty-five ug/l there is the likelihood for sleep wake transition disorders and abnormal sleep movements. The extreme decrease in serum ferritin levels may offer a possible explanation for at least thirty percent of ADHD severity. Since iron deficiency alters dopaminergic functions and given that the dopaminergic system is involved in motor control, it was speculated that a potential dysfunction of dopaminergic pathways may play a significant role, similarly to what has been hypothesized for restless legs syndrome (Allen, &
Early, 2007). Simakajornboon (2003) reported a decrease in periodic limb movements in sleep in children treated with iron sulphate. An uncontrolled pilot study researched the effects of iron supplementation on ADHD symptoms of non-anemic boys. The non-anemic boys were administered 5mg/kg of (ferrous-calcium citrate) supplement daily over a thirty day period.
After the thirty days blood samples were drawn from each of the non-anemic boys. The results of the blood work revealed an increase in serum ferritin levels and significant decrease of symptoms on Conners’ Rating Scales. There was no profound effect of the administering of iron supplement to non-anemic children. It was suggested this study be repeated with iron- deficient children with ADHD to determine the benefits of iron supplements. Iron is a co-enzyme in the anabolism of catecholamines (Kane, ). Since iron is vital to the creation of the neurotransmitters; it’s best to control the activity of the neurotransmitter dopamine. Therefore it may be beneficial to administer iron supplements to children with
ADHD and monitor the effect on ADHD. This concept appears to be a “no brainer” as to use iron supplements to combat the effects of ADHD. But not enough studies have be conducted to determine the positive or negative effects of iron supplements on ADHD. The following three studies, provides limited insight on iron supplements on ADHD. According to Kane (2006), none of the studies were double-blind studies, which means we cannot really rely on them all that much. Research 1
Research was conducted to evaluate the benefit(s) of iron supplements on ADHD boys between the ages of seven and eleven years old. According to method of the research none of the fourteen boys were diagnosed as being iron deficient at the time of this study. The benefit(s) of the boys’ use of iron supplements were measured with the Conners’ Rating Scale and the comments of the boys’ parents and teachers. Over a thirty day period each one of the boys were given an iron supplement and was again rated using the scale. The results concluded a significant decrease on the parents’ scores (behavioral) but not on the teachers’ score (academic).
Anecodotal and limited empirical evidence are surfacing to support the efficacy of iron supplementation (Brue, & Oakland, 2002).
Research 2 Thirty-three “normal” but iron deficient children were administered iron supplements.
The results of this study concluded these children were less hyperactive in comparison to children with ADHD. It was suggested that iron deficient could be a possible cause of hyperactive behavior some children. However, the treatment of iron deficiency may curtail the hyperactive behavior in children.
Research 3
A group of adolescent girl who were confirmed to be iron deficient were given iron supplements for two months. At the end of the two months those adolescence girls who received iron supplements excelled on verbal learning and memory test in comparison to those adolescence girls who did not receive iron supplements.

These three studies were brief and less than impressive. But what was provided was a glimpse of iron supplement in difference settings on various children. If nothing more came from these studies, it was apparent iron deficient children can benefit from iron supplements.
The link between hyperactive behavior and iron deficiency mirror the symptoms of ADHD.
Children who demonstrate hyperactive behavior are more likely to be iron deficient in comparison to non-hyperactive children. Furthermore hyperactive children require higher than average iron needs in comparison to other children. Kane (2006) suggested children may test “normal” on all their blood work, but still be considered to be iron deficient. This “false positive” stems from the child’s need for more than average amount of iron.
Failure to find any various in these studies may suggest low iron levels may not only effect children with ADHD but needs to be further investigated in those children with deficiency.

References
Allen, R.P. & Earley, C.J. (2007). The role of iron in restless legs syndrome. Mov Disord, 22, 440-448

Beard, J.L., Connor, J.D., Jones, B.C. (1993). Brain iron: location and function. Prog Food Nutr Sci, 17, 183-221

Biederman, J. (1997). ADHD across the lifecycle. Biol Psychiatry, 42(Suppl), 146

Black, M.M. (2003). Micronutrient deficiencies and cognitive functioning. J Nutr. 133(Suppl), 3927-

Brue, A.W., & Oakland, T.D. (2002). Alternative treatments for attention deficit/ hyperactivity deficit/ hyperactivity disorder: does evidence support their use? Alternative Therapies in Health and Medicine, 8(1), 68-70

Bryan, J., Osendarp, S., Hughes, D., Calvaresi, E. Boghurst, K., & Van Klunken, W.J. (2004). Nutrients for cognitive development in school-aged children. Nutrition Reviews, 62(8), 295-306

Curt, L.T., & Patel, K. (2008), Nutritional and environmental approaches to preventing and treating autism and attention deficit hyperactivity disorder (ADHD): a review. J Altem Complement Med, 14, 1904-1909

Hagan, P. (2004). Why hyperactive children need iron—not Ritalin. Daily Mail, 48, 1-3

Juneja, M., Jain, R., Singh, V., & Mallika, V. (2002). Iron deficiency in Indian children with attention deficit hyperactivity disorder. Indian Pediatrics, 47(11), 955-958

Konofal, E., & Cortese, S. (2007). Lead and neuroprotection by iron in ADHD. Environ Health Perspect, 115, 398-399

Konofal, E., Lecendreux, M., Arnulf, I., & Mouren, M.C. (2004). Iron deficiency in children with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med, 158, 1113-1115

Lozoff, B., Jimenez, F., Hagen, J., Mollen, E., & Wolf, A.W. (2000). Poorer behavioral and developmental outcome more than 10 years after treatment for iron deficiency in infancy. Pediatrics, 105, 51

Murray, M. (2011). Don’t discount the power iron for maintaining health. Natural Foods Merchandiser, 32(3), 96

Osendarp, S.J.M., Murray-Kolb, L, E., 7 Black, M. (2010). Case study on iron in mental-development- in memory of John Beard (1947- 2009). Nutrition Review, 68, 48- 52

Sinn, N. (2008). Nutritional and dietary influences on attention deficit hyperactivity disorder. Nutrition Review, 66(10), 558-568

Thomas, D.G., Grant, S.L., Aubuchon-Endsley, N.L. (2009). The role of iron in neurocognitive development. Development Neuropsychology, 34(2), 196-222