One of the biggest growth areas in medicine, particularly in America, is the problem child. Instead of "hard to handle", his symptoms now go by a variety of masterful medical euphemisms hyperactivity, attention deficit, hyperkinesis, minimal brain damage, minimal cerebral dysfunction and, Attention Deficit Hyperactivity Syndrome. These labels, all redolent of serious organic pathology, are shorthand for the type of child who just cannot sit still, cannot concentrate, has a difficult time settling down to eat or sleep, cannot adapt to new situations, overreacts to new stimuli and, through his unpredictable, impulsive and often destructive behaviour, makes life a hell on earth for every other member of the family.

The standard therapy for hyperactivity, particularly in America, is drugs central nervous stimulants like methylphenidate (Ritalin), which have a paradoxical effect on children. Instead of hyping them up, stimulants in general (including caffeine) drug them into a calmed, soporific state. And now the most recent tack taken by medicine is to blame it on genes. One recent study (New England Journal of Medicine, 8 April 1993) concluded that hyperactive children have something in their makeup that causes them to have a "generalized resistance" to thyroid hormone. In other words, they're restless because their thyroid gland isn't regulating properly.

In 1973 the late American pediatrician and allergist Ben Feingold introduced the then ground breaking theory that foods containing salicylates, aspirin like substances such as artificial colours and artificial flavours, were mainly responsible for hyperactivity. He found that reducing a child's intake of sugar or artificial additives or locating possible allergies could help. Although study after study backs Feingold's theories, many standard medics still label his approach a fad and are happier to reach for the prescription pad and sentence a small child to many years of stupefying, potentially addictive medication.

What the standard medical approach fails to consider is that hyperactivity doesn't stem from a single cause. Dr Sidney M Baker, director of the Gesell Institute of Human Development in New Haven, Connecticut, who has worked with many learning disabled and hyperactive children, emphasizes that short attention spans and impulsive, restless behaviour are indicative of "individual chemical imbalance" anything from nutritional shortages to constant exposure to allergens or food additives, a situation often exacerbated by the typical American or British child's constant consumption of "altered, adulterated, sweetened, fatty and refined foods". Anyone faced with a hyperactive child, says Dr Baker, has to do a great deal of detective work with a trained practitioner to find out both what is lacking and what the child might be getting too much of.

Dr Melvyn R Werbach, assistant clinical professor at University of California at Los Angeles' School of Medicine, has spent years studying the effect of nutrition on a variety of so called mental illnesses, including childhood hyperactivity. In his book Nutritional Influences on Mental Illness (Third Line Press, Tarzana, CA) he has compiled a source book of all clinical research published on nutritional influences on hyperactivity, among other disorders. The following is a summary of his findings (noted with full medical references). Keep in mind that these findings are meant to be a sourcebook, not a treatment manual. Any readers wishing to use nutritional therapy should work in tandem with a trained professional, who will carefully consider a patient's dietary history, discover nutritional deficiencies, and perform relevant lab tests before initiating treatment.