NHS prescribing drugs ‘when diet might help children with autism’

By Judith Duffy, Health Correspondent

THE NHS is failing to provide advice on nutrition which could help children with conditions such as autism and attention deficit disorder, amid a culture of prescribing powerful drugs with potential side-effects.

That is the claim made by Dave Rex, lead child health dietician with NHS Highland, who has warned that despite evidence that special diets can help some individuals, nutrition is still being treated as a “Cinderella” subject in the health service.

Speaking ahead of a major conference on diet and children’s behaviour later this month, Rex told the Sunday Herald that while many NHS professionals will prescribe powerful drugs, they are reluctant to consider dietary interventions.

“It is very strange that we within the NHS are in the culture of prescribing medication which runs the risk of side-effects,” he said, “yet we are so nervous about giving tailor-made advice on what a healthy diet would look like.

“As soon as you talk about diet and autism or attention deficit hyperactivity disorder (ADHD), people assume you are going to be suggesting something wacky, because some people have done so in the past.

“But you can give responsible, tailor-made advice on diet, which is more likely to do good than harm.”

While there is wide debate about the causes and treatment of autism and ADHD, some research has suggested that dietary interventions such as removing milk and wheat, topping up nutrients or using fish oil supplements can help in some cases.

But Rex, who is one of just a few dieticians employed by the health service to give specialist advice on such conditions, said that the lack of interest in the subject within the NHS meant that parents often had to turn to the private sector for information, without knowing what advice or treatments could be relied upon.

“There are often all sorts of supplements and potions, sometimes at great expense. Sometimes they are ones that are potentially useful, sometimes it is based on half-baked science and sometimes it is downright irresponsible,” he said.

“I think families feel that they are caught between a rock and a hard place because, while they would trust the NHS, there isn’t enough knowledge or interest in these topic areas.

“Those who do have the interest to look through the research in detail are those who stand to gain commercially out of selling various supplements. So how do they (families) ever find their way through that?”

Rex, who also gives nutritional advice to schools in the Highland area, will be addressing a conference on Diet, Behaviour And The Junk Food Generation, in Glasgow on January 23.

He added: “We’ve known for decades and decades that the diet we eat has a major effect on our risk of heart disease, stroke, osteoporosis, diet-related cancers and so on. Is it remotely tenable that the food we eat doesn’t affect the way our brain works?

“The challenge is to find out which changes in which individuals make a real difference and that is the tricky bit – it is a very potent tool, but frustratingly also a very complex one to use effectively.”

Autism campaigners agree that specialist dietary advice should be widely available to patients.

Laura Slade, helpline manager at the National Autistic Society (NAS), said: “We believe it is important that people with autism and their parents and carers have access to a full range of nutrition advice and information from the NHS, which may be of benefit to them, and ideally from those practitioners who have knowledge of autism.”

Dr Lorene Amet, principal scientist at the Edinburgh-based Autism Treatment Trust – a charity which advocates dietary intervention – said that many parents who attended the trust’s clinic had seen significant improvements in their children.

“Some families had been advised against diet modification and were finally convinced to give it a go,” she said. “They have seen extremely fast and very significant improvement.

“I think generally there is a lack of help from the NHS, but it should be there, as these conditions do improve with diet modification to some extent.”

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