Exercise shown as a way to counteract ADHD

Homework used to be an ordeal for Kat Orlov.

Orlov, who has an attention disorder, once spent four hours a night on her assignments. These days, the 15-year-old can complete her work in about half that time.

Her salvation, she says, came from exercise. Orlov joined a community crew team in September and now works out nearly three hours a day. Although she still takes stimulant medications during the school year, she and her family are thrilled by her progress.

“When I exercise, I feel much more energized and awake,” says Orlov, from Wayland, Mass. “I have more of a feeling to sit down and get something finished.”

Across the country, doctors are studying a variety of non-medical treatments for attention deficit/hyperactivity disorder, ADHD, and similar disorders.

About 4 million Americans take stimulant medications for ADHD, including nearly 10 percent of 10-year-old boys, according to Steven Nissen of the Cleveland Clinic.

Nissen and other members of a Food and Drug Administration advisory panel were concerned enough about the drugs’ safety last month that they suggested adding a “black box” warning about possible heart risks. Last week, another advisory panel recommended adding label information about the risk of hallucinations. The FDA has not yet acted on those recommendations.

Doctors haven’t done many definitive studies about exercise and ADHD, says David Goodman, an assistant professor of psychiatry at Johns Hopkins University School of Medicine. But Goodman says it makes sense that working out would help people cope with the condition. Studies show that exercise increases levels of two key brain chemicals – dopamine and norepinephrine – that help people to focus. “Your cognitive function is probably better for one to three hours after exercise,” Goodman says. “The difficulty is that by the next day, the effect has completely worn off.”

If kids could exercise strenuously three to five times a day, they might not need medications at all, says John Ratey, an associate clinical professor of psychiatry at Harvard Medical School. Ratey is so intrigued by exercise that he’s writing a book about ways that it can reduce symptoms of ADHD or at least help patients cope.

Team sports may help kids with ADHD in several ways, says James Perrin, a professor of pediatrics at Boston’s MassGeneral Hospital for Children. Children with the condition benefit from following a regular schedule. Coaches who lead kids through structured exercises also may help to build concentration and organizational skills.

Yet many kids get little exercise, Perrin says. Studies show that children today are far more sedentary than in past generations, a trend that has contributed to increasing childhood obesity rates.

“You could speculate that one reason for the increasing rates of ADHD is that kids are exercising less,” Perrin says.

Researchers have looked at other habits to explain the rise in ADHD rates. But experts note that there isn’t much research to clearly link lifestyles with attention problems.

More than a few parents and teachers suspect that sugary snacks – with their artificial colors, flavors and preservatives – contribute to the problem. Others suggest that vitamins might reduce hyperactivity. But most controlled trials show these substances have no effect on ADHD, according to a July review in the Journal of the American Dietetic Association.

Still, cutting back on sugar won’t hurt children, so parents have no reason to fear giving it a try, says Martin Stein, a pediatrics professor at the University of California, San Diego, School of Medicine.

Many parents also wonder if television, computers and video games make it harder for kids to concentrate.

A 2004 study found that infants and toddlers who watch a lot of television are more likely to have trouble concentrating in their early school years. Every extra hour of TV raised the odds of having attention problems by 10 percent, according to the study, which was published in Pediatrics.

Stein cautions that parents shouldn’t put too much faith in a single study. A March 2006 study, also in Pediatrics, did not find a link between TV watching and behavior problems. Yet few doctors see TV as a healthy habit.

The American Academy of Pediatrics recommends children watch no TV before the age of 2, and older children should view no more than two hours a day of high-quality shows.

Many children watch far more TV, though, and about half have sets in their rooms, Perrin says. Those who watch a lot of TV may spend less time running around outside and more time eating sugary snacks. They also miss out on attention-building activities, such as reading.