ADHD and Nutrition - Is There a Link?
ADHD (Attention Deficit Hyperactivity Disorder) is characterized by a group of symptoms including difficulty with sustaining attention, impulsivity, and hyperactivity. There are different subclasses; not everyone exhibits all of the symptoms. According to the American Psychiatric Association, 8.4 percent of children and 2.5 percent of adults have ADHD. The incidence has risen significantly in the last eight years, which cannot account for genetics alone. AHDH can have negative effects on relationships, self-esteem, school and work performance, and can greatly affect quality of life. As with most conditions, nutrition can be helpful for those struggling with ADHD symptoms. Foods and nutrients can have direct effects on the development and functioning of the human brain. Sometimes these foods (or chemicals in the foods) have a negative effect and act like an irritant, but more often they are nurturing to the system, which can often be deficient in certain nutrients.
[While this article focuses mainly on food, there is often more to the ADHD picture. Ruling out the following can be helpful: allergies, anxiety, thyroid issues, undiagnosed learning disabilities, sensory processing disorders, auditory processing problems, visual development issues, heavy metals toxicity, and intestinal issues, such as chronic constipation, and stress or a dysfunctional home environment, among others.]
Irritants in food
Many irritants come into our bodies via food. Sugar is a prime example. It has been linked with behavioral issues, such as hyperactivity, in some children. This may be due to blood sugar surges with subsequent crashes. There are many other reasons to avoid sugar. It is tied to inflammation, obesity, and heart disease. Last, sugar is a source of empty calories. This means that it adds zero nutrients to your child’s diet and actually displaces nutritious foods. The more sugar your child eats, the less he has an appetite for other, healthy foods.
A deep dive into sugar is beyond the scope of this article. Know that it is called by many names, including dextrose, glucose, malt syrup, corn sweetener, fructose, maltose, agave, fruit juice concentrate, invert sugar, sucrose, honey, and high fructose corn syrup. Most processed foods contain one of the above. Examples of foods to avoid include cookies, candy, cereal, granola bars, cakes, pastries, ice cream, flavored milk, punch/lemonade/sports drinks/soda, crackers, and chips, among others. Although 100% fruit juice is technically all fruit, it contains very concentrated natural sugars and is best avoided. Choose whole fruit instead.
Food dyes and colorings, particularly red dye #40 has been linked with learning and behavioral issues, as well as other health effects. All food dyes are best avoided for this reason. Red food dye is found in many drinks such as sports drinks, lemonades, fruit punches and sodas. It can also be found in jams, cereal bars, chips, pizza, jello, hot dogs, instant chocolate pudding, fruit snacks, and licorice, among others. Other food chemicals to avoid include preservatives such as MSG, nitrates or nitrites, and artificial sweeteners like Aspartame.
Your child may also have a food sensitivity. Dairy is a common food sensitivity, especially if your child has a history of chronic ear infections and/or struggles with constipation. Consider a trial elimination of all dairy. Speak with a dietitian to prevent nutrient deficiencies during this time. Other common food intolerances include soy, wheat, and eggs.
What do we need to add back in?
One of the foundations of a healthy brain and body is a healthy diet. This includes lots of colorful vegetables (excellent source of fiber) and fruits, good sources of protein such as fish and seafood, meats, legumes, nuts and seeds, dairy (if tolerated), eggs; healthy fats such as avocados, olive oil, coconut oil, and pastured dairy fats; seaweeds; fermented vegetables and beverages; and grains, if tolerated (preferably soaked and sprouted). If your child is a selective or “picky” eater, there are ways to help. See my previous article on this topic for more information.
Many of the foods above are good sources of fiber. By now you have probably heard of the microbiome and its importance to overall health. Fiber helps to feed our microbiota, or residential microbial population. The massive increase of processed foods in our diets likely is having a detrimental effect on our microbiome, with subsequent negative health effects, including brain health. Some postulate that this is one reason behind the recent increase in ADHD and Autism Spectrum Disorder incidence.
Balancing out every meal and snack is important to keep young brains fueled and to prevent blood sugar crashes. This means having a good source of protein at least three times a day, and especially at breakfast. Balance all meals and snacks, as much as possible, with protein, carbohydrates, and fats.
While a healthy diet cannot be substituted with nutrients alone, sometimes a child’s diet is low in the following and can benefit from supplementation if adding in food sources is not an option. These include omega-3 fats, choline, Vitamin B12, folate, Vitamin D, magnesium, and calcium. Probiotics and a multivitamin/mineral can also be helpful.
DHA and EPA are types of omega-3 fats that are important for brain health and are found in fish like salmon, tuna, herring, sardines, and anchovies. Fish oil supplements can be substituted, and vegan DHA is also now available. Has your child ever grabbed a stick of butter and eaten a chunk? This can be a sign of omega-3 deficiency.
Choline can also be deficient. Kelly Dorfman, MS, LND, child nutrition expert, states that ninety percent of American children have a low intake. One symptom of a deficiency is a reduced capacity to learn. The best sources of choline are eggs (found in the yolks) and liver.
Nutrition is sometimes an overlooked contributing factor in ADHD. Hopefully the information above will help your child, and spur you to ask more questions. If you are looking for more targeted recommendations for your child, speak with a dietitian knowledgeable on the subject. Last, do not forget lifestyle factors, which are equally important. Getting enough restorative sleep, adequate physical activity, time in nature and away from screens, and minimizing or managing stress as much as possible are all key to having a healthy child who thrives, despite any diagnosis.
The information provided in this article is intended for general use only and is not to be used in place of medical advice from a licensed health professional.