ADHD Nutrition Information:
little things can make
a big difference
Did you ever get a blank stare when you asked your child’s doctor about the ADHD nutrition connection? If you are the parent of a child with attention deficit (with or without hyperactivity) disorder, you have certainly either read about such a connection or observed it in your own experience. But I can assure you that such information is not a routine part of medical education these days. MD’s are taught enough about ADHD to make a diagnosis (usually) and treat with the best medication available. But as in most areas, nutrition information is not much a part of medical education for ADHD either.
Because ideally we would like nutrition, lifestyle, psychotherapy and medication if needed to all work together, ADHD would be an ideal disorder for integrative or holistic medicine approach.
So what do we know about the ADHD nutrition connection? One of my first questions is to make sure the child is not anemic or iron deficient. Iron deficiency, even without anemia, can cause cognitive and behavioral problems in children and teens. And because it is often difficult to accurately diagnose iron deficiency before it gets to the overtly anemic stage, this can be a problem for adequate treatment. Unless a test is specifically done to test for non-anemic iron deficiency (such as measuring free erythrocyte protoporphyrin), it makes the most sense to make sure that ALL children and teens with ADHD are on an iron supplement (usually a multivitamin with iron will do). Take any such iron supplements with citrus fruit or orange juice, since the iron is absorbed better that way. Unfortunately, much of what we hear instead is polarization and opposing approaches: parents refusing stimulant meds like Ritalin because of real or supposed fears, and doctors asserting that all the “alternative” or “natural” remedies don’t work at all. As in most things in life, the truth is somewhere in the middle.
Beyond the iron deficiency question, overall food choices are a very important part of the ADHD nutrition link. This starts with a healthy breakfast. A child who eats no breakfast before school may be inattentive because the brain has no fuel. But suppose the child gets a high sugar breakfast with little to no protein or fat for lasting energy? After a rapid spike in blood sugar, by mid-morning the body has overcompensated for that; the blood sugar is now low and the adrenaline level is high attempting to raise it to normal again. The result? A jittery child with low-blood sugar: this looks an awful lot like inattention and hyperactivity. Please treat this with a healthy breakfast before looking at medication. I recommend a low glycemic load breakfast (whole grains, protein, fruits, healthy fat such as nuts, and omega3 eggs).
Years ago, Dr. Feingold proposed his hypothesis about the impact of artificial colors on ADHD. Many dismissed his claims, but recently research has shown there is a subgroup of kids with ADHD, not all, whose symptoms improve when artificial colors and preservatives are eliminated from the diet. How do you know if your child is one of the ones who would improve with this approach? The only way to tell is to completely eliminate them from the diet for 2-3 weeks, then add them back in to see if symptoms return. It may help parents to be more objective if they have teachers fill out rating scales while on and off the additives, without disclosing what the child is getting at the time. (Learn more about the Feingold diet and its potential benefit.)
In summary, the ADHD nutrition connection is a complex one, but is a piece that I would not leave out of the puzzle in addressing this difficult childhood issue.
to your health,
Robert Pendergrast, MD
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