Can diet help with ADHD in kids?

 
Young boy with glasses eating apple and grapes
 

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects children and often persists into adulthood. While medication and behavioral therapy are commonly used to manage ADHD symptoms, there is growing interest in the role of diet in ADHD management. 

Dietary interventions can play a role in managing ADHD symptoms in some children, although they are typically not a standalone treatment. A balanced diet rich in nutrients, with limited processed foods and sugars, may support overall health and can potentially help improve ADHD symptoms.

In this article, we’ll explore the relationship between diet and ADHD in children, the best diet for children with ADHD, how to optimize certain nutrients, and which foods to avoid when you have ADHD.

What is ADHD?

ADHD stands for Attention-deficit/hyperactivity disorder. It is a neurodevelopmental disorder that affects both children and adults and is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can interfere with daily functioning and development.

Inattention symptoms in children may include:

  • Difficulty sustaining attention in tasks or play activities

  • Often being forgetful in daily activities

  • Difficulty organizing tasks and activities

Hyperactivity-impulsivity symptoms in children can include:

  • Fidgeting or squirming in seat

  • Difficulty remaining seated when expected

  • Excessive talking or interrupting others

  • Difficulty waiting for one's turn

These symptoms can vary in severity and may impact various aspects of life, including academic performance, relationships, and daily activities. Treatment options for ADHD often involve a combination of medication, behavioral therapy, and support strategies tailored to individual needs.

What causes ADHD?

The potential causes of ADHD are still being researched but include genetics, exposure to environmental risks during pregnancy or at a young age (such as lead and other heavy metals), alcohol/tobacco use during pregnancy, premature birth, and low birth weight.

According to the Centers for Disease Control and Prevention, “Research does not support the popularly held views that ADHD is caused by eating too much sugar, watching too much television, parenting, or social and environmental factors such as poverty or family chaos. Of course, many things, including these, might make symptoms worse, especially in certain people. But the evidence is not strong enough to conclude that they are the main causes of ADHD.”

Is ADHD linked to a standard American diet?

Research suggests that there may be a link between ADHD and the standard American diet (SAD), which is characterized by a high intake of processed foods, sugars, saturated fats and a low intake of fruits, vegetables, and whole grains. 

Some studies have found that children with ADHD tend to have poorer dietary habits (for example, consuming more sugary snacks and drinks and fewer essential nutrients compared to children without ADHD). 

However, while there appears to be an association, it's important to note that the relationship between diet and ADHD is complex, and we don’t yet fully understand it. More research is needed to determine the extent to which diet contributes to ADHD and how dietary interventions could potentially help manage the condition.

Does sugar cause ADHD in kids?

While sugar consumption doesn't directly cause ADHD, some studies suggest that high sugar intake may worsen ADHD symptoms like hyperactivity and impulsivity in some children. High intake of dietary sugar can cause fluctuations in blood sugar levels, which may affect behavior and attention in children with ADHD. 

It's important to note that individual responses to sugar can vary, and not all children with ADHD will experience worsened symptoms from consuming sugary foods or drinks. However, whether your child has ADHD or not, a good rule of thumb is to follow the Dietary Guidelines for Americans, which recommends that people over 2 years old limit added sugar intake to less than 10% of the daily diet.

Can vitamins help kids with ADHD? 

Some studies suggest that certain vitamins, minerals, and nutrients may play a role in managing symptoms of ADHD in some children. While these may offer some benefits for children with ADHD, more research is needed to confirm their effectiveness.

Here are a few vitamins and minerals that have been studied in relation to ADHD:

As always, it is best to try and get vitamins and minerals by eating a healthy diet before adding supplements. Aim for well-balanced, nutrient-dense meals and snacks with healthy proteins, carbohydrates, and fats to help make sure your child is getting all the nourishment they need to thrive.

It's important to consult with a healthcare provider or registered dietitian before starting ADHD supplements (or any supplementation regimen). Your healthcare provider can provide guidance based on individual needs and circumstances. Vitamins should not be used as a standalone ADHD treatment. 

Do food additives cause ADHD in kids?

The link between food additives and ADHD is a topic of ongoing research and debate. According to the American Academy of Pediatrics, some studies suggest that certain food additives, such as artificial colors and sugars, flavors, and preservatives like MSG and nitrates, may contribute to ADHD symptoms or hyperactivity in some children. However, other studies have not found a clear link.

In Europe, the European Food Safety Authority (EFSA) has implemented regulations requiring products containing these additives to carry a warning label indicating that they "may have an adverse effect on activity and attention in children.”

In the United States, the Food and Drug Administration (FDA) regulates food additives and states,

“The totality of scientific evidence indicates that most children have no adverse effects when consuming foods containing color additives, but some evidence suggests that certain children may be sensitive to them.”

The FDA recommends that parents who wish to limit exposure can read food labels to avoid foods with these ingredients.

While some children with ADHD may be sensitive to food additives, it's important to note that not all children will react the same way. More research is needed to understand the impact of food additives on ADHD fully and to determine if there are specific additives that may be problematic for some children.

If you are concerned that your child may be negatively affected by food additives, consider prioritizing more minimally processed, whole foods for your child and limiting their access to processed, packaged foods with food additives.

Does ADHD make it harder for kids to eat healthy?

Children with ADHD may struggle with impulsivity and poor planning, which can make it challenging for them to maintain a healthy diet. Children with ADHD may also have impulsive eating behaviors and difficulty following structured meal times and sitting still to focus on eating. 

Some children with ADHD also have sensory sensitivities, making them more sensitive to certain textures, tastes, or smells, which can limit the variety of foods they are willing to eat and create more picky eating battles. Despite these challenges, there are strategies that can help promote healthy eating habits in children with ADHD. Parents and caregivers can:

  1. Provide structure and routine around meals and snacks

  2. Offer a variety of healthy foods and involve children in meal planning and preparation

  3. Minimize distractions during meal times

  4. Set a positive example by modeling healthy eating behaviors

Can food sensitivities cause ADHD?

There is some evidence to suggest that food sensitivities may contribute to ADHD symptoms in some children, but the relationship is not well understood, and more research is needed to establish a clear link.

Common food sensitivities that have been studied concerning ADHD include gluten (found in wheat and other grains), dairy, eggs, and artificial additives like food coloring and preservatives.

If you suspect that food sensitivities or food allergies may be contributing to your child's ADHD symptoms, it may be helpful to keep a food diary to track symptoms and identify potential triggers. 

Consulting with a healthcare provider or allergist can also help determine if food sensitivities are a factor and guide you in making dietary changes, if necessary, by trying an elimination diet.

Should kids with ADHD avoid energy drinks?

Yes, kids with ADHD should avoid energy drinks and other caffeinated beverages. In fact, ALL children and adolescents should avoid energy drinks! 

Energy drinks, like Celsius and Prime, often contain high levels of caffeine and sugar, which can worsen ADHD symptoms such as hyperactivity, impulsivity, and inattention. 

Caffeine is a stimulant that can increase heart rate, blood pressure, and anxiety, which may exacerbate ADHD symptoms. Additionally, the high sugar content in energy drinks can lead to blood sugar spikes and crashes, further impacting mood and behavior. These drinks can also interfere with sleep, which is important for managing ADHD symptoms.

It's important for parents to be aware of the potential effects of energy drinks and to encourage healthier alternatives such as water or milk

Foods to avoid for children with ADHD

Children with ADHD may benefit from avoiding or limiting certain foods that could potentially exacerbate their symptoms. While individual responses to foods can vary, some common foods to consider limiting or avoiding or limiting for children with ADHD include:

1. Sugary Foods and Drinks: High-sugar foods and drinks can cause blood sugar spikes and crashes, which may worsen hyperactivity and impulsivity.

2. Artificial Food Additives: Some children with ADHD may be sensitive to artificial colors, flavors, sugars, and preservatives, which are commonly found in processed foods. These additives may contribute to hyperactivity and other ADHD symptoms in some children.

3. Highly Processed Foods: Processed foods often contain high levels of sugars and saturated fats, which may negatively impact mood and behavior in children with ADHD. Do your best to choose whole, unprocessed foods and cook at home whenever possible. 

4. Food Sensitivities: Some children with ADHD may also have food sensitivities or allergies that can exacerbate their symptoms. Common allergenic foods include gluten, dairy, soy, eggs, and peanuts.

5 . Seafood High in Mercury: The most common culprit of mercury accumulation in the brain is from eating fish or other seafood with trace amounts of mercury including tilefish, swordfish, king mackerel, and shark. Mercury accumulation over time can cause problems with memory, attention, and cognitive thinking in children.

What is the best ADHD diet for kids? 

A balanced diet focusing on nutrient-dense, high-fiber, protein-rich foods to support brain health is helpful for children diagnosed with ADHD. As a pediatric registered dietitian, I find in my private practice that kids with ADHD tend not to get enough fiber and often struggle with constipation as a result. 

While research is still emerging about the benefits of certain vitamins and minerals in regard to ADHD, it is best to try to incorporate them frequently in the diet for overall brain health and well-being. 

Listed below are the dietary pillars that I recommend for kids with ADHD:

  1. Adequate protein: Protein helps with the function of neurotransmitters, which can affect attention and behavior. While a high-protein diet is not necessarily recommended, try to incorporate a good quality source of protein with each meal and snack, like lean meats, poultry, fish, eggs, dairy products, legumes, nuts, and seeds.

  2. Healthy fats: Omega-3 fatty acids, including EPA and DHA, like those found in cold-water fish like salmon and tuna, as well as those found in chia seeds, flaxseeds, and walnuts, are important for optimal brain function.

  3. Complex Carbohydrates: Opt for whole grains like brown rice, quinoa, farro, whole wheat bread, and oats, which release slowly into the bloodstream and prevent blood sugar spikes.

  4. Fruits and vegetables: Try to eat the rainbow! Colorful produce is rich in vitamins, minerals, and antioxidants, which are important for brain health.

  5. Probiotics: Foods rich in probiotics, such as yogurt, sauerkraut, pickles, kimchi, and tempeh, will support a healthy gut and, in turn, overall bodily function.

  6. Brain-Building Vitamins and Minerals: Focus on those that improve overall brain function.

    • Magnesium - found in spinach, kale, almond, cashews, bananas, oats, beans, lentils, and chickpeas

    • Iron - found in lean meats, seafood, tofu, beans and lentils

    • Zinc - found in beef, pork, oysters, pumpkin seeds, and cashews

    • Folate (vitamin B9) - found in asparagus, broccoli, citrus fruits, kidney beans, and black beans 

  7. Hydration: Encourage your child to drink at least 6-8 cups of water throughout the day to stay hydrated, as dehydration can decrease cognitive function and mood.

** TOP TIP ** - Consider a Mediterranean-style diet that emphasizes fruits, vegetables, seafood, whole grains, legumes, nuts, seeds, and olive oil - all of which are essential for brain health!

How do ADHD medications affect appetite in kids?

ADHD medications, such as stimulants like methylphenidate (e.g., Ritalin, Concerta) and amphetamines (e.g., Adderall, Vyvanse), can cause decreased appetite in kids, which can lead to weight loss or poor nutritional intake in some children.

The appetite-suppressing effects of ADHD medications are thought to be due to their impact on the brain chemicals dopamine and norepinephrine, which play a role in regulating appetite. These medications can decrease feelings of hunger and increase feelings of fullness, leading to reduced food intake.

It's important for parents and caregivers to monitor their child's appetite and nutritional intake while on ADHD medications. Do your best to provide nutrient-rich foods that are high in calories and nutrients to help meet your child's nutritional needs. It may also help to offer smaller, more frequent meals and snacks throughout the day.

While it's important to keep your regular follow-up appointments with your child’s pediatrician, I recommend avoiding calorie counting or weight checks at home unless advised by your healthcare provider. It is best not to focus on weight exclusively but rather on eating well-balanced meals to support energy and mood. 

If you have concerns about your child's appetite or nutritional intake while on ADHD medications, speak with their healthcare provider or a registered dietitian, who can provide guidance and recommendations based on your child's individual needs.

If you have further questions about the impact of diet on ADHD, please comment below or schedule a virtual one-on-one session with me to address your concerns. And if you have a picky eater, check out my pediatrician-endorsed online course, Solve Picky Eating, which includes 12 self-paced short video lessons, downloadable guides, and checklists to support you along your journey of growing healthy, intuitive, and adventurous eaters. 

Thanks for reading!

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