What Role Does Nutrition Play in the Management of ADHD?

Are you or a family member looking for natural options to complement what you are doing with other health care practitioners to help manage the symptoms of ADHD?  Although research linking what we eat (or do not eat) as the potential cause of ADHD has been inconclusive, there are a number of evidence-based nutritional considerations that have been found to help in the management of ADHD symptoms. While medications are typically the first treatment suggestion and are often necessary, the value of dietary interventions are often overlooked. However, in many cases, dietary changes alone are enough to see drastic improvements in symptoms.  Below we will explore some of the evidence-based nutritional considerations for the management of ADHD.

Sugar 

Although there is a common misconception that high sugar intake causes ADHD, It is true that sugar can  worsen symptoms of ADHD and is detrimental to overall health. Sugar intake causes a surge in dopamine, which amplifies the reward seeking behavior already common in individuals with ADHD. Sugar also increases adrenaline which leads to enhanced hyperactivity. While this is true for anyone consuming too much sugar, the implications for those with ADHD are often worse. Limiting your intake of added sugars to less than 25 grams per day is recommended by Health Canada. 

Simple/refined carbohydrates

Similar to refined sugar, foods containing refined carbohydrates (most often found in the form of white flour) can worsen symptoms of ADHD. Limiting your consumption of refined carbohydrates and consuming whole unprocessed grains a majority of the time is therefore recommended to help manage symptoms.

Gluten 

Although not everyone with ADHD is sensitive to gluten, studies have found that eliminating gluten from the diet can help reduce symptoms in some individuals with ADHD. It can therefore be worthwhile to eliminate gluten from your diet for 3-4 weeks to see if it has an impact.

Dairy

Some research has found a link between one type of casein (casein is the main type of protein found in dairy products) and a worsening of ADHD symptoms in some individuals. Specifically, they found that A1 caseins impacted information processing and also caused more gastrointestinal symptoms, while A2 caseins did not. This is believed to be related to the impact of A1 casein on the gut microbiome. Milk with A2 casein proteins is harder to find, but is available in some grocery stores. There are also a variety of plant-based milk and dairy alternatives available if you are interested in testing whether dairy may be contributing to your ADHD symptoms.  

Food additives 

Although findings have been mixed, several studies have found that artificial food additives increase symptoms of ADHD. However, some studies have also found food additives to cause symptoms in individuals not diagnosed with ADHD. Based upon the available research, it is estimated that as many as 30% of children with ADHD are sensitive to food additives, with the worst culprits being artificial colours (tartrazine in particular) and sodium benzoate. Eating more whole, unprocessed foods and learning to read food labels can help to minimize these in your diet. 

Caffeine

Caffeine, particularly in tea, is beneficial for improving attention, memory, alertness, cognition, and concentration, however it can also cause excitability. For this reason, it is important to limit how much caffeine you consume (less than 400 mg per day), and pay attention to how your body responds to it. It is also important to limit caffeine to the earlier portion of the day so it does not impact sleep. Be sure to check the sugar content of the caffeinated beverages you are consuming, as many contain a significant amount and, as discussed, can be harmful. As well, if you are taking medications for ADHD it is best to speak to your doctor if you are consuming regular caffeine. 

Skipping meals

Consuming regular meals is important with ADHD, as skipping meals leads to blood sugar crashes which often result in fatigue, irritability, difficulties concentrating and cravings for less healthy foods, all of which can increase symptoms. 

Essential Fatty Acids

Individuals with ADHD are more likely to be deficient in essential fatty acids (such as Omega-3), and have also been found to require more essential fatty acids due to their brain’s lower absorption rate, and/or ability to utilize it.  This is also impacted by other deficiencies, such as magnesium, zinc, vitamin C and some of the B vitamins. There is good evidence to support the use of Omega-3 (in the form of DHA and EPA) supplementation in individuals with ADHD, and it is something to speak to your doctor about if you are not already doing so. A diet rich in foods naturally high in Omega-3 is also beneficial. Foods high in omega 3 fatty acids include oily fish (salmon, herring, marcel, sardines), flax seeds, chia seeds and walnuts. 

Gut healthy diet

Gut bacteria have been found to play a role in ADHD due to the strong link between the gut and the brain. Consuming a diet that promotes a wide diversity of healthy gut bacteria is therefore recommended. Our healthy gut bacteria thrive on whole foods rich in fibre, which include whole (unprocessed) grains, fruits, vegetables, nuts, seeds, and beans/legumes. Foods that promote the growth of unhealthy gut bacteria are those common in a standard American diet, including refined grains and sugar, processed and fatty meats, high fat dairy, alcohol, fried foods and processed food. Probiotic rich foods, such as sauerkraut, kimchi and tempeh, also help to build up the gut microbiome and promote optimal gut health.   

Nutrient deficiencies

A large number of children with ADHD have been found to have nutrient deficiencies, with magnesium and zinc being the most prominent. Deficiency in both of these can result in ADHD type symptoms, including restlessness, fidgeting and difficulties concentrating, and studies have found improvement in symptoms with supplementation. While most studies focus on children, it is expected that adults would be much the same. Foods high in magnesium include pumpkin seeds, almonds, leafy greens, cashews, cacao, dark chocolate, legumes, oily fish, bananas and avocado. Foods high in zinc include shellfish, legumes, meat, seeds, nuts, whole grains and eggs.

Polyphenols

Polyphenols are naturally occurring phytonutrients found in a variety of plants. They act as antioxidants and can help to reduce the damage from free radicals and oxidative stress, possibly improving symptoms of ADHD. Foods high in polyphenols include berries (especially blueberries), spinach, green tea, cocoa powder and dark chocolate. 

Summary

ADHD is something that provides children and adults with many strengths as well as struggles.  Consuming a balanced, plant predominant, whole food diet that is low in sugar and refined grains (similar to a Mediterranean diet) is the best way to minimize the symptoms of ADHD. An elimination diet of gluten and/or dairy can also be beneficial to test for a possible food sensitivity, and ensuring you are not consuming too much caffeine and are consuming regular meals is also important. 

Are you looking for support, guidance and/or accountability to help manage your (or your child’s) ADHD symptoms so you can feel your absolute best? Book a free 15-minute consultation with Christy to learn more about the holistic nutrition and occupational therapy services offered. 

References

https://www.sciencedirect.com/science/article/abs/pii/S0306987710003531?via%3Dihub

https://www.sciencedirect.com/science/article/abs/pii/S0028390812002845

https://pubmed.ncbi.nlm.nih.gov/24934907/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441937/

Holford, P. (2010). Optimum Nutrition for the Mind. Piatkus.

Murray, M.T. & Pizzorno, J. (2012). The Encyclopedia of Natural Medicine: Third Edition. Atria Paperback

Naidoo, U. (2021). This is your brain on Food. Hachette Book Group