Nutrition and lifestyle strategies for supporting children with ADHD

There are many misconceptions about ADHD, for example, it isn’t a real medical condition, it’s just bad parenting/lack of discipline, it only affects boys, and people with ADHD are just lazy and need to try harder. This can be very frustrating for parents of children with ADHD, or the children themselves, who are often trying incredibly hard to pay attention, control their emotions and keep up with their neurotypical peers academically and socially.

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterised by a cluster of symptoms including inattention, hyperactivity and impulsivity. 

Research suggests that people with ADHD have impaired activity in the areas of the brain responsible for decision-making, attention, organisation and emotional regulation. 

Studies have also shown that ADHD brains have lower levels of the neurotransmitter dopamine, responsible for regulating the brain’s reward system. This explains why many children with ADHD crave sugar and carbs or become addicted to gaming - they are looking for a dopamine hit…

Conventional management of ADHD generally involves a combination of parent education, therapy and medication. In addition to these strategies, research has shown that addressing underlying metabolic, nutritional and dietary problems can increase the effectiveness of ADHD treatment.

A holistic approach to managing ADHD

The following strategies aim to significantly improve your child’s ADHD symptoms and can be used on their own or alongside ADHD medication.

Diet

Eliminate artificial colours (including the natural colour 160b), flavours, sweeteners and preservatives

This is one of the most important - and effective - changes you can make! There are many studies linking additives to hyperactivity so if your child has ADHD, it is well worth checking the ingredients of everything you buy and avoiding all of the above.

Reduce sugar, especially refined sugar

Refined sugar causes children’s blood glucose levels to spike and crash, resulting in fluctuations in mood and energy levels. Artificial sweeteners aren’t any better - they are  hundreds of times sweeter than regular sugar, highly addictive, negatively impact gut bacteria and are associated with a wide range of adverse health reactions. So no diet soft drinks!

Focus on healthy carbohydrates

Diets high in refined carbohydrates (e.g. white bread, cakes, crackers and biscuits) cause blood sugar fluctuations whereas healthy carbohydrates like wholegrains, fruit and vegetables release glucose into the body slowly, providing a more sustained source of energy.

Include quality protein with every meal 

Protein helps to stabilise blood sugar levels, energy, mood, focus and attention.

Load up on good fats, e.g. avocado, olive oil, nuts, seeds, oily fish

Omega 3 fatty acids are are a critical structural component of the brain and assist with learning and memory

Try reducing or eliminating foods high in phenols and salicylates (naturally occurring food chemicals that are also found in many food additives)

If your child displays any of the following signs, they may benefit from cutting back on phenols and salicylates in their diet: red cheeks and ears after eating, headaches, hyperactivity, hives, aggression, night sweats or cravings for foods high in phenols and salicylates (e.g. berries, grapes, apples, citrus).

Address food intolerances

Food intolerances and allergies can contribute to lack of focus and hyperactivity. I recommend completing a food and symptom diary for 1-2 weeks if you suspect your child is reacting to anything in their diet.

Heal and support the gut to maximise nutrient absorption and digestive function

The gut is connected to the brain so it makes sense to work on making sure your child’s gut is as healthy as possible. Gut-healing and nourishing foods include bone broth, oily fish, fermented foods (e.g. sauerkraut, yoghurt, miso, kombucha) and prebiotics (e.g. sweet potato, bananas, oats, garlic, onion, apples)

Correct nutrient deficiencies through diet and supplements

Magnesium

Magnesium deficiency is common in children with ADHD and it causes symptoms like mood dysregulation, sleep disruption, constipation, hyperactivity and inattention. Foods high in magnesium include leafy greens, beans, wholegrains, nuts, seeds and fruits.

Zinc

Zinc plays a crucial role in brain development and helps to maintain neurotransmitter balance. Signs of deficiency include picky eating, delayed growth, white dots on fingernails, frequent infections and eczema. Foods high in zinc include oysters, red meat, poultry, beans, nuts and seeds (especially pumpkin seeds)

Essential Fatty Acids (Omega-3s)

Omega-3 deficiency is is associated with mood and behavioural disorders, ADHD symptoms and impaired cognitive function. Foods high in Omega-3 include olive oil, oily fish, nuts, seeds and avocado

It may be necessary to address potential vitamin D and iron deficiencies as these are also common in children with ADHD.

Lifestyle - get the basics sorted!

• Establish a predictable sleep routine

• Encourage regular daily exercise

• Use schedules, checklists and timers!

Prepare for ADHD medication rebound 

Stimulants (e.g. Ritalin, Concerta) are one of the most commonly prescribed types of ADHD medication. Unfortunately, when the stimulant medication wears off, it can cause a sudden spike in ADHD symptoms, causing the child to become overexcited and impulsive or irritable, angry and emotional. All this conveniently tends to happen in the afternoon or early evening, just when you are trying to get them to do their homework or get organised for bed!

Stragegies to minimise medication rebound include:

• try to get homework done as early as possible (before the medication has completely worn off)

• give your child a high-protein snack, e.g. baked beans on toast, yoghurt with fruit and granola, bliss balls, crackers with cheese, hummus and vegie sticks, hard-boiled egg, apple slices with peanut butter

• engage in therapeutic exercise, e.g a game of soccer in the backyard, going for a walk or scooter ride

• create a calm and predictable evening home environment

References

ADHD Foundation, 2020, ‘Is there a link between ADHD and dopamine?’, AHD Foundation, Australia, viewed 13 February 2023, https://adhdfoundation.org.au/wp-content/uploads/2020/06/Dopamine.pdf

Epidemic Answers, 2023, ‘How phenols and salicylates may be contributing to your child’s mood, behaviour and hyperactivity’, Epidemic Answers, USA, viewed 13 February 2023, https://epidemicanswers.org/how-phenols-and-salicylates-may-be-contributing-to-your-childs-mood-behavior-and-hyperactivity/

Hjalmarsdottir, F, 2020, ‘Does nutrition play a role in ADHD?’, Healthline, New York, viewed 13 February 2023, https://www.healthline.com/nutrition/nutrition-and-adhd

Laake DG & Compart PJ, 2013, The ADHD and Autism Nutritional Supplement Handbook, Fair Winds Press, USA.

Rodden J, 2023, ‘ADHD medication rebound: what to do when a prescription wears off’, ADDitude, USA, viewed 13 February, https://www.additudemag.com/adhd-medication-rebound/#:~:text=ADHD%20medication%20rebound%2C%20sometimes%20called,the%20end%20of%20a%20dose.

Rowe K, 1994, ‘Synthetic food colouring and behaviour: a dose response effect in a double-blind, placebo-controlled, repeated-measures study’, Journal of Pediatrics, vol 125, no 5, pp. 691-8.

Silver L, 2023, ‘The ADHD brain: neuroscience behind attention deficit disorder’, ADDitude, USA, viewed 13 February 2023, https://www.additudemag.com/neuroscience-of-adhd-brain/#:~:text=ADHD%20brains%20have%20low%20levels,functional%20regions%20of%20the%20brain.