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ADHD and Diet - Part I

by Glenn Hefley

Ask ten nutrition experts what you should eat and you will get ten, often-conflicting diet plans. Add ADHD into the mix and you could need some quiet time afterwards.

First off, ADHD is not caused by diet. This has been proven and studied enough for me to put that statement in here. Does diet affect ADHD children? Of course. Diet, as in "what we put into our bodies," affects all of us whether we have ADHD or not. Just eat a turkey sandwich and drink a beer and you'll understand that point. Unfortunately, in most regards nutritional information is often like history; even the most respected historians have agendas - it's just the nature of things.

Nevertheless, there are some areas of bedrock we can build on. There have been enough studies and research done, from Dr. Feingold's dietary study on hyperactivity in 1975, all the "catch up" research after that, and then the calmer studies that followed, that we can be sure of a few things.

First off, let us look at a few guidelines that just about everyone can agree on. Changing diet is a process, not a pill. It is going to take a few days (more than a week in some cases) to see results. ADHD children are susceptible to any change, not just diet, so when judging whether or not the changes being made are good or not, keep in mind other environmental changes as well.

Many parents make changes to diet at the start of summer vacation, and then tell me they didn't see any results. In fact, they tell me, their child appeared more agitated and less focused. With the two "changes" so close in time, it seems obvious what really happened. However, when we are doing these adjustments ourselves, we sometimes fail to see the whole picture.

Major changes in diet can adversely affect anyone, not just ADHD children. For example, if you cut out all meat from your child's diet, it may not be the lack of meat which is causing irritability and discontent. It might be that you took away all of his favorite meals in one shot and he's a little upset about it. Again, looking at the whole picture is a good idea, and as with anything, moderation is always a good idea.

My son is adversely affected by dairy products. We've seen this over and over, even ice cream. When taking in a few large glasses of milk and a bowl of ice cream in a day, he becomes less focused, easily distracted, and mentally lethargic. His physical activity does slow down, but not in a good way.

Yanking all the dairy products from his diet proved to provoke discontent and resentment, which resulted in just about the same symptoms as the milk and ice cream did. If I wasn't paying attention, I might have concluded that the change in diet had no affect on him at all.

One difference was that he was more physically active. Again, if I wasn't paying attention I might have concluded at that point that removing the dairy from his diet was in fact a bad idea. Nutritionists will tell us just to make the change, but they don't have to live with our child, or live inside our child's minds either.

This doesn't mean they aren't right a good deal of the time. Dairy products were not helping my son's mental disposition, and the affect they were having was obvious. What we did was start with soy milk in his cereal. I used the vanilla flavored type, and added dried cranberries. Another thing I did was make sure I was eating the same thing. It might be a good idea not to let them see you pour it at first until they try it, as soy milk tends to be slightly tan in color and not the bleached white that milk normally is. Once in the cereal, it isn't noticeable for the most part and the dried cranberries are quick to add their own color to the mix.

This worked well, and he liked the flavor. He also became curious about the soy milk. It comes in chocolate flavor as well, and after a few days of cereal he tried some as a drink and found he liked it. After a time I was able to remove milk from my shopping list. Ice cream, however, is a whole different story. I have yet to find a soy substitute (or any other substitute) for ice cream that he can't spot a mile away. First taste and he knows it's not ice cream (so do I for that matter). What we have done with this is to limit the amount of ice cream, to the point that it is down to one night a week. Some weeks he forgets and I don't remind him.

I personally don't see any reason for raw sugars and hard candies. Halloween might be the exception to this rule, but other than this one night of sugar overload, we don't have it in the house. Any child, ADHD or not, eating sugar shows signs of irritability, high activity, and lack of focus (except on how to get more sugar candies). Taking them out of the daily diet is a good thing. Being militant about it is probably not a good thing. Some parents of ADHD children I know are very strict about not having any sugar in their house, and you would be hard pressed to find a nutritionist that thought daily sugar intake was a good idea. The nutritionists might vary in their opinion on what degree sugar affects our children, but I've never read a study that said it was good for them as a food group. Normally the papers read like a study on how much lead in the water is lethal or just toxic.

The fact of the matter is what we put in our bodies affects our mental state. Our bodies and minds are bio-chemical machines running on the fuel given to them. Diet is not a cause of ADHD, but diet can and does affect our child's mental state, and they have enough going on up there that they don't need to try thinking through dairy and sugar clouds.

Whole grains are a great idea. There have been many studies on the affects of whole grains on mental health. Just about every study on diet and ADHD suggests that whole grains are a good idea, the more the better. Wheat crackers, corn flake cereals, oat cereals, granola bars, trail mixes, good breads, and the like are perfect snacks and foods.

Vegetables are important - again, the more the better. I read a book not to long ago that made the statement "vegetables can be exciting". Perhaps exciting to that nutritionist, but they aren't high on the excitement scale around my house. The more they can eat, however, the better. Never hold back on the salad or raw vegetable trays at dinner. My son doesn't have to be excited about them, just has to eat them. I have personally found that if it is just a fact that there are vegetables at dinner and snack time, he just eats them. If I try to "spruce them up" or make them exciting, he rebels, because he knows better. They are vegetables.

If your child likes or will eat mushrooms, there have been some very interesting studies on those and the direct link they have to health and mental stability.

Fruits have high sugar (fructose) content, but they are much better than raw sugars or candies. Frozen grapes are a great snack. Most children see bananas, apples, oranges, and grapes in the fruit selection of their lives, but there are a many other fruits that are favorites around my house. Papaya is fantastic. A store near us sells dried Papaya spears, which don't sit around in the cupboard very long. Pineapple is a sugar rush to say the least. You might want to limit those, but they are still better than dried sugar on a lick-stick.

A run down on some of the studies and research land marks for diet and food additives:

In 1975, Feingold published his hypothesis that the elimination of certain food additives from the diets of hyperactive children can result in improvement of behavioral symptoms.

1981: Two studies were published which did not support Feingold's hypothesis. One study challenged children who had already been on Feingold's diet with high doses of color additives and found no effect, when compared to a placebo. Another found no effect of violations of the Feingold diet among children who had been on the Feingold diet for 3 months.

A 1986 review of studies which evaluated the Feingold diet concluded that there is no evidence for a causal association between food additives and behavioral disturbance in children.

A 1986 review of studies which controverted Feingold's hypothesis maintained that data from these studies were interpreted incorrectly, or that they were flawed in other ways.

A recent study of the food color additive tartrazine suggested a dose response relationship between that additive and behavioral disturbances (not necessarily ADHD) in children.

Read ADHD and Diet - Part II

References and Studies

Leung AKC, Robson WLM, Fagan JE, Lim SHN. Attention-deficit disorder. Getting control of impulsive behavior. Postgraduate Medicine 1994;95:153-160.

Cantwell DP. Attention deficit disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 1996;35:978-987.

Feingold BF. Why Your Child is Hyperactive. New York, Random House, 1975

Mattes JA, Gittleman R. Effects of artificial food colorings in children with hyperactive symptoms. A critical review and results of a controlled study. Arch Gen Psychiatry 1981;38:714-718.

Adams W. Lack of behavioral effects from Feingold diet violations. Percept Mot Skills 1981;52:307-313.

Wender EH. The food additive free diet in the treatment of behavior disorder: a review. J Dev Behav Pediatr 1986;7:35-42.

Weiss B. Food additives as a source of behavioral disturbances in children. Neurotoxicology 1986;7:197-208.

Rowe KS, Rowe KJ. Synthetic food coloring and behavior: a dose response effect in a double-blind, placebo-controlled, repeated-measures study. J Pediatr 1994;125:691-198.

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