Attention-deficit/hyperactivity disorder (ADHD) is a mental health disorder that includes a combination of persistent problems, such as difficulty paying attention, hyperactivity and impulsive behaviour. ADHD can lead to unstable relationships, poor work or school performance, low self-esteem, and other health-related problems.
There are several theories regarding how changes in diet can impact ADHD. Some of the most common include:
- Diets low in sugar and refined carbohydrate, high in quality protein
- Elimination/reduction of dietary allergens (sensitivities), and food additives
- Treatment of nutritional deficiencies with nutritional supplementation
- Detection of heavy metal toxicity and measures to reduce toxic burden
- Treatment of intestinal dysbiosis, including toxic bacteria, candida overgrowth
In the 1970s Benjamin Feingold, MD, popularized the concept that ADHD is caused and aggravated by intolerance to food additives and salicylates. His claims were based on over 1,200 cases in which food additives were linked to behaviour and learning disorders. He also believed that many affected children reacted adversely to salicylates – not only from aspirin but also salicylates that occur naturally in the food we eat. The principle of the diet is avoidance of the following:
- All foods that contain artificial colours and flavours
- Artificial fragrance in foods, air fresheners and lotions
- Artificial sweeteners including aspartame, sucralose and saccharin
- Food preservatives BHA, BHT and TBHQ
Also, avoidance of salicylates in both medications and naturally occurring in foods such as: almonds, currants, plums, prunes, gooseberries, raspberries, apricots, grapes (and raisins), strawberries, blackberries, cherries, nectarines, peaches, oranges, tomatoes, cucumbers (the list continues!).
Whilst research on the Feingold diet is mixed, there is general acknowledgement that the incidence of food sensitivities in people with ADHD is significantly greater than that seen amongst the general public. A hypoallergenic (oligoantigenic) diet has been shown to prevent bedwetting and migraines in some hyperactive children. Other studies have shown that eliminating individual allergenic foods and additives from the diet can significantly improve a child’s ability to concentrate.
Consuming sugar may aggravate ADHD. Studies have found that avoiding sugar reduces aggressiveness and restlessness in hyperactive children – girls more so than boys. Hyperinsulinism (too much insulin in the blood), along with low blood sugar can be a contributing factor in aggressive and irritable behaviour seen in people with ADHD. A glucose/insulin tolerance test can determine whether this may be a contributing factor.
Common allergenic foods include:
- grains, including wheat, barley, oats, corn and rye
- milk and cheese
- sugar and all refined carbohydrates – chocolate, cake, biscuits, ice cream etc
- corn syrup
Heavy metal toxicity does appear to be a factor in some people with ADHD. Whilst of course we are all exposed to heavy metals, it has been found that there is significantly greater retention especially of aluminium and cadmium in people with ADHD. High cadmium has also been detected in some studies of ADHD children. Lead exposure is associated with hyperactivity. There also appears to be a direct relationship between the levels of lead and the degree of psycho-social and learning impairment in children.
Intestinal Dysbiosis is another factor in ADHD. Imbalances in the intestinal bacterial flora can lead to over-growth of pathogenic organisms and the production of toxins. These toxins have frequently been identified in the urine of children with ADD, ADHD and autism. Dysbiosis can be treated using a programme of what is commonly referred to as the “4 R’s” – remove, repair, replenish, reinoculated – as well as enhancing immune function. Treatment should always be undertaken under the guidance of a suitably qualified practitioner.
Nutritional supplement treatment options
Magnesium – Some children with ADHD have lowered levels of magnesium. Controlled trials of supplementation have shown a significant decrease in hyperactive behaviour.
Zinc – In a double-blind study, children with ADHD who received 15 mg of zinc per day for six weeks showed significantly greater behavioural improvement, compared with children who received a placebo.
L-carnitine – In a double-blind study supplementation with l-carnitine for eight weeks resulted in clinical improvement in 54% of a group of boys with ADHD, compared with a 13% response rate in the placebo group.
Essential Fatty Acids – Many ADHD children have a deficiency of essential fatty acids (EFAs). There are a number of potential causes:
- they cannot metabolise the essential fatty acids normally
- they cannot absorb EFAs normally from the gut
- their EFA requirements are higher than normal
- A zinc deficiency will also contribute to poor metabolism of EFAs
- Wheat and milk can also block conversion of EFAs in the gut so there is also an additional link with potential food sensitivities
It is important for those with ADHD to restrict their intake of polyunsaturated oils, trans-fatty acids and hydrogentated oils (this would especially include fast foods, ready-made meals and packaged foods, as well as refined carbohydrates).
Iron and ferritin levels are frequently found to be lowered in children with ADHD.
B vitamins, particularly vitamin B6, have also been used for ADHD.
Vitamin B3 has repeatedly been shown in controlled trials to improve behavioural symptoms in children with ADHD.
Article contributed by Dr Tracy S Gates, DO, DIBAK, L.C.P.H., Consultant, Pure Bio Ltd. Copyright © Pure Bio Ltd 2021. All rights reserved. Pure Bio Ltd are a leading UK supplier of the highest quality PURE nutritional supplements, based in Horsham, West Sussex. Visit www.purebio.co.uk for all your nutritional supplement needs