ADHD Awareness Month

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 5% to 12% of the population in developed countries.

ADHD is a lasting pattern of inattention with or without hyperactivity that causes functional disruption in daily life. Symptoms include; impulsivity, hyperactivity, inattention, restlessness, talkativeness, boredom, inability to make decisions, procrastination and excessive fidgeting in situations such as meetings, lectures, or at the cinema.

The causes of ADHD are not fully established, but it is thought that reduced function of the brain leads to deficits in motor planning and cognitive processing (1). Potential underlying factors may include genetic causes, environmental elements and epigenetic components. Nutrition and lifestyle may both be influencing factors. (2).

Conventional Treatment

Treatment is based on a combination of behavioural and psychological therapy and medications. Medications are effective but may have undesirable side effects, such as: loss of appetite and weight, growth inhibition, abdominal pain, headaches, sleeping problems and increased blood pressure (3).  Given its adverse health outcomes and high healthcare and societal costs, other treatment options are being explored (4).

ADHD Awareness Month

ADHD Awareness Month is all about providing reliable information and resources to help people with ADHD to thrive. The theme of this years campaign is Awareness is Key!  The aim is to increase awareness and understanding by sharing ADHD information with all who could benefit. See https://www.adhdawarenessmonth.org/ for more information.

Diet and ADHD

The relationship between ADHD, obesity and eating habits

Both adults and children with ADHD are likely to consume less healthy foods (such as vegetables, fruits and fibre) and more unhealthy foods (fatty, sweet and processed foods) (4,5). These eating habits lead to a higher body mass index and a higher prevalence of obesity. Those with ADHD are also more likely to suffer from eating disorders, especially binge eating disorder (6).

Even though people with ADHD know what is bad for them and what is better to eat their behaviour does not match their knowledge. It has been found that environmental factors can influence food choices, particularly the attractiveness and convenience of the food. Those with ADHD may also be more influenced by advertising (7).

Several mechanisms have been suggested to account for this association including shared genetic transmission, dysregulation of dopamine, mood lability, impulsivity, inattention, sensitivity to rewards and low participation in physical activity.

Dietary Tips

Studies have shown that dietary patterns may influence the risk of ADHD, and specific dietary interventions have been proposed as complimentary treatments in this disorder (4). The following dietary tips are all likely to improve overall health and may improve ADHD symptoms:

Eat a high nutrient diet - rich in fruits, vegetables, and fibre. This is especially important during pregnancy, lactation and periods of intensive growth and development (3).

Avoid sugar, saturated animal fats, and ultra processed foods.

Avoid food additives - several studies have demonstrated the positive impact of the elimination of synthetic food additives, like artificial food colourings and preservatives on the behaviour of children with ADHD.

Eat low glycaemic food –eat whole grains rather than refined grains and avoid sugar and processed foods.

Lifestyle Tips

Sleep - good sleep practice is important for brain health and behaviour. Good sleep habits include: having a regular bed time and rise time, sleeping in a cool, quiet, dark room and avoiding screens for 2 hours before bedtime.

Mindfulness – meditation and mindfulness may be helpful for those with ADHD and their families. It can help with staying in the present moment and calming the mind.

Exercise - physical activity can help alleviate the symptoms of ADHD in children and may improve attention, executive function, and motor skills (8).

Nutrients for ADHD

Vitamins, minerals and essential fats are vital for the proper functioning of the brain and nervous system. Chronic deficiencies of certain minerals such as zinc, iron, magnesium, iodine and long-chain polyunsaturated fatty acids may have a significant impact on the development and deepening of the symptoms of ADHD in children.

Serotonin regulates a wide variety of brain functions and behaviours including executive function, sensory gating, and social behaviour, which may all be implicated in ADHD. Serotonin production and its use in the body is dependent on vitamin D and the omega 3 fatty acids, EPA and DHA (9).

Vitamin D – optimizing vitamin D intake may help prevent and modulate the severity of brain dysfunction (5,9). Vitamin D has been found to improve ADHD symptoms in those with deficiency.

Iron - Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, dopamine production, and DNA synthesis (2).

Magnesium – taken alongside vitamin D, magnesium may improve behavioural function and the mental health of children with ADHD (10).

Omega-3 - necessary for proper development and function of the brain. Deficiency may contribute to increased risk of ADHD in children (3). Optimizing omega-3 fatty acid intake may help with symptoms (5,9).

Probiotics – the bidirectional relationship between the gut and the brain means that having a healthy gut microbiome can have a big impact on brain function and behaviour (11,12).

Zinc – needed for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins, with important roles in neurological function, inattentiveness, impulsiveness, finicky appetite, and mood changes (2).

References

1. CNS Neurol Disord Drug Targets. 2023;22(5):711-735. The Effects of Vitamin Therapy on ASD and ADHD: A Narrative Review. Mohadeseh Poudineh et al.
2. 2021 Nov 13;13(11):4059. The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials. Roser Granero et al.
3. Rocz Panstw Zakl Hig. 2012;63(2):127-34. The influence of components of diet on the symptoms of ADHD in children. Klaudia Konikowska et al.
4. 2022 Oct 16;14(20):4332. Eating Patterns and Dietary Interventions in ADHD: A Narrative Review. Sofia Pinto et al.
5. Can J Psychiatry. 2024 Aug;69(8):567-589. The Role of Dietary Patterns and Nutritional Supplements in the Management of Mental Disorders in Children and Adolescents: An Umbrella Review of Meta-Analyses: Le rôle des habitudes alimentaires et des suppléments nutritionnels dans la prise en charge des troubles mentaux chez les enfants et les adolescents : une méta-revue de méta-analyses. Maria Talib et al.
6. Hershko S, Aronis A, Maeir A, Pollak Y. (2018). Dysfunctional Eating Patterns of Adults With Attention Deficit Hyperactivity Disorder. J Nerv Ment Dis.
7. Hershko S, Cortese S, Ert E, Aronis A, Maeir A, Pollak Y. (2019). Advertising Influences Food Choices of University Students With ADHD. J Atten Disorders. Journal of Attention Disorders 25(8)
8. Psychiatry Res. 2022 May:311:114509. Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: A meta-analysis. Wenxin Sun et al.
9. FASEB J. 2015 Jun;29(6):2207-22. Vitamin D and the omega-3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior. Rhonda P Patrick et al.
10. BMC Pediatr. 2021 Apr 17;21(1):178. The effect of vitamin D and magnesium supplementation on the mental health status of attention-deficit hyperactive children: a randomized controlled trial. Mostafa Hemamy et al.
11. 2021 Jan 16;13(1):249. Current Evidence on the Role of the Gut Microbiome in ADHD Pathophysiology and Therapeutic Implications. Ana Checa-Ros et al.
12. Curr Nutr Rep. 2023 Sep;12(3):383-394. Nutrition in the Management of ADHD: A Review of Recent Research. Klaus W Lange et al.