Using Nutrition to Help Children Manage ADHD

One of the most common childhood disorders is Attention Deficit Hyperactivity Disorder (ADHD). Symptoms of this disorder include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity).

According to the Centers for Disease Control and Prevention (CDC), more than 1 in 10 U.S. school-aged children had received an ADHD diagnosis by a health care provider by 2011. That number increased by 42% between 2003 and 2011.

Scientists are still unsure what exactly causes ADHD, and it may be a combination of several factors, such as genetics, environmental factors, nutrition, and brain injuries.

Possible Factors Contributing to ADHD

Pesticides

A nationwide study published in the Pediatrics journal in 2010 found that children exposed to higher levels of pesticides, found in trace amounts on commercially grown fruit and vegetables, were more likely to have ADHD than children with less exposure. Organophosphates are "designed" to have toxic effects on the nervous system, says the lead author of the study, Maryse Bouchard, Ph.D., a researcher in the department of environmental and occupational health at the University of Montreal. "That's how they kill pests."

"Organic fruits and vegetables contain much less pesticides, so I would certainly advise purchasing those for children," says Bouchard. "National surveys have also shown that fruits and vegetables from farmers' markets contain less pesticides even if they're not organic. If you can buy local and from farmers' markets, that's a good way to go."

When dealing with your yard and garden, there are many effective, nontoxic fixes to pest problems (for grass, garden & pests), and learning to use the alternatives will help your child's health. 

Mercury and Lead

Mercury is considered to be a major environmental threat by scientists. We often are exposed to mercury by eating fish. In 2012, JAMA Pediatrics published a study on the effects of prenatal exposure to mercury and fish consumption during pregnancy and ADHD in children. The study reached two conclusions that were almost contradictory. Results suggested prenatal mercury exposure is associated with a higher risk of ADHD-related behaviors. However, fish consumption during pregnancy is associated with a lower risk of these behaviors. What this means is the nutrients found in fish, DHA and EPA, are healthy for the baby, but the man-made chemicals and toxins fish absorb into their meat are terrible for humans. 

Eating two servings a week of low mercury fish while pregnant may extend these protective benefits. Certain types of fish are more likely to have a higher mercury content, such as swordfish, fresh tuna, albacore tuna, marlin, orange roughy, shark, and mackerel. Fish with the lowest levels of mercury include anchovies, catfish, herring, salmon, tilapia, and freshwater trout. (For a more extensive list, visit the Natural Resources Defense Council for a Consumer Guide to Mercury in Fish.)

I prefer a fish oil supplement that has removed the mercury and other toxins via molecular distillation. My kids take this fish oil supplement.

Lead toxicity has been associated with cognitive and behavioral problems in children. Studies have shown lead toxicity and environmental toxins were clearly linked to ADHD.

Inflammatory Foods (Sugar, Food Additives, Gluten)

Certain foods affect the brain in a negative way. Foods that contain trans fats, food additives, white flour, sugar, gluten and dairy can all be pro-inflammatory and negatively influence inflammatory pathways throughout the body. Many parents find reducing their children's exposure to these pro-inflammatory foods can have a positive effect on behavior.
 
Gluten can trigger a low-grade, chronic immune response that inflames the brain and many other systems. It would be worthwhile to temporarily remove gluten-containing foods and monitor whether or not it helps behavior. I recommend a complete 100% elimination of all gluten and dairy foods for a full six weeks, along with aiming to remove as much of the sugar and processed foods as possible. After this time, you can slowly reintroduce foods (or additives) one at a time, recording any changes in behavior. 

Nutrition to Help Manage ADHD Symptoms

Many parents of children with ADHD find nutrition can make a big difference in the behavior of their children with ADHD. Science has yet to prove that nutrition is a cause for this disorder, but many studies suggest good nutrition can play a role in managing it.

Protein

Protein-rich meals can trigger the brain to produce alertness-inducing neurotransmitters, boosting a child's ability to focus. On the contrary, carbohydrate-rich meals can trigger drowsiness. Depending on their age, children need between 24 to 30 grams of protein a day, but if your kiddo is served protein at most meals and snacks, they'll eat enough. 

Here are some after-school snacks that contain protein and are low in added sugar. These snacks also provide fat and fiber, which are important for the brain too.  

**Peanut butter toast, a tortilla wrap with almond butter & sliced bananas, protein shake, meat and cheese roll-up, fruit and cheese slices, high protein nutrition bar, veggie platter, raw nuts and seeds

**Nut butters are convenient and contain both protein and fat. Since kids like variety, I mix it up and alternate between almond, peanut, cashew, and sunflower seed butter. 

Hydration

Every cell in our body requires water so if they’re dehydrated, that will have a big impact on mood and energy. Offering kiddos sugar-y drinks is not a good choice – they’re not the key to rehydrating.

**Encourage your kiddos to drink water, and when water gets boring, add a scoop of an organic green powder to their water bottle. It will hydrate and provide a good dose of nutrients.  

Stop Blood Sugar Spikes

Protein and good fats are the fuel your brain needs to work. The important thing about protein and fats is they take time to digest, which influences blood sugar levels. You get a steadier blood sugar level rather than peaks and valleys. Keeping the blood sugar more stable will allow your child to concentrate, behave better at school, and have a more even mood.

**Include protein, fats, and high-fiber foods (fruits and veggies) at every meal and snack to minimize blood sugar spikes. This is key! I always make sure to give my kids an after-school snack that contains protein and fat. Their favorites are a wrap with nut butter and banana slices, peanut butter toast, and jerky with orange slices.

**Remove as much sugar and as many refined carbs as possible from your child's diet. This means offering grapes instead of candy, water instead of gatorade, carrots instead of goldfish crackers, etc., etc. If you're used to serving these types of convenience foods, it will be a challenge, but it will be worth it when you notice an improvement in your child's behavior and temperament. 

Why not sugar? The body burns through sugar really, really fast as a source of energy, which means we get a spike and then a crash. With that crash comes fatigue, crankiness, and irritability. It also creates a craving – when your body burns through it, it wants more of it, which is a perpetuating cycle. It doesn’t mean no sugar ever but as a parent, think it through. If you want your child to sit down and focus on homework, the sugar isn’t going to be the fuel for that.

Here are many more useful tips for how to support healthy blood glucose levels and reduce insulin spikes.

Address Nutrient Deficiencies

A host of nutrient deficiencies, including magnesium, zinc, selenium, tyrosine, and fatty acids play significant roles in the development of ADHD. Many of these nutrients work synergistically. 

Studies find significantly low levels of vitamin D in children with ADHD. I like this vitamin D3/K2 supplement for my kiddos. 

Low levels of zinc are associated with lowered immunity, poor heavy metal detoxification, and ADHD. 

Low magnesium levels are very common, especially if a child isn't eating a lot of fruits and vegetables. Here are examples of foods high in Magnesium. A deficiency can lead to headaches, anxiety, insomnia, muscle spasms, cramps and aches, and hypersensitivity to noises.

Zinc, magnesium, and iron are minerals needed to produce neurotransmitters and to improve cognitive function. Zinc and iron are used by the brain to produce and regulate dopamine, and magnesium is used to make neurotransmitters that are involved in attention and concentration and have a calming effect on the brain. These three minerals are found in poultry, seafood, and nuts.

Eat More Foods that Support Healthy Inflammatory Levels

Maintaining a healthy ratio of omega-6 to omega-3 fats is important for promoting healthy inflammatory levels. Unfortunately, the typical American diet contains too many omega-6 fats, which is implicated in inflammation. 

Omega-3 Fatty Acids (DHA and EPA)

The omega-3 fatty acids, DHA and EPA, are essential for brain and nerve cell function. In fact, 60% of the brain consists of DHA. A lack of these fats is strongly associated with ADHD, as well as eczema and immune deficiency. These essential fats are typically found in cold-water, fatty fish such as sardines, tuna, and salmon. If your child doesn't eat fish, or eats less than 2 servings per week, consider an omega-3 fish oil supplement.

**Choose a fish oil brand with a reliable purification process that removes mercury and other chemicals. In general, most studies indicate 120–1,300 mg of combined DHA and EPA per day is beneficial for children.

I give my kids Nordic Naturals for DHA and EPA. Depending on what form (liquid, soft gel, gummy) your kids will take their fish oil in, here are some options I prefer:

This soft gel version is great for any age. My nine-year-old chews these up, haha!

Antioxidants

Antioxidants are linked to brain health by supporting cell health and healthy inflammatory levels. Normal levels of inflammation are important for brain health and ADHD. Here are my favorite foods high in antioxidants, and they usually contain more than one type of antioxidant.

  • Berries (strawberries, blackberries, blueberries, raspberries, black currants, mulberries)
  • Nuts (sunflower seeds, almonds, hazelnuts)
  • Broccoli
  • Leafy Greens (kale, collards, spinach)
  • Beets
  • Cherries
  • Oranges
  • Green Tea
  • Peppers (bell and chili)
  • Mushrooms
  • Grapes
  • Turmeric

Herbs

Adults and some children have experienced the benefits of stimulating herbs, such as Ginkgo biloba and ginseng, according to the editors of ADDitude Magazine. These herbs may act like stimulants without the side effects of ADHD medication, improving ADHD rating scales and reducing impulsivity and distractibility. Asian ginseng may be too much for younger children, who may want to try American ginseng instead.

Rhodiola rosea is an Arctic grown herb that may support a normal level of alertness, attention, and accuracy. While usually too stimulating for younger children, it could be beneficial to older children, such as junior high, high school, or even college aged people who need to spend long hours reading or completing papers and projects.

Fix Gut Health

There's a huge connection between the health of your child's gut and brain function. In fact, most allergic and autoimmune diseases originate in the gut, but so do depression, autism, OCD, ADHD, dementia, and Parkinson's disease! 

If your kiddo experiences diarrhea, constipation, stomach aches, anal itching, and a sensitive stomach, that's a sign of digestive imbalances. The use of frequent antibiotics can lead to yeast overgrowth and abnormal gut flora. This results in a leaky gut (also called intestinal permeability). This condition gives way to food allergies, systemic allergies, and inflammation. 

Since the microbiome does so much in your child's body, Meet your microbiome here and find out my favorite gut nourishers. Slip a handful of these foods into your child's diet every day. 

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods


References:

http://www.cdc.gov/ncbddd/adhd/features/key-findings-adhd72013.html

http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml#part2

http://pediatrics.aappublications.org/content/125/6/e1270.abstract?sid=11b2c1ea-67e5-442d-85ab-1ddb22cdd9f6

http://archpedi.jamanetwork.com/article.aspx?articleid=1377487&resultClick=3

http://www.nrdc.org/health/effects/mercury/guide.asp

http://www.additudemag.com/adhd/article/859-2.html

https://www.ncbi.nlm.nih.gov/pubmed/25790022

https://www.ncbi.nlm.nih.gov/pubmed/11153584

The best way to test heavy metals.

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