From Our 2012 Archives
Is There an ADHD Diet?
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Not Really, but Certain Healthy Changes to Your Child's Diet May Help
By Denise Mann
Reviewed by Hansa D. Bhargava, MD, FAAP
Jan. 9, 2012 -- There isn't a specific diet or magic vitamin that will curb hyperactivity, impulsiveness, and other symptoms of attention deficit hyperactivity disorder (ADHD), but steering clear of certain unhealthy foods may make a difference, a new review shows.
Foods that may predispose a child to ADHD include:
Replacing these ADHD-linked foods with healthier choices including fish, vegetables, fruit, and whole-grain cereals may help improve some of the symptoms of ADHD. These are some of the findings of a review article in Pediatrics that looked at the role diet plays in treating ADHD.
As many 5.4 million children aged 4 to 17 have been diagnosed with ADHD, a behavioral disorder marked by trouble focusing, impulsive behaviors, and hyperactivity. ADHD is usually treated with medication and behavioral changes, such as adapting a regular routine. Many parents and doctors don't like the idea of medication and would prefer a more natural or dietary approach.
"A healthy diet should be encouraged and an ADHD-provoking diet avoided," says researcher J. Gordon Millichap, MD. He is a pediatric neurologist at Children's Memorial Hospital in Chicago.
Also worth a try are supplements of omega-3 fatty acids. There is no consensus on how or even if these supplements help children with ADHD. But children with ADHD who have low levels of fatty acids may benefit from these supplements.
"Special elimination or hypoallergenic diets, omitting dyes, milk, and sugar, are time consuming and [should be] tried only with definite evidence of adverse response to these items," Millichap says.
Healthy Diet May Improve ADHD Symptoms
"What makes the most sense is to look at a child's diet and see what changes may be healthy in general and may also help improve ADHD symptoms," says Marshall Teitelbaum, MD. He is a child, adolescent, and adult psychiatrist in private practice in Palm Beach, Fla.
"Cut back on soda, junk food, hot dogs, and processed foods," he says. Many of the restrictive diets out there such as the Feingold diet are hard for children to stick with, he says. The Feingold diet was popular in the 1970s. It aims to cut out foods with artificial coloring and flavoring and certain preservatives.
"If you are going to try something, it may as well be something that will stick," Teitelbaum tells WebMD.
There is also a role for trial and error. "If someone is more sensitive to sugar, pay attention and keep it in moderation," he says.
The whole family has to be on board with any changes. "You can't tell a child to eat a special diet when the rest of the family isn't," Teitelbaum says.
Stephen Grcevich, MD, says medication and behavioral changes should always come first, especially for children with issues in addition to ADHD, such as anxiety or depression. Grcevich is a child and adolescent psychiatrist at Family Center by the Falls in Chagrin Falls, Ohio.
"Do the things that we know work best first," he says. Diet is not a substitute for these tried-and-true treatments, he says.
Grcevich is also against highly restrictive diets largely because they are difficult to comply with for the long haul. But "if your kid swings from the chandelier every time you give them a diet soda, don't give it to them anymore," he says.
First, do no harm, adds Andrew Adesman, MD. He is the chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park.
"There are several different options that are likely not harmful and may offer some benefit, including supplementing omega-3 and iron and zinc, if a child is deficient," he says.
Avoiding ADHD-associated foods may not make a big difference in ADHD symptoms, but cutting out these foods may have other health benefits such as reducing your child's risk of being overweight or obese, he says.
Feingold Diet Advocate Responds
JaneHersey is the director of the Feingold Association. She takes issue with some of the points made in the new study. "The Feingold diet is neither 'complicated' nor 'disruptive,'" she says in an email.
It is the synthetic additives in the foods, drinks, and candy that are the big offenders, not the sugar, Hersey says.
SOURCES: Millichap, G. Pediatrics, published online Jan. 9, 2012.J. Gordon Millichap, MD, pediatric neurologist, Children's Memorial Hospital, Chicago.Marshall Teitelbaum, MD, child, adolescent, and adult psychiatrist, Palm Beach, Fla.Stephen Grcevich, MD, child and adolescent psychiatrist, Family Center by the Falls, Chagrin Falls, Ohio.Andrew Adesman, MD, chief of developmental and behavioral pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, New Hyde Park, N.Y.Jane Hersey, director, Feingold Association.