Eating Habits and Dietary Interventions in ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, affecting about 8% of children and adolescents worldwide. The prevalence estimate was twice higher in boys (10 %) compared to girls (5 %). (1)
It usually starts in early childhood and, in most cases, persists into adulthood. Symptoms include hyperactivity, inattention, impulsivity, impaired executive function, and emotional dysregulation, with several comorbidities emerging along the developmental trajectory.
Symptoms interfere with the quality of life of those suffering from this condition in various areas of life, whether school/work, leisure activities or everyday life, and can be categorised as predominantly attention deficit, predominantly hyperactivity or a combination of both. This diagnosis is based on a thorough clinical and psychosocial assessment, as well as a complete psychiatric history. (2)
Although ADHD is highly heritable, studies suggest that its ethology is multifactorial, with both genetic and environmental factors reflecting its phenotypic heterogeneity.
Given its adverse health outcomes and high healthcare and societal costs, other treatment options beyond pharmacotherapy have been explored.
Diet, as a modifiable environmental factor, has been investigated as a potential therapy option in ADHD. (3)
The Relationship between Diet and ADHD
The results of observational studies emphasise that it is not yet possible to establish a direct and definitive causal relationship between diet and ADHD.
In fact, the relationship between eating patterns and ADHD has produced inconclusive results, with some studies showing that a healthy eating pattern can decrease ADHD symptoms and others showing no significant effect.
Furthermore, lifestyle factors (e.g. physical activity, screen time and sleep) influence eating patterns and may be important confounding factors in establishing this relationship.
Even so, although the association between sugar consumption and ADHD remains contradictory in the literature, it is always important to limit sugar consumption as part of a healthy eating pattern.
In fact, the consumption of sugar and foods containing it in high quantities promotes a rapid rise in blood glucose levels (peak) and then a sharp drop, which leads to a greater feeling of tiredness, irritation and difficulty concentrating.
In addition, sugar consumption also promotes an excessive release of dopamine by the brain. Since people with ADHD have naturally lower levels of dopamine, these sudden spikes in release make the patients' symptoms even worse. (3)
Important nutrients in ADHD
Several studies have shown that children with ADHD have lower plasma levels of trace elements such as zinc, copper, iron, magnesium and selenium, which are essential for brain development and functioning.
Iron is an essential cofactor needed for various functions, such as the metabolism of neurotransmitters, especially the production of dopamine, which is an essential factor in ADHD.
Zinc is also an essential mineral, necessary for cellular functions related to the metabolism of neurotransmitters, melatonin and prostaglandins. Altered levels of iron and zinc have been linked to the worsening and progression of ADHD.
Furthermore, polyunsaturated fatty acids (PUFAs) are crucial for optimal neurotransmitter function, and some studies have confirmed that children and adolescents with ADHD have lower levels of these fatty acids in their blood and tissues.
Besides, some authors have found that a high consumption of sugary products, fried foods and salt was positively associated with learning, attention and behavioural problems, while a balanced diet, with regular meals and a high consumption of dairy products and vegetables, was negatively associated with these problems.
Finally, some studies have shown that children with ADHD have a lower adherence to healthy eating patterns than children without this disorder. (3)
Key points in the relationship between diet and ADHD:
- Dietary patterns can influence the range of ADHD symptoms and possibly the risk of them appearing, since ‘processed’ and ‘excessively sweet’ foods have been positively associated with this pathology. In fact, the Western pattern, rich in red and processed meats, refined cereals, soft drinks and hydrogenated fats, can increase symptoms by 92%.
- On the other hand, healthy eating patterns, such as the Mediterranean diet and vegetarian diets, full of vegetables and fruit and rich in micronutrients such as vitamin D, zinc and iron, have been inversely associated with worsening ADHD symptoms (3).
Conclusion and position of Oh! My Snacks
The nutritional approach to ADHD should be a healthy eating pattern, characterised by high amounts of fruit, vegetables, low-fat dairy products, vitamin C, iron, zinc and PUFA and low amounts of simple sugars.
At Oh!MySnacks, we are committed to personalised nutrition and food education for children, developing balanced snacks adapted to their preferences, needs and goals.
The children's snacks exclude white sugar, artificial sweeteners, high levels of protein and salt, and focus on plant-based ingredients such as nuts, fruit and whole grains, in line with dietary recommendations to help reduce ADHD symptoms and for children with this condition.
Some of our Snacks for Kids
· Cocoa coated protein balls with raspberry cream
· Dried fruit with apple and cinnamon
Bibliography
1- 1- Ayano G, Demelash S, Gizachew Y, Tsegay L, Alati R. The global prevalence of attention deficit hyperactivity disorder in children and adolescents: An umbrella review of meta-analyses. J Affect Disord. 2023 Oct 15;339:860-866. doi: 10.1016/j.jad.2023.07.071. Epub 2023 Jul 24. PMID: 37495084.
2- 2- National Institute for Health Care Excellence. Attention Deficit Hyperactivity Disorder: Diagnosis and Management NG87. Available online: https://www.nice.org.uk/guidance/ng87
3- 3- Pinto, S.; Correia-de-Sá, T.; Sampaio-Maia, B.; Vasconcelos, C.; Moreira, P.; Ferreira-Gomes, J. Eating Patterns and Dietary Interventions in ADHD: A Narrative Review. Nutrients 2022, 14, 4332. https://doi.org/10.3390/nu14204332
Author:
Rita Lima (CP3003N)